Botox injections are a minimally invasive treatment option for patients suffering from migraine headaches. They can also be used for spasticity and cervical dystonia. Derived from the botulinum toxin, Botox is a purified protein that helps relax overactive and painful muscles. While this injection procedure is most known for its effect on wrinkles, it is also a highly effective pain therapy that can provide three to four months of headache and pain relief. During the procedure, a Modern Pain & Spine physician will ask the patient to contract his or her muscles to help identify the treatment sites. After determining the locations for the Botox injection, the physician will administer the treatment. These injections typically contain a mixture of botulinum toxin and saline solution.
What Type of Headache Responds Best to Botox?
Botox is only FDA-approved for chronic migraines, which means headaches on 15 or more days a month. Botox is not recommended for patients who experience fewer than 15 headache days a month.
What is Botox?
Botox is a form of botulinum toxin, a neurotoxin produced by the bacteria that causes botulism. When the Botox botulinum toxin is purified and used in tiny doses in specific areas, it temporarily reduces muscle contractions for approximately 3 months.
How Does Botox Work?
Botox is injected around pain fibers that are involved in headaches. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.
Botox prevents migraine headaches before they start but it takes time to work. Typically, maximum affects will be seen on the second and third treatments.
One treatment lasts for 12 weeks, and patients have reported that Botox treatments reduced the number of headache days by approximately 50%. In many cases, the number of headache days are decreased more than 80%.
Who Uses Botox?
The FDA approves the use of Botox to treat chronic migraine in adults who are age 18 or over. Botox is considered an “off-label” treatment if it’s used for children or adolescents. This means that a doctor can prescribe it, but insurance companies might not pay for it.
Getting Botox Treatment Paid for by Insurance
Because Botox is FDA approved for chronic migraine, it is covered by most plans, including Medicare and Medicaid. Allergan offers a “Botox Savings Card” which offers patients reduced fees.
Before your insurance company will approve Botox as a treatment for your chronic migraine, you typically must have tried and failed to respond to several other preventative treatments. These might include anti-seizure medications, antidepressants, or blood pressure medications that are typically used to prevent migraine. Such medications are amitriptyline, topiramate, gabapentin.
What is Treatment Like?
The doctor uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. The treatment typically involves injections in areas of the head and posterior neck.
