Botox Treatment for Chronic Migraine

Botox for migraine headaches

Botox has been used as a medical treatment for a multitude of conditions for decades. Since 2010, it has also been approved for the treatment of chronic migraines in adults. The active ingredient in Botox, botulinum toxin type A, is a neurotoxin that paralyzes muscles by blocking signals that travel between the nerves and the brain. For headaches, it is believed that Botox blocks the neurotransmitters that signal pain, leaving patients pain-free. If you have been diagnosed with migraine headaches and suffer from headaches on most days of the month, then Botox may be a suitable treatment. Having headaches on most days means experiencing symptoms of headaches 15 or more days of the month, with at least 8 of these days including migraines.

Types of BTX injections for migraine

The type of Botox injections required to treat migraines differs from the injection technique used in other Botox treatments. Though the ingredients used in both the Botox used to treat medical conditions and cosmetic imperfections are the same, the approach to injection differs. It is therefore very important that a specialist who is familiar with Botox treatment for migraines specifically is performing the injections. To lessen the pain of migraines or to prevent them all together, a patient is likely to receive between 30 to 40 shots total in 7 key areas spread over the head and neck. If there is a localized spot where the pain is occurring, the patient may receive more shots in that area, but there will usually be an equal number of shots on each side of the head.

Quick facts you should know about Botox treatment

Before receiving Botox injections for chronic migraines, there are some things you should know:

  • Prevents headache and migraine – In a study of adults who received Botox injection to treat chronic migraine headaches, treatment was able to decrease the total amount of days participants experienced migraines as well as other kinds of headaches. They also reported an increased amount of days free from pain. In some studies, up to 70% of participants reported that they had half as many headaches in a month as they did before treatment.
  • Small needle, less pain – Injections involve a small needle, so even patients who have an aversion to needles are able to tolerate it. Many patients report that injections simply feel like tiny pinpricks.
  • Injected by Botox specialist – Injections must be performed by a doctor who is experienced in using Botox specifically for migraine headaches.
  • 15-minute treatment – Injections are performed in a doctor’s office and 1 treatment session typically lasts only about 15 minutes.
  • It is given every 12 weeks – To determine whether Botox injections are effective for you, it will require 2 treatments administered 12 weeks apart. You may not experience the full benefits of the injections if you don’t receive injections every 12 weeks.

What to expect after treatment

Following treatment, you will be able to return to your daily activities. Applying an ice pack to the injection site to reduce pain and stiffness is recommended, and patients can continue taking their regular migraine medication after injections. It may take some time to start feeling results, though every patient reacts differently. Some patients may not experience the maximum results until up to 6 months after the first injections. It is important to keep track of your migraine frequency after receiving treatment, so you and your doctor can determine whether it is an effective treatment for you.

Side effects of Botox for migraine headaches

Like any other medical procedure, Botox injections for migraine headaches may cause temporary side effects. These include:

  • Muscle stiffness in the neck or upper back
  • Bruising, swelling, or pain at the injection site
  • Mild headaches or nausea
  • Dry eyes
  • Flu-like symptoms


Botox injection treatment can cost anywhere from $200 to a couple thousand dollars depending on your treatment requirements. However, on average, a vial of 100 units of Botox costs approximately $525, and a typical dose for migraine treatment involves 155 units. However, some insurance companies will cover Botox treatments, and patients who receive regular Botox injections can apply for a savings card that could save them over a thousand dollars a year.

Botulinum toxin injections for migraine sites

There are 31 injection sites that are proven to provide results for migraine sufferers. These sites are spread across the head and neck in 7 specific areas. Typical treatment includes 10 units of Botox divided between 2 sites in the corrugators area, 5 units in the procerus area, 20 units divided between 4 sites in the frontalis area, 40 units divided between 8 sites in the temporalis area, 30 units divided between 6 sites in the occipitalis area, 20 units divided between 4 sites in the cervical paraspinal muscle group, and 30 units divided between 6 sites in the trapezius area.

Is BTX right for you?

Though Botox injections work for many patients, they may not be right for everyone. Unfortunately, treatment is not right for patients who experience headaches on 14 or fewer days in a month, or if they experience any type of headache other than chronic migraines (e.g. tension headaches, episodic migraines, cluster headaches). It is also not suitable for patients who have a known allergy to botulinum toxin or similar ingredients, or for patients who have a skin infection in any of the injection areas. It is also unknown whether injections are safe for patients who are pregnant or breastfeeding, so treatment is not advised for these patients.

Conclusion: Is it safe and long-lasting?

Botox treatment for chronic migraines is not only proven to be safe, but also effective and long-lasting. Many patients have experience great results in receiving treatment, with patients on average experience 8 to 9 fewer days with headaches every month. Patients will experience even more benefits with continued treatment cycles.

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Disclaimer: These articles, and any views and opinions expressed, are not endorsed by Raskel Medical. The articles are strictly for informational purposes and should not be considered medical advice. Raskel Medical does not check or edit the content of these articles for medical accuracy. Contact your medical practitioner for any medical advice needed.