What Is Treatment Like
When you receive your first Botox treatment, expect the appointment to take about 20 minutes. The doctor uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. Each treatment typically involves 31 injections in seven key areas of the head and neck.
The most common side effect from the Botox shots is a sore neck, and we recommend using an ice pack to reduce the discomfort.
It can take up to six months to see the maximum benefit from Botox. In the meantime, you can continue your regular medications with no risk of a drug interaction.
Reviewed for accuracy by the American Migraine Foundations subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. to read about our editorial board members.
Adding Botox To Your Treatment List
Botox has been used to treat medical conditions for many decades and its an evidence-based treatment option for people with chronic migraine. Side effects are rare and mild and many peoples biggest fear are the needles.
As well as the quantitative effects Botox can have, such as a decrease in the severity and frequency of migraine attacks, theres also the little day to day things we often forget were missing out on.
Botox may help you to claim back hours previously lost to migraine, including:
- more quality time with friends and family
- less time off work and school
- ability to function better during a migraine attack
- head space to take on extra responsibility at work
- ability to pursue a passion project.
Botox isnt a quick-fix solution for chronic migraine and if it works, you need to continue treatment every 12 weeks for ongoing benefits. Botox isnt a cure, and like other migraine treatments such as preventatives, abortives and lifestyle changes, Botox is another piece of your treatment plan.
If you qualify for Botox on the PBS and youre prepared to spend more of your migraine budget, Botox can be a great treatment option for chronic migraine that can help to give you back more migraine free days.
Am I A Good Candidate For Botox For Chronic Migraine
You may be a good candidate for Botox injections if you are an adult suffering from chronic migraine headaches. Botox is not FDA approved for people with migraine who have 14 or fewer headache days per month.
Because Botox can cause serious side effects, it is important to tell your doctor about any other medical conditions you have and any medications you take. You may be at higher risk for serious side effects, such as difficulty swallowing or breathing, if you have neuromuscular conditions such as amyotrophic lateral sclerosis , myasthenia gravis, or Lambert-Eaton syndrome.
You should not receive Botox injections if you have had an allergic reaction to any botulinum, including:
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Important Safety Information Contraindications
BOTOX® is contraindicated in the presence of infection at the proposed injection site and in patients who are hypersensitive to any botulinum toxin product or to any of the components in the formulation.
BOTOX® is contraindicated for intradetrusor injection in patients with a urinary tract infection, or in patients with urinary retention, or post-void residual urine volume > 200 mL who are not routinely performing clean intermittent self-catheterization .
Does Botox For Migraines Help Wrinkles
As Botox for migraines is the same Botox as for cosmetic use, Botox can reduce the appearance of fine lines and wrinkles at or near the injection sites for chronic migraine. Many of the muscle groups that lead to increased pain signals in the brain are also responsible for fine lines and dynamic wrinkles along the brow line and forehead, so injections in these areas will relax those muscle groups and lead to a more youthful appearance. In fact, the discovery of Botox for migraines was inspired in part by patients using Botox for cosmetic use who experienced relief from migraine symptoms and tension due to their Botox treatment.
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What You Need To Know About Migraine And Botox
Weve all heard of Botox, responsible for generations of smooth foreheads in Hollywood. But Botox has also brought relief to many people who suffer from chronic medical conditions. In 2010, Botox was approved for use with chronic migraine, and many patients are reporting success. What do you need to know before considering it?
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.
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How Botox Is Given
Botoxs form is a powder that comes in a single-use vial. The drug is mixed into a liquid solution. For preventing headaches in adults with chronic migraine, the medication is given as intramuscular injections. Youll receive these from a healthcare provider.
Because intramuscular injections are given directly into a muscle, you may be wondering where they are injected for migraine headaches. Here are the Botox injection sites:
- between your shoulder and neck on your right and left sides
- at the back of your neck, by the base of your skull on both your right and left sides
- the back of your head, behind each ear
- the middle of your forehead, above each eye
- the lower part of your forehead, right above your nose
- the lower part of your forehead, near the inside edge of each eyebrow
- behind each temple, above the ear
Who Is Not A Good Candidate For Botox Treatment
There are some people who should not get Botox for migraine attacks or for any other reason.
