Non-Surgical Solutions for Treating Pain
Dr. Philip Lim's Medical Musculoskeletal Clinic

Migraine Botox Treatment

Neurologists have been using botulinum toxin for over 15 years for treating disorders of overactive muscles. It has proven to be a safe and effective treatment for a variety of conditions including spasms of the facial muscles and contraction of the neck muscles. In the last few years, cosmetic surgeons have been using botulinum toxin to treat frown lines. Patients with this treatment reported that their headaches improved. This had lead to the use of botulinum toxin for the treatment of headache.

Botulinum toxin works by blocking the nerve signal to muscles. The reason for the effect is not clear, but several lines of evidence suggest that the botulinum toxin blocks pain nerves.

Who should have botulinum toxin for headaches?
This is a new treatment for headache, and the best use for botulinum toxin has not yet been established. Current practice in North America is to try botulinum toxin when standard headache treatment has failed. Thus, the person with headache should have already addressed lifestyle factors such as stress, sleep and exercise; already tried medications for attacks such as anti-inflammatory drugs, and preventative drugs such as amitriptyline, nadolol or Epilim.

How well does it work?
It is clear that botulinum toxin is not effective for all people with headache, but the case histories suggest that some experience substantial improvement in their headaches. A series of case histories published in the literature suggest an excellent response to botulinum toxin.

How will the botulinum toxin be given?
It is given via injections across the forehead and sides of the head. Approximately 8 injections are given per side.

How quickly will it work?
Typically over 2-10 days.

How long will it last?
The studies indicate and effect on headaches lasting 2-4 months. At the end of this time, some people report a re-emergence of migraines.