The word “Botox” may forever be synonymous with wrinkles, but the toxin has had a long history of medicinal use before it got into the hands—and faces!—of the aging averse.
Made of a highly diluted preparation of botulinum toxin type A, Botox was first approved in the 1970s to treat eye muscle spasm disorders. Over time, some patients noticed an incidental improvement in headaches. Clinical trials followed in the 1990s, though disappointing results showed little to no difference over placebo in tension headaches and migraines that were experienced up to a few times a month.But in 2010, the Food and Drug Administration (FDA) approved Botox for use in chronic migraine sufferers after more trials showed that this subset of headache patients did, in fact, experience a significant decrease in frequency over those receiving placebo injections.
“Chronic migraine is defined as headache pain occurring on 15 or more days per month for more than three months, which has the features of migraine headache on at least eight days per month,” explains Brian Grosberg, M.D., director of Montefiore Headache Center and Associate Professor of Neurology at Albert Einstein College of Medicine.
To be eligible for Botox treatment, you must meet this definition of chronic migraine—and it’s estimated that about 3.2 million Americans do.Migraines are typically characterized by debilitating pain on one side of the head, nausea, sensitivity to light and sound. Those symptoms are what led me to personally seek out the help of Dr. Grosberg many years ago after more than a decade of unsuccessful migraine care elsewhere. He recommended Botox as one of my treatment options shortly after it was approved.
How Botox Treats Migraines
Contrary to popular belief, Botox doesn’t just merely relax muscles in the head. It functions on a deeper neurological level, though the mechanism behind its success isn’t fully understood.“Botulinum toxin is believed to work for prevention of chronic migraine by reducing pain-mediating messages sent to the brain from both muscles and peripheral sensory nerves,” says Grosberg, who has been administering and teaching other physicians how to use the toxin for more than 10 years. It’s thought that by blocking pain signals, migraines are reduced or even stopped cold.
The standard treatment is not for the needle-weary: 31 injections are administered every three months at fixed sites, including the forehead, sides and back of the head, neck and shoulders. While that might sound scary, the injections are quick pricks, and my sessions are usually over in about 10 minutes with no side effects. At least two separate injection visits are typically needed to see if a patient responds, since it’s not an uncommon experience for the Botox to not entirely “take” until the second treatment.
The goal of Botox for migraine is to cut down the number and severity of headaches, though individual results can vary greatly. “For some, Botulinum toxin significantly reduces the frequency and intensity of migraine attacks, whereas in others, it may provide some relief or none at all,” shares Grosberg.
For me, Botox is a blessing and has become an invaluable ally in my fight against headaches. Before treatment, a migraine used to escalate from an inkling to full-blown in a matter of about 20 minutes. I would have to lie down in a dark room to wait while my medicine struggled to work.
Now, I have plenty of time to feel the migraine coming on, which gives me the opportunity to treat it while it’s still a molehill. That means faster and full relief with medication, and I can continue on with my day without having symptoms overwhelm me. I’ve also experienced about a 50 percent reduction in the number of migraines I get since getting Botox treatments, which makes me a very happy woman.As with most medical procedures, you practically have to sign your life away beforehand. Side effects may be some soreness at the injection sites, or the pressure from the pricks can actually trigger a headache in some people. If you go to someone who isn’t properly trained, a drooping eyelid that eventually corrects as the Botox dissipates may be a risk. You can find a doctor who is qualified to inject Botox for migraine in your area by searching here.
For most migraine sufferers, including myself, Botox isn’t the only solution. It’s part of a comprehensive plan that can include lifestyle and diet changes, preventative medication and natural supplements, and avoidance of triggers such as certain foods, alcohol, stress, sleep deprivation, dehydration and going too long between meals. (Tip: You can discover your own triggers by keeping a headache diary.)
Anyone who’s tried Botox knows that it’s expensive. The good news is that most insurance companies cover the treatment for chronic sufferers. However, lower benefit plans may not, or may only cover a portion, so this is definitely something you want to discuss with your doctor’s staff before a sky-high bill triggers another headache.For migraineurs who feel like they’ve tried everything, I urge you to keep the faith and talk to your doctor about different treatment strategies. Botox may just turn out to be your next shining beacon of hope.