You arent a good candidate for Botox if any of the following apply to you:
- known sensitivity or allergy to botulinum toxin
- signs of infection at or near the injection site
- neurological conditions that make you more prone to muscle weakness, such as amyotrophic lateral sclerosis or myasthenia gravis
- youre pregnant or breastfeeding
Many Sufferers Regain Functionality Thanks To This Simple Procedure
The onset of migraine headache symptoms is enough to drive fear into the stoutest of hearts.
Severe head and neck pain which can pulsate and throb or simply pound away for hours on end often combine with nausea and vomiting, and light and sound sensitivity, to create a truly horrific experience for sufferers, forcing them to retreat from life for hours or days at a time.
Those who suffer from chronic migraine headaches defined as 15 days or more a month with some sort of headache symptoms, eight of which are associated with migraines may find themselves despairing as they resign themselves to a life of consistent pain and discomfort. And while oral medications may provide some relief, these remedies may carry their own side effects and concerns.
Longstreet Clinic physician Britta A. Okyere, M.D., wants you to know that even if you find yourself spiraling through this scenario, which happens to an estimated 2 percent of the population, there is reason for hope and it is called Botox.
Yes, Botox, the same treatment made famous for cosmetic care, is also a powerful tool in the fight against migraines. And it can offer sufferers a chance to regain some normalcy in their lives.
Ive seen Botox make a huge difference for patients, Dr. Okyere said. When I meet a patient in this situation, theyre often in crisis mode, and this can help them to reclaim functionality.
Benefits Of Botox Injections For Migraines
Actually, the FDA first approved the use of Botox for chronic migraine headaches in 2010. Since that time, there have been over 100,000 treatments performed by medical doctors, anesthesiologists, and pain management experts across the U.S.A. including Michigan Pain Consultants. Here are a few benefits in which chronic migraine sufferers find relief:
- Botox injections prevent pain before it begins.
- Patients are treated approximately every three months.
- There is minimal discomfort. The injections feel like tiny pinpricks.
- The procedures take about 15 minutes.
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How Much Does Botox For Migraines Cost
The cost of Botox treatments can vary somewhat, so its important to ask your healthcare provider upfront what you will be charged.
In general, each treatment session will use a total of about 155 units of Botox, and that can cost anywhere between $300 to $600, or even more. Because these treatments can be expensive, you should search for coupons or savings plans that are available to help lower the cost. For example, the manufacturer of Botox, Allergan, offers a savings card and a patient assistance program to help reduce costs or even make it free for patients.
Getting Medicare Cover For Botox To Treat Migraines
Insurance coverage is not always assured. However, there are certain steps you can take to ensure that the Botox treatment is covered, such as:
- Have your Medicare-approved doctor submits a request to Medicare detailing why Botox is medically necessary for your migraine treatment
- Send your migraine medical reports to Medicare, including proof of diagnosis, symptoms, and failure of other treatment methods
You should consult with your doctor regarding the documentation and information you will need to provide to Medicare. You will also need to call Medicare directly to ensure that your application is successfully submitted.
Make sure to inquire about all necessary documents you need to submit to Medicare and any other steps you may need to take.
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How Is Botox Given
The guidelines recommend Botox is given as a series of between 31 and 39 small injections. These are given under the skin or into the muscles in and around the head of the forehead, above the ears, and into the neck. The person doing your treatment will have been trained to provide Botox for chronic migraine.
Injections are given every 12 weeks. Botox is usually given until your migraine has changed to episodic migraine for three months in a row, or that there is significant improvement in disability using quality of life questionnaires. If Botox doesnt improve your migraine enough it may be stopped.
When Do Side Effects From Botox Typically Go Away
Most side effects from Botox usually go away after a few days or weeks as the effects of the injection wear off. But this may vary depending on the condition being treated, the specific side effect, and how your body reacts to the drug.
If you have side effects that are troublesome or that last longer than a few days or weeks, talk with your doctor.
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Do Botox Treatments For Migraines Have Side Effects
Immediately following your treatment, you can return to your usual activities without limitations.
You may have some discomfort at the injection sites, which should resolve without additional treatment. The team recommends using over-the-counter pain relievers and ice packs to alleviate your discomfort.
Botox also doesnt interfere with other medications youre taking for existing medical conditions. You can use it safely without concern for drug interactions.
Learn more about Botox injections as a preventive treatment for chronic migraine headaches by scheduling a consultation with The Center for Neurology and Neurophysiology online or by calling the office nearest you.
