Chronic Migraine Tx
Botox for Migraines: Could It Be Your Solution?
If you’re struggling with chronic migraines and haven’t found relief, Botox might be the answer you’ve been looking for. Approved by the FDA specifically for migraine treatment, Botox has helped many people reduce the frequency and severity of their headaches.
Quick Facts About Botox for Migraines
Who it’s for: People with 15 or more headache days per month (chronic migraines).
How it works: Small injections target specific areas to block pain signals.
What to expect: Treatments are quick, with results improving over 2–3 sessions.
Curious to learn more about how Botox works, what the process looks like, and whether it’s right for you? Watch our video to get all the details and hear from Dr. Hannah who can guide you through this innovative treatment option.
Chronic Migraine Botox
Initial Consultation:
Cost: Free
Time: 10 minutes
In person/ phone
Botox Treatment:
Cost: $250 physician injection fee
Patients will have received a prescription for Botox after their initial consultation appointment. For those with extended benefits, the pharmacy and patient will go through these benefits to minimize out of pocket costs for those eligible.
Time: 30 minutes
Botox works by temporarily relaxing muscles to reduce the appearance of wrinkles and fine lines. It is made from a purified form of botulinum toxin and is injected into specific muscles. Botox blocks the nerve signals that cause these muscles to contract, allowing the overlying skin to smooth out. While commonly used to address dynamic wrinkles, such as frown lines, crow’s feet, and forehead lines, Botox can also treat medical conditions like chronic migraines, excessive sweating (hyperhidrosis), and muscle spasms. The effects typically last 3 to 6 months, after which the treatment can be repeated if desired.
How does Botox work?
Has Botox been proven to be effective for the prevention of migraines?
Health Canada has approved the use of Botox for the treatment of chronic migraine in 2011. The clinical trials proved its efficacy and safety for the treatment of chronic migraine. Botox should be offered as a treatment to people who live with chronic migraine.
Should Botox be used for any person with migraine?
No. Botox is approved only for Chronic Migraine. Chronic migraine is the most severe form of migraine. 1 to 2% of the population suffers from chronic migraine. These people have more than 15 days of headaches a month for at least three months, 8 or more of which are migraines. The other days can be «tension type», as the severity of headache varies in Chronic Migraine (See this post).
Unfortunately, Botox does not work for people who have a less severe form of migraine called episodic migraine. Studies on people with episodic migraine were negative. You may want to see a headache specialist to discuss if Botox would be right for you.
What are the expected benefits of Botox therapy?
We look for an improvement of more than 50% in the frequency and intensity of migraines. If you have 20 days per month, your 50% response would be 10 days per month (not zero).
In studies nearly 50% of patients achieved this goal after 6 months of treatment (2 sets of injections).
Some people improve more than others (responders). 23% of patients in the studies improved by 75% (super responders). If you start at 20 days, you would go down to 5.
Is a decrease in frequency the only benefit observed with Botox?
Other benefits can be felt by the person who receives Botox. Here are examples:
The attacks are less severe
The attacks are easier to control with acute treatments
The «baseline headache» or «baseline neck pain» are less intense
The tolerance to triggers is higher
The person functions better overall
Some of those effects may be seen earlier with the first treatments, before the impact on the frequency appears. Always use a headache diary! (See this post)
How long should I try Botox before making a decision?
A trial of 3 cycles (or 9 months) is reasonable. The effect over the first treatments seems to be cumulative. 10% of people will notice an improvement only at the third treatment, especially if the situation was very severe to start with.
Could Botox work if I have medication overuse headache?
Studies show that Botox works for people with or without medication overuse. Of course, if there is a severe overuse, or if there is opioid use, it might be best to plan a withdrawal as a part of your treatment plan. People taking opioids were not included in the Botox studies.
Could Botox work if other preventives did not work for me?
Yes. Botox has a different mechanism of action than oral preventives. Studies have demonstrated a benefit in patients who had tried other preventives. In real life, Botox is covered only after previous trials, and improvements are observed.
Is the effectiveness of Botox sustained over time?
Yes. For most people who respond to Botox, the benefit are sustained over time. Remember that migraine is a fluctuating disease and that even if Botox is effective for you, you may have better phases and more difficult ones.
If you want to read about Botox risks and side effects go HERE.
If you want to learn about Botox access and coverage in Canada go HERE.
If you want to prepare for a first injection and see how Botox is injected go HERE.
Magnesium for Migraine Relief: Your Natural Ally
Struggling with migraines? Magnesium might be the natural solution you’ve been searching for! This essential mineral has been shown to help reduce the frequency and severity of migraines, making it a popular choice for those seeking relief.
But how does it work? Which type of magnesium is best? And how much should you take?
Watch the video to discover everything you need to know about magnesium for migraines—from the science behind it to practical tips for getting started.
Don’t miss out on this simple, natural way to take control of your migraines.
Frampton JE, Silberstein S. OnabotulinumtoxinA: A Review in the Prevention of Chronic Migraine. Drugs. 2018;78(5):589-600.
Ashkenazi A, Blumenfeld A. OnabotulinumtoxinA for the treatment of headache. Headache. 2013;53 Suppl 2:54-61.
Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010;50(6):921-36.