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Botox for migraines treatment

Botox (onabotulinumtoxinA) is a prescription medicine that has a variety of uses. One of its most well-known uses is treating fine lines and wrinkles, but it’s also approved by the FDA to treat chronic migraine headaches.

Botox was originally used to treat strabismus in the late 1980s, and then later approved to treat blepharospasm, cervical dystonia, and focal spasticity. In 2010, the FDA approved Botox for the prevention of chronic migraines. Chronic migraines are defined as having 15 or more headache days per month that have lasted four hours or more on average. The headache days must also include a migraine on at least eight of those days.

This distinction between chronic migraines and episodic migraines is important because this is what led to Botox being FDA-approved for the treatment of chronic migraines.

You may find it hard to access the right information on the internet, so we are here to help you in the following article, providing the best and updated information on Botox for migraines treatment, botox injection sites for migraines diagram. Read on to learn more. We at collegelearners have all the information that you need about botox for migraines covered by insurance. Read on to learn more.

Botox for migraines treatment

Wrinkle-reducing treatments that use botulinum toxin injectables may also be used to treat chronic migraines. These treatments, known as neuromodulating drugs (such as Botox, Dysport, Xeomin and Mybloc), were approved by the U.S. Food and Drug Administration in 2010 for migraine treatment.

Plastic and reconstructive surgeon Sashank Reddy, M.D., Ph.D., explains how these drugs are a powerful treatment option for patients with chronic migraines.


  • The injectables used to treat migraines are the same kind used by aesthetic surgeons and dermatologists to minimize facial wrinkles.
  • Licensed medical professionals treat migraines by injecting botulinum toxin into multiple areas around the head and neck.
  • The treatments are approved for select people age 18 and older who experience 15 or more migraine days per month.
  • It may take four weeks or more after treatment before you see a reduction in the frequency of your migraines, and more than one set of injections may be needed.

How do botulinum toxin injectables help treat migraines?

Researchers are eager to learn how botulinum toxin-based drugs help relieve migraine pain.  Evidence suggests that the drug interrupts the pathway of pain transmission between the brain (central nervous system) and nerves that extend from the spinal cord.

When you have a migraine, your body releases substances called neurotransmitters and molecules that are associated with pain. Botulinum toxin interferes with the transmission of these substances, typically where the nerves and muscles meet. Researchers think that when the drug is injected into the muscles around the face, head and neck, it is taken up by the nerves and interferes with pain-associated neurotransmission.

Why might I need botulinum toxin injections for migraine treatment?

Botulinum toxin treatments have been proved effective in clinical trials, and are one way to treat chronic migraines. Other medications, and lifestyle changes, might be recommended. If your doctor determines that you have chronic migraines, you might be a candidate for this treatment.

Sashank Reddy says, “Botulinum toxin injectables are part of a comprehensive suite of options that neurologists and headache specialists have for treatment of chronic migraines. While no single option is best for all cases, an approach that includes several different treatments can often reduce headache frequency and severity.”

Migraine Treatment with Injectables — What to Expect

Using a very small needle, a specialist injects botulinum toxin into the tiny muscles under your skin throughout various areas around your face, head and neck.

You might get injections in your forehead, temples, and the back of your head and neck. Sometimes the specialist will inject areas called “trigger points” where the headache pain originates.

“These treatments for chronic migraines should be individualized, respecting the unique anatomy and origin points of pain in each patient,” Reddy says.

It can take several weeks and multiple treatments before you start experiencing relief from your migraines. Some patients find they can discontinue injections without frequent migraines returning. Others need regular treatments to keep migraines under control.

“Injectables can be effective in reducing the frequency of headaches in patients with chronic migraine and can also reduce debilitating symptoms associated with these migraines,” says Reddy.

What are the risks of using injectables for migraines?

Botulinum toxin injectables should be avoided by pregnant women and nursing mothers, as well as people with an allergy to proteins in cow’s milk.

When given by an experienced and qualified health care specialist, botulinum toxin injections are relatively safe. However, some people experience pain, bruising or swelling where the drug was injected. Other possible side effects are:

  • Headache or flulike symptoms
  • Dry or watering eye
  • Drooping on one eyelid, eyebrow or side of the mouth
  • Drooling

Very rarely, if the toxin accidentally spreads into your body, other, more serious symptoms might occur over the course of hours or days. Call your doctor right away if you notice:

  • Vision problems
  • Muscle weakness
  • Trouble speaking or swallowing
  • Inability to control the bladder
  • Difficulty breathing

botox for migraines covered by insurance

If you’ve ever had a migraine, you know that it’s more than just a headache. The throbbing head pain can be associated with nausea, vomiting, and sensitivity to light. For many people, migraine symptoms are so severe that they can interfere with normal life.

