Botox for Migraines: Will it help and what’s involved?

Dr. Risa Ravitz | April 15, 2019

There are 37 million migraine sufferers in the U.S., and it’s likely that many of them are unaware that Botox injections can help alleviate some of the symptoms of their condition. In fact, Botox’s effect on migraines was discovered purely by coincidence, when people noticed that their headaches were improving after getting injections for cosmetic purposes. Botox was licensed specifically for the treatment of chronic migraine (15 or more headaches per month) in the U.S. in 2010.

Many doctors, including myself, are enthusiastic and excited about the prospects of Botox for migraine treatment. Studies have shown shots of Botox reduce the number of days that chronic migraine patients suffer. Patients in a recent study had an average of 1.6 fewer migraine attacks per month three months after injection, and patients in another found that two botox treatments cut their number of headache days in half.

Furthermore, research has also found that by reducing the number, severity and frequency of the headaches, Botox also helps to reduce other debilitating symptoms of migraine. Sufferers subsequently take fewer days off work, experience a reduction in symptoms of depression and anxiety, and have improved symptoms of poor sleep quality and fatigue.

How does it work?

As neurologists, we don’t know exactly how Botox works as a treatment for migraines, but it is widely thought that when Botox is injected around the pain fibers that are involved in headaches, it enters the nerve endings around the point of injection and blocks the release of chemicals that are involved in pain transmission. In theory, the pain networks in the brain are then prevented from being activated.

Botox can prevent migraines and headaches before they start, but I think it’s important to note that the injections might not start working immediately. Although some patients can experience results as soon as two to three weeks after the first treatment, ideally it needs six to nine months for a fair trial. I recommend that migraine sufferers wanting to treat their condition with Botox should start with a series of several shots around the head and neck once every 12 weeks, and if the patient gets migraines in a particular spot, they may need more injections there.

Other things to note

I also can’t stress enough how crucial it is that migraine sufferers seeking this treatment get the right physician. Patients looking to try Botox as a treatment for migraines should seek out a headache specialist or neurologist.

Some patients may experience side effects of neck pain or headaches, and allergic reactions are also possible but rare. It’s also important to know that Botox is not a suitable treatment for episodic or tension-type headaches. Though overall, it can serve as a highly effective treatment for reducing the frequency of migraines, take a look at this story from one of my own patients as an example of what Botox can do.

Interested in finding out more about Botox for migraines? Book an appointment for an online consultation with me, Dr. Risa Ravitz MD, here.

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