Botox

When most people hear about botox, they assume it is only used for cosmetic purposes.  In fact this neurotoxin has been found to work for numerous medical purposes and new uses are constantly being found.  It’s uses include treatment of chronic migraine, trigger point pain, muscle spasticity, hyperhidrosis (increased sweating to both palms and under arms), overactive bladder and more.  While botox was the original brand on the market and thus has the most popular name, there are many other neurotoxins on the market that work very similarly.

I started using botox for migraine pain about 5 years ago.  For many years my migraines were very well controlled with one prophylactic treatment.  Unfortunately, after about 15 years of well controlled symptoms, my medication stopped working.  There were may factors involved including hormonal changes, musculoskeletal issues, diet and life style causes.  After suffering for many years, I began to use botox.  

Botox is a neurotoxin that blocks signals from your nerves to your muscles leaving them paralyzed.  It is secreted from the bacteria Clostridium botulinums.  This can be very dangerous if ingested in food because it can paralyze the muscles that you need to breathe.  Luckily, scientists found that if injected into your muscles, it paralyzes them but does not get absorbed into your systemic circulation.

While this paralytic affect was first made popular for aesthetic uses by paralyzing some of the muscles of your face and smoothing wrinkles, it is now used for a host of medical problems and is FDA approved for the treatment of chronic migraine. 

Chronic migraine is described as having more than 15 headaches per day.  Usually in order to qualify to have your insurance pay for botox, you must also prove that you have tried and failed several other oral preventative medications. 

Botox injected for migraine is injected in a different pattern and dose than traditional aesthetic practices.  This includes injections to your forehead area which will provide relaxation to wrinkles, and is also injected around your scalp and on the sides of your neck.  For people with any component of tension type headache that starts in the neck with tight muscles, botox injected into this area should provide significant relief.

Botox can also be injected into your masseter muscles in your jaw that cause pain from clenching and grinding and TMJ symptoms.  Having tight muscles in the jaw can also be a trigger for migraines.

Botox is very well tolerated by most people with very little side effects other than cosmetic appearance.  There is a small subset of patients who do get paradoxical tightening of muscles and increased muscle pain after botox injections.  And for some, it just doesn’t seem to help the migraine pain at all.  It is best to get 3 treatments, 12 weeks apart, before concluding that it doesn’t work for you as symptoms will often improve with each series of injections.

Unfortunately, botox is primarily injected in a “migraine protocol” by a neurologist and they do not take into account any cosmetic preferences.  This has frequently left me with a less than desirable cosmetic effect, but the pain relief I get from it is worth it to me.

Overall, I highly recommend botox as a preventive treatment for those with chronic migraine and who have failed other oral medications.  It has truly been a game changer for me.  Botox alone typically will control the symptoms of most chronic migraine sufferers, but some with severe symptoms may require additional oral prophylactic drugs as well.

If you haven’t tried botox and you suffer from chronic migraine, be sure to ask your medical professional to see if you qualify or for a referral to a neurologist who may be able to perform your botox.

And if you live in the Southern California area and think that botox might be a solution for you, or if you have been unsatisfied by your cosmetic appearance after the injection of botox for migraine, be sure to contact me at CamilleCowne@gmail.com.

Best wishes on your migraine journey,

Dr. Camille

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