Does Botox Really Help With Migraines?

If you are one of the 37 million people who suffer from migraines, you’ve probably heard about Botox as treatment option. In 2010 the FDA approved the use of this drug in treating chronic migraine headaches. Since then, many people have questions about Botox’s ability to reduce the frequency and severity of migraines. Since everyone’s body and circumstances is unique, there’s no one answer, and you should discuss this with your health care provider.

However, here’s some information to help you consider whether it might be an option for you.

How Botox Works

It was first used therapeutically (in small doses) to treat eye problems and later for cosmetic treatments. Finding that Botox helped migraine sufferers came as a surprise when people receiving cosmetic injections noticed an improvement in their migraines. Scientists still don’t know exactly why. But it’s thought that Botox relaxes a person’s muscles enough to limit the tiny muscle spasms that cause migraines and block the spread of pain.

The same Botox dose (155 units) used to reduce frown-lines is injected into seven locations around the neck, back of the head, temples and the forehead through 31 tiny injections. Treatment may sting or feel like burning, but many say the pain is less than migraines. Each treatment takes five to ten minutes and lasts about three months.

Determining If It’s Right for You

Botox is not a first-line treatment for chronic migraines. It doesn’t work for everyone. And like any injected medication, it can have side-effects, especially neck pain. Figuring out if it’s an option for you:

Botox might be worth considering if: You’ve tried everything for over a year and you still have 15 or more migraines a month with pain lasting more than eight hours. You already:

  • Use the recommended medications as prescribed and they just aren’t helping enough
    • These include but aren’t limited to: Nonsteroidal anti-inflammatory drugs, triptans or dihydroergotamine, anti-nausea drugs, and stronger medications
  • Work hard on lifestyle changes to control migraine triggers

Hold off on Botox if: Lifestyle changes go a long way to lessening the incidence and pain of migraines. If you haven’t yet done all you can do with lifestyle changes, try these first:

  • Keep a log to identify triggers
  • Tackle headache triggers mentioned in bullet two above
  • Try physical therapy, biofeedback, acupuncture, and other treatments for neck pain

Botox is not an option if: Some people have other conditions or circumstances that make Botox use a bad idea. If you have an infection at the injection site or if you are using Botox to treat bladder function problems, you’ll have to wait. Don’t use Botox if you are:

  • Sensitive or allergic to any of the ingredients in this medication
  • Planning to become pregnant or breastfeed
  • Diagnosed with myasthenia gravis, amyotrophic lateral sclerosis, or Eaton Lambert syndrome

Closing Thoughts

Migraines can be debilitating. Every safe treatment tool is worth investigating, and you’ll want to work with your doctor along the way.

Botox requires a commitment of up to a year of treatments every three months before you know if it works. Health insurers usually require trying at least two anti-migraine medications unsuccessfully before paying for Botox, so check your coverage. If cost is an issue, the manufacturer of Botox, Allergan, has some assistance programs.

Meet the Author

Jean E. Dill, NP is a Nurse Practitioner at Aurora Medical Group in Green Bay, Wisconsin.

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The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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