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Is Botox Good For Migraines

Candidates For Botox Injections For Migraines

Botox for Migraine Headaches – Good Medicine with Dr. Will Gibbs

BOTOX injections have received United States Food and Drug Administration approval for treating migraines in adults at least 18 years old who have been diagnosed with chronic migraines. In clinical studies, BOTOX injections were shown to be a safe and effective treatment for those who have 15 or more days of headaches each month, and whose headaches last for at least 4 hours. BOTOX treatment reduced the number of days that study participants experienced headaches by as many as 9 days a month . Migraines that do develop are often less severe than those experienced prior to BOTOX treatment.

BOTOX injections may be a successful treatment for chronic migraine sufferers whose headaches have not responded well to, or who have experienced rebound headaches from, other migraine medications. Studies have not yet confirmed whether BOTOX Cosmetic is an effective form of treatment for episodic migraines, which occur 14 or fewer days per month.

What Type Of Headache Responds Best To Botox

Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month. The more frequent the headaches, the better the patient does with Botox, says Dr. Andrew Blumenfeld, Director, The Headache Center of Southern California. Botox is not recommended for patients who experience fewer than 15 headache days a month.

Am I Eligible For Botox

A full evaluation by a certified professional is necessary to know if Botox is a safe and potentially effective option for you or someone you care about.

You are most likely agood candidate for Botox for Chronic Migraine in Long Beach, CA if:

You are at least 18years of age.

You have a headachefor at least 15 days each month, and the headache lasts for four hours or moreeach day

For most insurance plansto cover Botox for Chronic Migraine, you need to fail to respond to two or moreother treatments. If this is your first treatment for chronic migraine, itslikely your insurance wont cover it.

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The Path To Migraine Use

Botox was first used in the 1970s by ophthalmologists to treat eye conditions such as blepharospasm , and squint. Since then, its been approved to treat other medical conditions including bladder dysfunction, muscle contractions and excessive armpit sweating.

In 1998, an American plastic surgeon reported some of his patients receiving cosmetic Botox experienced an improvement in their migraine headaches after treatment.

Encouraged by other anecdotal evidence, researchers began to formally study the efficacy, safety and tolerability of Botox for chronic migraine through clinical trials. The most notable trials were the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy clinical program, or PREEMPT study.

The PREEMPT study involved 2 double-blind, randomised, placebo-controlled clinical trials involving 1,384 people who fulfilled the trial criteria of chronic migraine. Half the participants received Botox injections and the other half received a placebo.

The results from the clinical trials were combined and the study concluded treating chronic migraine with Botox reduced the number of migraine days and reduced headache-related disability.

From PREEMPT, the Food and Drug Administration approved Botox for use in chronic migraine in 2010. In Australia, Botox was approved for use in chronic migraine in 2011.

Botox is the brand name of onabotulinumtoxinA approved for chronic migraine and is made by the pharmaceutical company Allergan.

How Much Does It Cost And Does Insurance Cover It

Does Botox® Treat Migraine Attacks?

It can also be expensive. Depending on your insurance, it can cost quite a lot of money â I’ve changed insurance providers since I first started, and my first provider was around $330 a month and charged me around $1,000 per Botox round . My new plan is much more expensive, around $600 a month, but the Botox copay is only $30 each time, so even if Botox is the only medical procedure I need to have done in the year, it made sense to switch.

The last thing I’ve found to be a little frustrating is that my body tends to metabolize the Botox a bit faster than I can get it. While Ravitz tells me I can’t get the treatment any more frequently than every three months, because that’s the rate at which the body can develop antibodies against it, I find my migraines amping up in frequency again about two to two and a half months after I get the shots. However, given the fact that with the Botox, my migraines have gone down from about four a week to one or two at most, it’s absolutely increased my quality of life, and I’m glad I gave it a shot…or 40.

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The Medical History Of Botox

Botox injections are commonly recognized as a solution for wrinkles and fine lines, so it might surprise some to find out that it has a long medical history. The main ingredient of Botox, botulinum toxin, was first used in the 70s to treat crossed eyes . This was before the product Botox even existed!

The injectable Botox was officially introduced to the market in 1989, which means we just passed the 30th anniversary of Botox. Since its inception, Botox has been used to address a variety of medical conditions like neck spasms, overactive bladders and, of course, chronic migraines.

What If Migraine Symptoms Return Before 12 Weeks

For some people, Botox does not last the full 12 weeks, which is the standard treatment timeline. In general, insurance companies do not approve Botox sooner than 12 weeks. You have two options. You can ask your doctor to write to the insurance company requesting approval that Botox be administered to you sooner. You can speak to your doctor about doing nerve blocks and trigger point injections a few weeks before the next Botox treatment to provide you the necessary relief. My doctor does nerve blocks/trigger point injections 2 weeks before Botox and 2 weeks after Botox for some patients while they wait for the treatment to kick in.

