Botox Helps Migraine Sufferers Find Relief

April 12, 2023

Woman receives Botox injection in forehead

Botox is not just a cosmetic procedure used to smooth fine lines and wrinkles; it also has many other clinical uses, including as a treatment for migraines. Botox was FDA-approved as a migraine treatment over a decade ago, and since then has provided relief for thousands of migraine sufferers.

University Hospitals family medicine physician and certified headache specialist John Wolf, DO, FACOFP, says that just a small amount of Botox, injected into various areas of the head and neck every few months, can significantly decrease migraine frequency and severity, and can greatly improve a migraine sufferer’s quality of life.

How it Works

Botox (onabotulinumtoxin A) is a toxin that works by blocking the neurotransmitters that tell your muscles to contract. When used in small doses, it can paralyze the muscles that contribute to or worsen migraine headaches. Dr. Wolf says that Botox is suitable for anyone 18 years or older who has been diagnosed with migraine headaches and suffers 15 or more headache days per month.

“These migraines should be debilitating enough to interfere with work, school and social events. Patients should also have tried other migraine medications without sufficient improvement in symptoms,” says Dr. Wolf.

Botox for migraines is a simple outpatient procedure. With the patient seated in a chair, their provider will inject 5 units of Botox at various locations in the scalp – including the forehead, the sides and back of the head – as well as in the neck and the trapezius muscles (back of the neck and shoulders). The procedure can be modified based on the patient’s needs – adding more or less Botox to areas depending on where migraines usually occur.

A Significant Improvement in Migraine Symptoms

Botox treatments are typically given every 12 weeks. Patients will usually decide between the second and third sessions whether Botox is beneficial enough to continue treatments, but Dr. Wolf says the majority of patients will see at least a 50 percent decrease in both frequency and severity of migraine headaches while undergoing Botox treatments.

Dr. Wolf says patients using Botox can usually stop other preventive migraine medications, such as calcitonin gene-related peptide (CGRP) inhibitors, but will want to continue to have an abortive medication on hand in the event of a migraine attack. Abortive medications include over-the-counter and prescription non-steroidal anti-inflammatory drugs (NSAIDs), triptan medications such as Maxalt, Relpax or Imitrex, and some abortive CGRP inhibitors such as Ubrelvy and Nurtec.

Side Effects

Botox is well tolerated by most people but there are some possible side effects, including redness or soreness at the injection site, drooping eyelids and neck pain. These are all usually mild and temporary. Serious side effects such as muscle weakness, blurry vision or trouble swallowing are extremely rare, but you should discuss with your provider if you have concerns.

How Much Does Botox for Migraines Cost?

Because Botox for migraines is considered therapeutic and not cosmetic, it is covered by most insurances if you meet certain requirements. In addition, the company that makes Botox, Allergan, offers the BOTOX Savings Program, which can help cover the cost of co-pays and reduce out-of-pocket cost for Botox treatments.

Other Therapeutic Uses for Botox

There are numerous other clinical uses for Botox in addition to migraine. These include treating conditions such spasticity (increased muscle tone or stiffness), overactive bladder, hyperhidrosis (excessive sweating), strabismus (crossed eyes), and temporomandibular joint dysfunction, or TMJ (pain in the jaw joint and surrounding muscles).

Because TMJ affects some of the same muscles as migraines, patients being treated for migraines potentially find some relief from TMJ symptoms as well.

A Life-Changing Treatment

Patients interested in Botox for migraines should look for a certified headache specialist, says Dr. Wolf. These providers are experts in evaluating headaches and recommending personalized treatments, and are specially trained in administering Botox injections.

Dr. Wolf says that by time a migraine sufferer comes to see him, they’ve tried everything; they’re often in near constant pain, and their quality of life is poor.

“It’s really rewarding to see how effective treatment is for patients who have been suffering, usually for years,” he says. “If someone is suffering they should reach out to a doctor who treats migraines with Botox because it can be a life-changing event.”