Treating migraine with BOTOX® is different from treating wrinkles or having Botox for pain relieving purposes. The best person to administer Botox specifically for treating migraine is either a headache specialist or a neurologist who understands which muscle groups to target for migraine. The first person to speak to about this treatment is your doctor, as he or she will refer you to a qualified specialist.
How Botox Works for Migraine
Botox works to prevent migraines from occurring, unlike most treatments or medications that are designed to halt migraine in its tracks once it has started. Botox is estimated to prevent somewhere around eight or nine headache days each month which, for chronic migraine sufferers who experience 15 or more headaches a month means you could reduce your painful days by half.
Botox (proper name OnabotulinumtoxinA or just Botox-A) is a bacteria-produced neurotoxic protein. The Botox injections block some of the chemical signals in the body, specifically those responsible for muscle contraction. The neurotransmitter responsible for muscle contraction is acetylcholine. Botox blocks the release of acetylcholine and so prevents the muscles contracting. While we are not really certain exactly why Botox relieves migraine pain, it is thought that this relaxing of muscles helps to block pain signals that would otherwise reach the patient's brain.
Having Botox Treatment
Many people going for Botox treatment for their migraines for the first time worry about how much pain is involved. People who are afraid of needles are especially concerned.
Unfortunately, there is no other way to administer the Botox other than by injection, and there are 31 sites around the head and neck. This means you can expect to receive 31 different injections. The good news is, the needles are extremely fine and small, delivering minute doses of the Botox. It’s not like getting a regular shot or vaccination, where a fairly large amount of liquid is pushed through the needle.
Many people rely on Botox injections to help control their migraines, returning for repeat treatments every three months. According to most, the injections are not especially painful although, of course, you will be aware of them. If you imagine a little pricking or stinging sensation, or maybe a mild bee sting, this is probably the worst you will feel. If you are particularly nervous or apprehensive, most doctors don’t mind you taking a friend along for moral support.
What Might Happen At the Surgery or Clinic?
Botox injections for migraine can be done in the doctor’s office, and the whole process usually only takes around 15 minutes.
On your arrival you may see rows of injections already laid out, with syringes already filled. This is purely to save time, since the injections are small and over in just a few seconds. Having the next one ready makes getting through the treatment much quicker for everyone.
The doctor will inject the Botox into the various areas of the head and neck in turn. These include:
- The forehead
- Both temples
- The back of the head
- The upper shoulders
During treatment you will be asked to sit in a chair or lie on an examination table. The doctor will sterilize your face to avoid all chances of infection. Botox injections go into very shallow muscles, so the needle never travels far beneath the skin.
Are the Side Effects Of Botox for Migraine Painful?
The most common side effect following Botox treatment for migraine is neck pain, but research shows that even though this side-effect is the most frequently seen, only 9% of people experience neck discomfort.
Other side effects may include:
- Partial paralysis in the face
- Muscular weakness
- Musculoskeletal stiffness
- Muscle spasms
- Drooping eyelids
- Pain at the site of the injections
Any of these side effects affect only a very small percentage of people, with most experiencing no more than mild discomfort or occasionally some slight lumpiness beneath the skin. This goes away within a few hours, or at most a day or two.
Very occasionally, more severe side effects need immediate treatment. These include difficulties in breathing or swallowing, weakness in the muscles, or changes in vision. They are uncommon, but your doctor will advise so you are aware of what to look out for after treatment.
Some people report feeling a little woozy or shaky, but this is usually due to a spike of adrenaline caused by nerves rather than from the Botox. Following treatment, you will be well enough to return home or go back to work.