Nerve blocks are procedures during which a mixture of a local anesthetic and a steroid are injected in the area around the nerves. Although an occipital nerve block is one of the most common procedures, continue to experiment with your neurologist/headache specialist until you find the combination of nerves/trigger points which provide the most relief for you.

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Will Botox Work To Treat My Migraines

Individual results may vary, so theres no way to know for sure. But theres strong reason to believe that it might.

Multiple studies have shown that treating chronic migraines with Botox means fewer headache days each month when compared with placebo. It may take 10 to 14 days for the result of the Botox to start to take effect.

Some people dont respond to this type of treatment for migraine, and it typically takes two treatment cycles to figure out if youre one of them.

How Well Botox Works

Botox For Migraines

Two clinical studies have demonstrated the effectiveness of Botox injections for preventing headaches in adults with chronic migraine.

These studies looked at adults with chronic migraine. The participants received injections of Botox or a placebo . They received injections in two sets, which were given 3 months apart.

Researchers compared the number of headache days that people had at the start of the study with how many they had after 6 months of treatment. The results showed that people who received Botox averaged fewer headache days than people who received a placebo.

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Boxed Warning: Spread Of Toxin Effects

This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.

After Botox is injected, the drug may sometimes spread to other parts of the body. This can lead to a serious condition called botulism, which may cause symptoms such as:

  • muscle weakness
  • difficulty breathing
  • loss of bladder control

Its possible for botulism to occur hours, days, or weeks after receiving Botox. If you experience any of the symptoms above after having a Botox injection, you should talk with your doctor.

Rarely, the difficulty swallowing or breathing that botulism can cause can be life threatening. If you already have trouble swallowing or breathing, you may have an increased risk for these problems. Call your doctor immediately if you have trouble swallowing or breathing after receiving a Botox injection. If you think your symptoms are life threatening, call 911 or your local emergency number.

How Does Botox Work

Nerves communicate by releasing molecules to their targets: the muscles, the sweat glands but also the sensory organs of the skin. The molecules released bind to receptors and induce actions: muscle contraction, sweat production, sensory modulation. Botox prevents nerves from communicating with their targets. If the target is a muscle, it will stop contracting. If the target is a sweat gland, it will stop producing sweat!

In chronic migraine, we know now that sensory nerves become inflamed and hypersensitive . The inflammation is caused by different molecules that may be released by the sensory nerves. Botox blocks this, and that has a «calming» effect on the pain. There are studies done on animals showing that Botox modifies the electric activity of the pain network of the face and neck.

In summary, Botox works by an effect on sensory nerves that modulates pain.

An effect on muscle contraction may also play a role but is not thought to be the key mechanisms for migraine.

The story of Botox is interesting because it starts with an observation of effect on people which led to a scientific understanding on how it works.

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How Does Botox Work In Treating Migraine

Onabotulinumtoxin A, also known as Botox-A, was approved in 2010 by the FDA for the treatment of chronic migraine.

Botox is injected into specific areas of your head and neck involved in migraine pain. The effect lasts for about 3 months.

Botox injections were developed to block neurotransmitters that tell your muscles to contract. By blocking these signals between your body and your brain, Botox diminishes the appearance of wrinkles.

However, blocking neurotransmitters is also a way to prevent migraine attacks. Botox blocks the release of these chemicals from reaching your nerve endings and causing pain.

Migraine attacks are typically best treated right at the very beginning of an attack but it can really difficult to do that.

If you try to treat a migraine with oral medication, you can end up taking too much of it. This can result in medication overuse headache and sometimes even trigger more migraine attacks.

Botox can work as a preventive treatment that keeps your brain from receiving the initial migraine signals, without the risk of rebound headache that comes with many oral medications.

How Botox Treats Migraines

Botox and Migraines: What You Need to Know

Migraine remains undiagnosed and undertreated in at least 50% of patients, and less than 50% of migraine patients consult a physician, according to a study based on the records of a community pharmaceutical department.Pavone E et al

Much how Botox treats wrinkles, the mechanism of treating migraine is fairly simple, despite how complex the toxin works to block signals between nerve endings. The nervous system is a vast and complex connection of so many more complicated things, so to make it easy for you to understand as to how Botox really works for migraines, have a look at the chart below:

Very simply put, thats how Botox works for treating chronic migraine. Its fascinating indeed how a very small amount of an otherwise harmful toxin can bring about relief to a chronic problem!

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In A Survey 92% Of Current Botox Users Said They Wish Theyd Talked To Their Doctor And Started Botox Sooner*

I had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be. Jennifer

Remember, only a doctor can determine if BOTOX® is right for you, too. Not sure where to start? Download the Doctor Discussion Guide.

*2020 BOTOX® Chronic Migraine Patient Market Research BOTOX® Current Users .