Fortunately there are different treatments for migraines, and one that you may have heard about is Botox. Here we’ll talk about how Botox works for migraines and if it’s a good treatment option for you.

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How do Botox injections help treat migraines?

Botox contains a toxin known as onabotulinumtoxinA that is naturally produced by the bacteria called Clostridium botulinum, which is found in soil. It’s a neurotoxin, which means it blocks the nerve activity in muscles and temporarily paralyzes them. If the toxin is consumed in contaminated food, it can cause paralysis and death. Although onabotulinumtoxinA is probably the most well-known toxin from this bacteria, there are several others that are commercially available (such as abobotulinumtoxinA in Dysport).

When used correctly and in small amounts, Botox can be used very safely to treat many different conditions. Most people know that it’s used to treat and prevent wrinkles, but Botox is also used to treat:

  • Chronic migraines
  • Overactive sweating (hyperhidrosis)
  • Crossed eyes (strabismus)
  • Prolonged eye twitching (blepharospasm)
  • Stiffness and/or spasms (spasticity) in the arms or legs
  • Abnormal neck contraction (cervical dystonia)

While we don’t know exactly how Botox works to prevent migraines, it may help block some of the pain signals in the nerves that cause migraines.

When should I consider Botox for my migraines?

About 1% to 2% of people have chronic migraines, which means they get migraine-like headaches 15 or more days every month for at least 3 months. Medications for chronic migraines include treatments to help symptoms once a migraine has started and treatments to help prevent migraines from happening.

Common treatments for acute migraines (ones that have already started) include:

  • Sumatriptan 
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen
  • Analgesics (pain medications like opioids)

Preventative treatments are used to help lower the number and severity of migraine attacks. Examples include:

  • Valproate and topiramate (medications often used to treat seizures)
  • Metoprolol and timolol (medications often used to treat high blood pressure)
  • Frovatriptan

Botox is an FDA-approved treatment to help prevent migraines and to lower the number and severity of migraine attacks. Some studies have shown that it works better than some of the other preventative treatments commonly used.

For people who have tried other migraine treatments without success, or who have had side effects from those treatments, Botox may be a good option.  

What are Botox treatments like?

Unlike other migraine treatments, Botox is given as a series of small injections directly into the muscle.

In a single treatment session, between 31 and 39 shots are given throughout seven different parts of the forehead, head (side and back), and neck (upper and lower). Each treatment cycle can last about 10 to 20 minutes. It’s important that the correct sites are treated, or else the treatment may not be as effective.  

It’s recommended that a treatment cycle be given every 3 months in order to help control migraine attacks. How long you continue getting them will depend on how you respond to treatment. While many people improve with just one treatment cycle, some may require more. Most people seem to need fewer than three treatment cycles, but each person is different. Your doctor will work with you to see how long you should continue getting treatments and may recommend that you keep taking other medications until you see an improvement.

What are common side effects of Botox?

There are very few side effects associated with Botox treatments. The needle used is very small — while some people may feel a small pinch with the injection, many don’t feel anything.

Other side effects can include some neck pain and muscle weakness where the medication was injected. Using ice packs can help reduce this pain if it happens. Rarely, people can experience eyelid drooping or muscle weakness in areas further away from the injection site.

Studies have shown that up to five treatment cycles of Botox is safe and effective for chronic migraines.

How much does Botox for migraines cost?

The cost of Botox treatments can vary somewhat, so it’s important to ask your healthcare provider upfront what you will be charged.

In general, each treatment session will use a total of about 155 units of Botox, and that can cost anywhere between $300 to $600, or even more. Because these treatments can be expensive, you should search for coupons or savings plans that are available to help lower the cost. For example, the manufacturer of Botox, Allergan, offers a savings card and a patient assistance program to help reduce costs or even make it free for patients. 

Will my insurance cover Botox injections for migraines?

Since Botox is an approved treatment for chronic migraines, many insurance companies will cover some — or all — of the costs. This includes both Medicare and Medicaid plans. It’s important to keep in mind that insurance companies will usually only cover Botox treatments if you have tried — and failed — two other treatments for your migraines. To verify this, they may ask that you work with your healthcare provider to submit a prior authorization form. 

Like with any prescription medication, it’s important to work with your healthcare provider and insurance company to see what cost is covered and what you will be expected to pay out of pocket.

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