Migraine BOTOX® Injections

What is BOTOX® injection?

BOTOX® is the brand name of a toxin produced by the bacterium Clostridium botulinum. Scientists have discovered a way to use it to benefit people. Small, diluted amounts can be directly injected into specific muscles, causing controlled weakening of the muscles. Since the 1980’s, when the FDA approved the use of BOTOX® to treat ailments such as blepharospasm (uncontrolled blinking) and strabismus (lazy eye), BOTOX® has expanded its list of approved indications. BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected to prevent headaches in chronic migraine sufferers 18 and older who have 15 or more days each month headaches that last 4 or more hours each day.

How is BOTOX® injection done?

BOTOX® therapy is injected by a doctor every 12 weeks. For Chronic Migraine patients, the FDA has approved a specific dose and injection pattern for BOTOX® treatment—31 injections are given over 7 key areas of the head and neck once every 12 weeks to prevent headache days. Very fine needles are used for 31 total injections. The injections feel like tiny pinpricks—you may feel mild discomfort.

How effective is BOTOX® injection?

In clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks), BOTOX® prevented up to 9 headache days a month (vs up to 7 with placebo injection).

Committing to 2 treatment sessions is important in order to see how BOTOX® is working for you, since BOTOX® showed significant reduction in headache days at 24 weeks.

What are the risks?

The most common side effect in Chronic Migraine clinical studies was neck pain experienced by 9% of BOTOX® patients (vs 3% in placebo). Other side effects include headache, migraine, slight or partial facial paralysis, eyelid drooping, musculoskeletal stiffness, muscle weakness, pain in 1 or more muscles, ligaments, tendons, or bones, muscle spasms, injection-site pain, dry mouth allergic reactions, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes. This does not cover all the possible serious side effects of BOTOX®. Please see the Important Safety Information including Boxed Warning and Medication Guide and talk to your doctor.

What happens afterwards?

Not knowing when a headache or migraine will occur can be challenging. While other treatments may help you once you already have a headache, a preventive medication like BOTOX® therapy is approved to help prevent headache days. After 2 treatment sessions you may be able to start experiencing fewer headache days too! Based on your progress, you and your doctor will discuss re-treatment every 12 weeks. Remember: BOTOX® is a preventive treatment, which means it’s taken to prevent headaches and migraines from occurring. So, it is recommended that treatment be given once every 12 weeks.

Who should NOT receive BOTOX® injections?

Patients who are pregnant, breastfeeding, those who have a neurological disease, those who have a skin infection at the planned injection site, or those allergic to albumin or a constituent of the preservative should not use BOTOX®. Patients who are on blood thinning medications should consult with the pain physician before receiving the procedure. There may be special instructions or lab testing or the procedure might need to be rescheduled.

Will my insurance pay for a BOTOX® injection?

BOTOX® is not generally covered by insurance when used for cosmetic purposes. For FDA-approved indications like migraines, prior authorization from your insurance carrier is often required. Check with your insurance carrier for coverage details. Our staff is available and ready to assist you with the authorization process.

Is BOTOX® injection right for you?

If you are 18 years or older with chronic migraines, meaning you have 15 or more days per month with a headache that lasts 4 hours or more despite treatment with standard migraine medications, you may benefit from BOTOX®.

For more information talk with your doctor or refer to the BOTOX® Medication Guide.

At PrairieShore™ Pain Center, our goal is to relieve your pain and improve your quality of life. If your primary physician has advised you to see a specialist for your pain, turn to us for help. To schedule your appointment, please contact us here or give us a call at (847) 883-0077.

References:
American Society of Plastic Surgeons. Botulinum Toxin
MedlinePlus. Botox Allergan Botox for Chronic Migraine