AbbySo, the first time I was going to get my BOTOX® I was super nervous. I did not know what to expect.

AliciaI was afraid for a couple reasonsone, I was afraid it was going to hurt.

JenniferI had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be.

KatieThey were fine. It just was little injections.

AbbyThe shots were tiny.

So, they start in the back of your neck. And then theyll do the sides, and then they do the top and the front. And it only took about 15 minutes.

CourtneyOnce were done, I go on with my day.

AliciaThe benefit outweighs the pain for sure. I find if I breathe through it, its certainly easy enough. Its not nearly as bad as a migraine.

Please see Important Safety Information including Boxed Warning at the end of this video or on the website below.

Botox Injections For Migraines

Although known primarily as a treatment for facial frown lines and “crow’s feet,” BOTOX® Cosmetic, which is made from a type of bacteria known as Clostridium botulinum type A, also helps, according to the American Headache Society, to reduce the severity and frequency of migraine headaches. Migraines are often caused by reactions to certain triggers that stimulate the production of neurotransmitters in nerve cells, producing pain and other debilitating symptoms.

BOTOX injections are believed to work by either reducing muscle contractions or blocking pain-transmitting chemicals, or by a combination of the two. Patients typically receive BOTOX injections every 3 months benefits are usually seen by the second treatment. Eventually, some patients are able to extend the time between treatments by up to 6 months.

Read Also: What Type Of Headache Do I Have Quiz

Botox Treatment For Migraines: What You Need To Know

Around one in seven people across the world experience a migraine at some point in their life, according to The Migraine Trust. Approximately two percent of the global population deals with chronic migraines. If youre a part of that two percent and you deal with migraine headaches often, youre likely wondering what you can do to reduce their occurrence and prevent them.

In 2010, Botox was approved for the treatment of chronic migraines in adults. While youve likely heard of it being used as a cosmetic treatment for forehead lines and other facial lines and wrinkles, its also been proven effective for some individuals suffering from migraines. Heres a look at what you need to know if youre considering this treatment.

What is Botox and How Does It Work?

Botox is a type of neurotoxin, which is a poison thats made by Clostridium botulinum bacteria. If you ate it in spoiled food, it could cause a severe and deadly reaction known as botulism because it blocks the signals from nerves paralyzing muscles. However, its safe for injections because the toxin isnt digested, and you get a much smaller amount than what youd encounter in spoiled food.

Injections of Botox smooth wrinkles with its ability to relax the facial muscles. Botox is also found to help people with spasms and tics due to nerve diseases.

Botox Treatment for Migraines

Potential Benefits of Botox Treatment for Migraines

Potential Side Effects from Botox for Migraines

Who Should Consider Botox for Migraines?

Is The Effectiveness Of Botox Sustained Over Time

Experts Say Botox is Good For Migraines

Yes. For most people who respond to Botox, the benefit are sustained over time. Remember that migraine is a fluctuating disease and that even if Botox is effective for you, you may have better phases and more difficult ones.

If you want to read about Botox risks and side effectsgo HERE.

If you want to learn about Botox access and coverage in Canada go HERE.

If you want to prepare for a first injection and see how Botox is injected go HERE.


  • Frampton JE, Silberstein S. OnabotulinumtoxinA: A Review in the Prevention of Chronic Migraine. Drugs. 2018 78:589-600.
  • Ashkenazi A, Blumenfeld A. OnabotulinumtoxinA for the treatment of headache. Headache. 2013 53 Suppl 2:54-61.
  • Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010 50:921-36.


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What Does Treatment With Botox Involve

First, you need to be sure to choose a doctor who has training in administering therapeutic Botox.

Both Dr. Khayat and Dr. Becerra have completed intensive training at the American Academy of Facial Esthetics to provide Therapeutic Botox and Trigger Points Treatment.

Although the actual treatment takes only minutes, our Hingham dentists need to find out some information about you before they begin.

Step 1: Consultation A comprehensive muscular examination of the head and neck will be completed to identify any trigger points. Also, be ready to answer questions such as:

  • How often do your headaches occur?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Does anyone else in your family have migraines?

Step 2: Treatment Treatment will begin right away in the targeted muscles and trigger points. You should start to see results within two to ten days.Step 3: Follow-up Appointment Results are reassessed in about two weeks, and we can make adjustments if need be.Step 4: Three Months Later The effects of Botox will last for about three months. We will set up a regular schedule of appointments at three-month intervals to provide consistent pain management.

Who Would Be A Candidate For Botox And Who Wouldnt

Since its introduction Botox has become an accepted treatment for chronic migraine when other standard treatments have failed. Botox can help people feel and function better with fewer missed days of work, and the treatments are often covered by health insurance plans.

Botox is not typically used in people who have 14 or fewer migraine headaches per month. However, it is sometimes used off label for other forms of chronic headache, such as chronic tension headache.

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