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How Do Botox Injections Work
Botulism occurs when someone eats something that contains the bacterium Clostridium botulinum. The neurotoxins produced by the botulinum can cause paralysis in various parts of the body. If the muscles in the chest become paralyzed, for example, breathing becomes difficult and, in extreme cases, this paralysis can lead to death.
When Botox is injected into a specific part of the body, the neurotoxins attach themselves to the nerve endings that surround the affected muscles. The toxins inhibit the release of acetylcholine — the neurotransmitter that triggers muscle contractions.
In doing so, the Botox injections help your muscles to relax by effectively blocking the signals your body sends to them that tells them to contract abnormally or to spasm.
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Ongoing Evidence To Support Botox
Further prospective and retrospective studies support the results of the PREEMPT study. The COMPEL study, which began in 2011, included 716 patients with an average of 22 headache days per month. The participants received 155 units of Botox at the 31 injection sites from the established migraine protocol every 12 weeks for 2 years. Just over half the participants completed the study and by weeks 60 and 108, there was a significant reduction in headache days reported.
In 2019, researchers reviewed the data from 211 patients who received Botox at 7 private neurology practices in Australia. The study found 74% of patients benefitted from Botox treatments, including reduced headache days and a decrease in the number of days they used acute pain medication.
How Long Does Botox Last For Migraines
As Botox is a temporary treatment, the pain-relief that comes with it is, unfortunately, impermanent. However, regular treatment every 12 weeks has been determined as an ideal treatment plan to not only lessen the amount of headache days a chronic migraine sufferer experiences, but also prevent future migraine attacks. Continual botox treatment of chronic migraines is defined as preventive treatment, allowing patients to continue to experience a pain-free, improved quality of life.
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How Long Does It Take For Botox Treatments To Be Effective
Botox is an effective chronic migraine prevention option, but it takes time to work properly. The team creates a customized treatment plan based on the frequency of your headaches and your overall medical history.
The benefits of Botox can be felt in as quickly as 4-10 days and builds up to efficacious levels after 6 weeks. However in some patients studies found it may take up to three treatments to reach efficacy. Therefore, if you failed Botox in the past, you may need more than one treatment to truly benefit from the therapy. The treatment can last as long as 12 weeks and is repeated every 12 weeks.
During your consultation, your provider can determine how many Botox treatments you need to reduce the frequency and severity of migraine headaches, so youll know what to expect.
Does Insurance Cover Botox For Migraines
As Botox for migraines is a medical treatment that is FDA approved for those 18 or older who experience more than 15 migraine days per month, some private insurance companies may cover the costs of treatment. Allergan also offers a Botox savings card for those who use Botox regularly for medical and preventive treatment for migraine pain.
Though a healthcare provider can recommend botox injections for adolescents or those who experience fewer headache days per month, this recommendation is considered off-label and therefore is unlikely to be covered by an insurance plan. Further, if you are considering Botox treatment for chronic headaches, many insurers will require you to try two alternate treatment options, such as antidepressants or anti-seizure medication, before turning to Botox for migraines. If you think you may be eligible for coverage when it comes to Botox treatment of chronic migraines, contact your insurance company to see what, if any, restrictions may be in place for care.
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How Do Doctors Use Botox For Migraines
In 2010, The FDA approved Botox as a therapy for chronic migraines.
Your doctor will administer Botox injections once every 12 weeks. Many find that Botox treatments greatly reduce their migraine symptoms. However, not everyone responds to Botox. If your migraine symptoms do not lessen after the first two injections, you wont continue with the treatment.
If Botox works for you, the more Botox treatments you receive, the better the results. This means that your fifth injection will provide better results than your first treatment.
It takes about a week for the Botox to work, and it last about 12 weeks.
The Verdict: Yes I Would Recommend It
So far, it’s been a lifesaver for me. Prior to Botox, I’d been experiencing around three or four migraines a week that would have me waving the white flag, and now I’m down to one on average . I also find that my medication works better when I feel one coming on.
That said, there are a few things I’d make sure everyone knows before trying it. For one thing, it can be pretty painful. I have a pretty high pain tolerance, but getting 30 to 40 shots every three months is pretty rough â it feels a bit like getting tattooed with a bee’s stinger, but once the needle is out of your skin, the pain goes away, and if it works for you, it’s worth it. It’s also important to know that it can take some time to work. The first treatment barely worked at all for me, and the second round took a few weeks. If you’re going to try it out, be patient.
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