Medical professionals have been effectively using BOTOX to treat migraine headaches since around the 1990s. To most people, this comes as a surprise, as BOTOX is more commonly known as a cosmetic treatment that reduces the appearance of lines and wrinkles.

The reason it also works for some migraine headaches is similar to the reasons it works to reduce signs of aging, and this result is now being extended to tension headache sufferers. 

What is BOTOX?

The word ‘BOTOX’ is a shortened form of the medical term botulinum toxin type A. When the substance is injected beneath the skin, it targets the release of acetylcholine from the nerve endings and reduces the release of certain pain neuropeptides. It also reduces pain sensations by interrupting the feedback loop caused by the pain. This is in addition to the commonly understood properties of causing the slight muscle paralysis that results in the cosmetic effect of wrinkle smoothing.

Does BOTOX Work for all Headaches?

There are some headache types that don’t respond well to BOTOX treatment. The most notable are those where the pain affects the regions between the eyes, behind the ears, on the top of the head or around the cheeks.

Tension headaches have been shown to respond to BOTOX treatment in some instances, but not all sufferers are so fortunate. The patients who get the best results have headaches that stem from chronic muscle tension or contraction. The reason for this is by partially paralyzing the contracting muscle, the relaxing effect helps prevent the headache occurring.

The types of headache that respond best to BOTOX treatment include:

• Those with vise-like, crushing or squeezing types of pain.

• Headaches caused by muscle spasms originating in the back of the neck.

The areas of the head where BOTOX has the most noticeable effect are typically experienced across the forehead extending to the temples, and down the back of the neck.

How is BOTOX Administered?

The only way to receive BOTOX treatment is via injections. This can cause some people who might benefit from it to shy away from the treatment. Because the needles and doses are very small, however, it’s not like receiving a normal shot. Most patients describe the sensation as briefly pricking or stinging, and uncomfortable rather than painful. Since the doses injected are very small, the procedure takes only a few minutes, with the majority of patients well enough to go home or back to work immediately afterwards.

Injections are normally administered in the forehead, the temples, between and/or above the eyebrows, and in the upper neck behind the head.

How Fast Does the Treatment Work?

The relief experienced by BOTOX is not immediate, and most people find they still need rescue medications or some form of additional meds that they normally take for headache reduction.

It generally takes a few days, around three or four in most cases, for the effect of BOTOX to take hold. It can be as long as a week to ten days before the full benefit is realized.

Treatments for tension headaches or migraine normally need to be repeated every three or four months. It's important to realize that the overall effect is likely to be a reduction in the frequency of headache or migraine episodes, rather than a complete cure.

Going from 15 or more headaches per month down to around seven or eight is common. Some people may find that Botox has no effect on their pain levels or frequency, but for most it means fewer days out of action with pain, and less reliance on other forms of medication. Particularly for tension headaches, BOTOX can be an effective preventive medication.

How to Get BOTOX Tension Headache Treatments

Not everyone qualifies for BOTOX treatment. The type of patients who are not suitable for this include:

• Patients with neuromuscular disorders
• Those with myopathic disorders
• Pregnant women

For everyone else, the criteria for being eligible for BOTOX treatment are the same:

• If you have tried alternative treatments and these have been ineffective, or have produced severe, unacceptable side effects.
• If BOTOX would prove more cost-effective than your normal medications.

• If your neurologist recommends it and will confirm that:
  • you have chronic headache pain, with your first headache occurring over six months ago,
  • you have 15 or more headache episodes per month, and
  • you have tried and failed to respond to all other headache medication types, including antidepressants, antiepileptics and antihypertensives.

If you have chronic, persistent tension headaches, your first step is to get your healthcare providers on board as your advocates. Speak with your doctors so together you can explore all the avenues of treatment up to, and including, BOTOX.