Chronic migraine is a progressive and highly disabling headache disorder characterised by headaches that occur on 15 or more days each month. It affects about 7 million Americans (approximately 2.4 percent of the general population.  New studies have found that Botox(Botulinum Toxin Type A) significantly reduces the number of days each month that patients with a chronic form of migraine experience migraine attacks. Migraine days may decline by almost a third (26.9 percent) among the patients treated with Botox injections, compared to increasing 6 percent in patients who received placebo injections as discovered by the American Headache Society.

How does BOTOX® Cosmetic Treat Headaches?

It is not clear exactly how BOTOX® treatments help headaches. When used for reducing wrinkles or treating certain medical conditions, BOTOX® Cosmetic works by blocking nerve impulses responsible for controlling muscles, thereby relaxing the treated area and preventing muscle contraction that can wrinkle the skin or induce spasm. However, with migraine headaches, there is often no muscle component. Scientists speculate that BOTOX® Cosmetic works by blocking a specific protein that carries the pain message to the brain.

Candidates for BOTOX® Head Pain Treatment

The ideal candidates for BOTOX ® treatment of head pain are realistic in their expectations. Though studies have shown that treatment with BOTOX® Cosmetic is successful at reducing or eliminating headache pain for many patients, results are not typical for all patients. Most individuals who opt for treatment of headaches with BOTOX® Cosmetic are often chronic sufferers whose lives have begun to be negatively impacted by the pain. Candidates should also be knowledgeable about the procedure, and in good physical and psychological health. BOTOX® treatment for head pain is not recommended for women who are pregnant or breastfeeding.

For some, severe headaches can be triggered by temporomandibular joint (TMJ) disorder. In these cases, BOTOX ® Cosmetic can alternatively be used to treat the associated jaw tension caused by the disorder. Read more about BOTOX ® Cosmetic and jaw tension.

Clinical Studies

Botox for MIGRAINES: Studies in the treatment of migraine have shown a decrease in the incidence and severity of headaches for a period of 3 to 4 months after injection of Botox®, along with a reduction in the use of pain killers (Barrientos 2002; Mauskop 2002). Some people respond well after only a single treatment session, while others improve after repeated injections (Binder 2000; Silberstein 2000; Mathew 2002). Some physicians believe that Botox® may even change or halt the course of headaches (Mathew 2002).

Botox for TENSION HEADACHES: The efficacy of Botox® in the treatment of chronic tension headaches is under debate. Some studies suggest positive benefits (Relja 1998; Schulte-Mattler 1999; Smuts 1999; Freund 2000).  A recent study analysed the results of 271 patients with chronic daily headaches, tension headaches, or migraines, and found that Botox® injections decreased the frequency of all headaches by more than a half(Blumenfeld 2003). Overall, 85.6% of study participants claimed their symptoms improved. Temporary eyelid or eyebrow drooping was each reported by three people; other side effects were minimal.

Preliminary studies have suggested that, in patients who do not find relief from traditional pain medication, Botox® injections are safe and provide local relief of low back pain without systemic side effects (unlike central nervous system side effects seen with other more traditional pain treatments). In a small randomised trial of 31 adults with low back pain lasting longer than 6 months, 73% of participants who received injections reported significant pain relief after 3 weeks (Foster 2001). More studies—especially larger, randomised trials—are necessary to further evaluate the use of Botox®. Although there was initially concern that large doses repeatedly injected into the spinal muscles could lead to muscle weakness, this occurrence has not been noted in any studies (Difazio 2002; Wheeler 1998).