In April 2012, the Journal of the American Medical Association published a review and meta-analysis to assess the association of botulinum toxin A with reducing headache frequency when used for preventive treatment of migraine, tension, or chronic daily headaches in adults. This review and meta-analysis examined 31 clinical trials of Botox for migraine relief.
When the researchers looked at the placebo-controlled trials, they found that Botox was associated with only two fewer headaches a month for people with chronic migraines and those with chronic daily headache (chronic meaning in this case, more than 15 headache days a month). For people who don’t fall into this category, the report states that “Botox is no help for people with episodic migraines (fewer than 15 a month) or chronic tension-type headaches.”
Botox is currently considered a preventative medication for migraines. The review and meta-analysis from 2012 found that Botox provided “a small to modest benefit for patients with chronic migraine headaches and chronic daily headaches.”
The review’s lead author, Dr. Jeffrey Jackson, said, “If I was having more than 15 migraines a month, I’d give Botox a try. It has few side effects. And, if it helps, you can go 90 days without as many headaches and without daily side effects.”
The good news about Botox side effects is that they aren’t very common and only occur in about 10% of the people who are treated. The most common side effect is neck pain but the other side effects include:
- slight or partial facial paralysis
- eyelid drooping, bronchitis
- musculoskeletal stiffness
- muscle weakness
- pain in one or more muscles, ligaments, tendons, or bones
- muscle spasms
- injection-site pain
- high blood pressure
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What does it cost?
Some insurers won’t pay for this procedure so this may be something that you’ll have to pay for out-of-pocket and it doesn’t come cheap so check with your insurer first. According to migraine.com, the cost of a 100 unit vial of Botox is approximately $525. A typical dose of Botox for migraine treatment is 155 units, but that can vary. Depending on what your doctor charges in addition to the Botox itself, you can end up spending $1500-$2500 total before you even know if it is working for you or not.
What is it like?
Here’s what one person said who thought it was worth it had to say:
“I was finally migraine free for the first time in 53 years of suffering. I did have one bad side effect from it early on. My neck became so weak from the botox that I could barely hold my head up. It was a severe side effect and very scary. Finally after 2 months of this the botox wore off and I was able to hold my head up properly. Now every 3 months I get botox treatments in the head neck and upper back I am finally enjoying life with very few headaches. The injections are stressful to go through but is definitely worth it.” [Read the full review here]
And here’s what one person who definitely didn’t think it was worth it had to say:
“Within 24 hours I had the worst headache of my life. I thought I was literally going to die. The headache decreased a small amount daily but in crept anxiety, depression, nightmares and a strange feeling of disassociation. I lost my job and my marriage suffered as well. Oh, and my migraines are meaner than ever” [Read the full review here]
Many of the stories I’ve read state that the person was not told of all of the potential side effects and the long term side effects so take the time to do your research before jumping into this. It is also important to understand your migraine triggers. Anecdotally, it seems that certain triggers fair better with this treatment than others, so be sure to discuss these with your doctor first.
How does Botox work for migraines?
The simple answer is that we don’t know fully at this point and it was only really discovered as a migraine treatment when people who were using Botox for wrinkles experienced changes in their headaches.
A study by Rami Burstein et al. using animal models suggested that “botulinum toxin inhibits pain in chronic migraine by reducing the expression of certain pain pathways involving nerve cells in the trigeminovascular system. The trigeminovascular system is a sensory pathway thought to play a key role in the headache phase of a migraine attack.”
What should you do?
Only you can decide if this is right for you but I would recommend first listening to the cry for help that your body is sending. Migraines aren’t just a nuisance to drive away, they are a signal that something is off and needs your attention. That may be a buildup of heavy metals in the body, a parasite, a hormone imbalance, a nutritional gap, but it certainly isn’t a botox deficiency.
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