Finding solutions for migraines can be a difficult process. Today, we’ll does if Botox for migraines is a sustainable treatment option.
While more commonly known as a cosmetic injectable, Botox was not originally discovered or developed to soften crows’ feet and complement face lifts. Botox is a neurotoxin first researched and developed for the treatment of strabismus, a misalignment of the eyes, and has since been used to treat different neuromuscular conditions, especially muscle spasms and migraine.
Botox is the shorthand for onabotulinumtoxinA, or Botulin A, a drug derived from the rod-shaped Clostridium botulinum bacteria, which causes the potentially fatal condition botulism.
There is functionally no difference between the drug Botox and the toxins that cause botulism, aside from dosage and administration. Only four types of botulinum toxin are currently used for medical purposes, including three types of Botulin A and one type of Botulin B. Under the supervision and guidance of a medical professional, properly diluted and administered Botox can treat:
- An overactive bladder
- Urinary incontinence caused by neurological issues
- Anal sphincter disorders
- Nerve-related esophageal achalasia (inability to keep food down)
- Chronic headaches and migraines
- Muscle spasms
- Spasms caused by cerebral palsy
- Involuntary neck and face movement
- Excessive sweating
- And more.
Does Botox for migraines actually work? When administered for chronic migraine, Botox has been shown to increase the number of headache-free days. Chronic migraine is defined as migraine developing at least 15 times per month, for episodes of over 4 hours at a time. Understanding how the drug can help alleviate migraine requires knowing how and why migraine can occur in patients.
What Causes Migraines?
Migraine is a term used to describe severe throbbing pain, usually on one side of the head. The general difference between a regular headache and a migraine is severity and unilaterality. Other differences include that migraine attacks are often recurring and can last hours at a time.
Migraine can occur with or without “aura”, or visual disturbances. These include strange colors, flashing lights, and blind spots. Other physical symptoms aside from pain may also be present during a nausea attack, including photosensitivity, nausea, tingling, numbness, or difficulty speaking.
Migraine attacks are generally split into multiple stages. There are four at most, but not everyone who experiences migraine experiences all four. These are the:
- Pre-migraine stage, or the prodrome stage
- Aura stage
- Attack itself
- Post-drome stage
Depending on how many stages a person goes through, their migraine attack may last anywhere from 4 to 72 hours in total.
The mechanism behind migraine attacks is not completely understood by medical science just yet. We do know that genetics are heavily involved, and that migraine attacks can be hereditary. Chemical imbalances in the brain may be key to the cause, especially involving serotonin and CGRP, and the communication between the brainstem and the trigeminal nerve in the head.
Notable risk factors for migraine aside from genes include age, sex, and hormonal changes. Migraine attacks are up to three times more likely to occur in women, and peak during the 30s. In women, they can often coincide with a specific point during the menstrual cycle, often just before or just after the onset of menstruation.
Aside from hormone changes during menstruation, other common migraine triggers include food, certain drinks, changes in sleep and schedule, changes in weather, and excessive stress.
How Does Botox for Migraines Work?
When a person is experiencing severe pain associated with migraine, a doctor may recommend different interventions based on family history and severity. Most of these are analgesic in some way, or relieve associated secondary symptoms such as severe nausea.
Aspirin and ibuprofen are some of the most commonly prescribed over-the-counter pain meds for migraines, and paracetamol can be effective for mild attacks. Overreliance on these medications can lead to stomach and liver problems, however, which is why a more long-term treatment plan is crucial.
Other medications for immediate pain relief include CGRP antagonists, vasoconstrictors like triptans and newer drugs, and even opioid medication.
However, preventative medicine is just as important to treating a migraine problem, especially in chronic cases. This is where Botox for migraines come into play.
Botox is injected into the muscles in the neck and head in multiple different places, typically once every 12 weeks. The mechanism by which it helps relieve pain involves blocking the release of acetylcholine, a neurotransmitter that helps contract muscles and relay pain signals.
Botox for migraines is an incredibly low maintenance treatment. 12 weeks is a very long time, and each session takes no more than 15 minutes. Depending on a patient’s history, their doctor will be able to continue to prescribe them different medication to mediate the symptoms of the attacks that still persist, while the injection serves to reduce the number of attacks as well as their overall severity.
However, as with many other drugs that require regular intake, there’s a time period before the drug reaches saturation and can begin working to its fullest extent. For Botox, this can take up to the second session. Most healthcare providers advise that patients should wait until after the second session to determine whether Botox for pain is working for them.
Can Botox Cure Migraine?
Botox is not recommended for the treatment of episodic migraine, and so far has shown to be effective in drastically reducing the frequency of chronic migraine attacks. Botox does not make migraine go away forever.
There is currently no cure available for chronic or episodic migraine. Certain lifestyle factors were found to potentially have an effect on migraine severity and recurrence, but these are not necessarily going to cure you either.
Finding the right medication for you, applying a long-term preventative plan, and implementing proven positive lifestyle changes such as hard physical exercise and no smoking can help lessen the severity of symptoms, and keep migraine attacks from disrupting your day to day life.
Side Effects of Botox for Migraines
Like any other drug, there are individual levels of sensitivity that can affect how well the drug works, as well as whether side effects become an issue. Side effects can include problems breathing or swallowing after injection, neck pain, botulism, tiredness, pain at the injection site, dry mouth, painful urination, and more.
Before you get Botox for migraines, be sure to discuss your medical history and family history thoroughly and weigh your options.
If you are suffering from chronic headaches or migraines, our team of professionals at Pain Management & Injury Relief can help. We will work with you to create an individualized pain management plan for your needs. Contact us today.