Page Updated on Feb 5, 2020 by Dr. Reyfman (Pain Management Specialist) of Pain Physicians NY

Botulinum Toxin was initially used for the treatment of wrinkles, focal dystonias that affect the face and eyes, but in the last few years it has been used also for the treatment of chronic headaches. 

Onabotulinumtoxin A is an injectable drug used by our pain management center for the treatment of chronic headaches, approved by FDA.

Treating Chronic Headaches With BotoxHeadaches are known to be more frequent among women, then among men. Headaches vary from one person to another. They vary in severity and frequency, interfering with everyday life and affecting the quality of life. There are different medication treatments for headaches. However all of them have their side effects and contraindications. In many cases these treatment options are also very little effective or even ineffective.

Botox as a treatment option for chronic headaches

Botox as a treatment option for chronic headaches was discovered coincidentally. Many patients who received Botox injections for wrinkles on their face and forehead reported relief of their migraines. This led to a number of clinical trials using Botox as a treatment option for headaches, especially for chronic headaches. These studies showed that treatment with Botox relieved migraine headaches, muscle tension headaches or even chronic daily headache.

It is believed that Botox works by reducing the muscle contraction or by blocking a pain – transmitting chemical, or as a combination of both these actions.

Approximately 10 – 12 injections are given for this treatment, half of them in the forehead and the other half of them in the back of the neck. It usually takes up to two weeks for the Botox injection to have an effect, which than usually lasts 2 to 5 months.

As any other treatment options, even Botox injections have their side effects. Luckily the side effects and complications after receiving Botox injections for headache treatments are very rare. The most common reported side effects include: pain at the injection site, stiffness, headache, loss of strength, muscle weakness, drooping eyelids, vision changes, hoarseness, loss of bladder control, etc. In very rare cases this neurotoxin can also spread in other parts of the body.

If Botox injections are the right treatment option for your chronic headaches only your pain doctor and you can decide. You should consult with your doctor when considering Botox injections. However, keep in mind that this treatment option is not recommended for everyone. Botox injections are contraindicated in people with a known allergy or hypersensitivity reaction to human albumin and botulinum toxin, people who suffer from multiple sclerosis, myasthenia gravis, Eaton – Lambert Syndrome, etc. Botox injections should also be avoided during pregnancy and lactation.  Until now, the effect of Botox injections during pregnancy and lactation has not been studied, so it is wiser to avoid them until childbirth or until giving up with lactation.