Botox: Migraine Treatment

Over recent years, Botox (Botulinum Toxin Type A) has become more widely used as a treatment of chronic migraine. For myself, it has been a Godsend but it doesn’t work for everyone. Here, I’d like to give you some of the facts about the treatment, as well as my experience.

I have tried numerous medications over a period of 16 years, prior to my first course of treatment. I was on the waiting list for Botox treatment for a year. The waiting list time will differ dependent on where in the country (or world) you live.

Before & during treatment, sufferers are required to keep a headache diary, recording the level of their pain each day using a score between 0 (no pain) to 10 (worst pain ever imaginable). This diary is continued during the course of the treatment to measure any changes that may take place to sufferers’ pain.

Before I had my first course of injections, my daily pain score was between 7-9. After my first course this had reduced by 19% & I was experiencing daily pain between 5-7! My quality of life was greatly improved just by this first treatment! I had been experiencing multiple shooting pains daily & their effect was felt hours after, these also reduced in frequency & intensity. My second course took my daily pain score down still further to between 3-4, with a few 2s & 5s thrown in. The shooting pain had turned into a cold sensation &, once again, its frequency had reduced. After a month or so I was no longer experiencing this symptom at all!

Botox treatment is Initially given as 2 courses, then review. To be eligible to continue under NICE guidelines, the sufferer needs to have experienced a 30% or more reduction in their migraine pain but still be classed as chronic. I have to admit that I was nervous about my third appointment – the decider as to whether I could continue with Botox treatment. I knew I would still be classed as chronic, as I have no let up in my migraine pain, just changes in intensity. I was concerned the scores from my headache diary wouldn’t reflect the improvement I had experienced & as a result I would not be able to have a further course of injections.

My concerns were unfounded & I received my third course of Botox on the 4th of August. Since then I have seen a further improvement with my pain down at the lowest it’s ever been since my migraines started! The majority of the time I am experiencing a pain score of 2. The worst pain I’ve experienced since my last set of injections has been a 5 (however, these higher pain days have all been caused by poor sleep due to shoulder pain). I’ve got to the point where I’m having to go include ½s in my scores because I’m having a days where the pain is worse than a 2, but not as bad as a 3! Prior to my Botox treatment, the pain was so bad that I was unable to differentiate to that extent.

A Little About Botox

Botox is a specially prepared protein created by a certain bacteria. It is this protein that makes up the ‘active ingredient’ in the Botox injections. These injections are used as a preventative treatment for chronic migraine. That is to say they are used reduce the pain & frequency of migraines rather than stop them once they’ve started. It is thought that this is done by blocking pain signals & (indirectly) blocking the development of migraine.

The Treatment Itself

Botox treatment takes place in a hospital or clinic & consists of approximately 31 injections into the muscles around the head, neck & shoulder area. If your migraines are more prevalent in one area of your head, injections may be concentrated slightly more around that area. The needles of the injections are small, both in length & circumference. The pain of these is felt mostly in the forehead area, but I would describe the sensation as more of a stinging than pain itself. The whole process takes approximately 15 minutes & you can usually leave 10 minutes later. Botox treatment takes place once every 12 weeks.

Side Effects

As with any medication & treatment, there are some potential side effects. The Common side effects (occurring in fewer than 1 in 10 people but more than 1 in 100) are worsening of headache (3%), rash, itching, pain where injection was given (3%), drooping of the eyelid (3%), muscle weakness (6%), neck pain (7%), muscle pain (2%), cramp & muscle stiffness (2%).

Botox treatment has made a huge improvement on my quality of life, though it is worth noting that as a result of my receiving this treatment I am unable to get life insurance as there is no research into it’s long term effects.

I really hope you’ve found this interesting & useful if you are considering Botox as a form of treatment (or even if you aren’t!).

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Information taken from ‘Botox Treatment For Chronic Migraine’ provided by the National Hospital For Neurology & Neurosurgery, UCLH Hospital.