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When you think of Botox, you probably imagine cosmetic injections meant to smooth fine lines and wrinkles. While that is the primary use for Botox, it’s also become a popular treatment for chronic migraine.

If you have migraine attacks for 15 days or more every month, your doctor may have suggested Botox as a treatment. However, there are some side effects of Botox injections for migraine, including neck stiffness and muscle weakness. Other side effects are less common but can occur.

This article discusses possible side effects of Botox for treatment of chronic migraine.

Botox is well-tolerated by most people and is considered very safe if you go to an experienced practitioner. Still, there are some possible side effects that you should know about if you start using Botox to treat migraine.

Common side effects

Common side effects of Botox for migraine include:

  • redness, soreness, or swelling at the injection site
  • bruising
  • chills
  • fatigue
  • dry mouth
  • neck stiffness

A 2014 study showed that neck pain was the most common side effect, affecting 4.3 percent of study participants. Injection site pain, drooping eyelids, and muscular weakness was reported in 2.1 percent of people.

In general, these side effects are simply the effect of injecting a foreign substance into your body. They typically go away after a day or two.

Longer-term side effects

However, there’s also the possibility of longer-term side effects. These may include:

  • muscle weakness
  • eyebrows that appear to “droop” or look uneven

These side effects are from the Botox treatment itself and may take several weeks to subside.

Serious side effects

In the study noted above, serious side effects from Botox for migraine were uncommon, and were rarely severe enough for people to stop treatment.

However, there are cases when serious complications do occur from Botox. You should seek immediate medical help if you notice any of the following symptoms after your treatment:

  • blurry vision
  • swelling of your tongue or throat
  • difficulty speaking or swallowing

Onabotulinumtoxin A, also known as Botox-A, was approved in 2010 by the FDA for the treatment of chronic migraine.

Botox is injected into specific areas of your head and neck involved in migraine pain. The effect lasts for about 3 months.

Botox injections were developed to block neurotransmitters that tell your muscles to contract. By blocking these signals between your body and your brain, Botox diminishes the appearance of wrinkles.

However, blocking neurotransmitters is also a way to prevent migraine attacks. Botox blocks the release of these chemicals from reaching your nerve endings and causing pain.

Migraine attacks are typically best treated right at the very beginning of an attack — but it can really difficult to do that.

If you try to treat a migraine with oral medication, you can end up taking too much of it. This can result in medication overuse headache and sometimes even trigger more migraine attacks.

Botox can work as a preventive treatment that keeps your brain from receiving the initial migraine signals, without the risk of “rebound headache” that comes with many oral medications.

If you’re thinking about Botox treatment for your migraine attacks, here are some questions you might consider and talk with your doctor about:

  • Are your migraine attacks chronic? Chronic migraine is defined as taking place 15 days (or more), on average, out of every month. If your migraine attacks aren’t chronic, it’s unclear whether Botox would be helpful for you.
  • Are you okay with multiple treatments? Botox might not be effective to treat migraine after your first treatment, and even when it works, it isn’t permanent. You’ll need to plan to get regular Botox treatments every 3 months if Botox becomes your long-term treatment plan.
  • Will your insurance cover it? Your insurance may only cover Botox for migraine if you can document that you’ve already tried other treatments. Even then, you may have a hard time getting approval from some insurance providers. If you don’t have insurance, Botox can become costly, especially when you add up the cost of multiple treatments.

Who is not a good candidate for Botox treatment?

There are some people who should not get Botox for migraine attacks or for any other reason.

You aren’t a good candidate for Botox if any of the following apply to you:

How long does a Botox treatment take?

With an experienced provider, a Botox treatment will take about 20 minutes. Your first treatment might take a little longer to fill out paperwork and to speak with your provider about concerns and questions.

How many injections will I have to get?

More than you might think. If you’re getting Botox for migraine treatment, expect to get 30 or so injections, all in targeted areas in your forehead and neck. These areas are different than the targeted areas where you’d have Botox for a cosmetic treatment, like smoothing out your forehead.

How much does Botox hurt?

People with different pain tolerance (and different expectations) may answer this question differently. Botox needles hurt as much as any injection would, and the experience is over quickly. Be prepared for it to feel a little uncomfortable, and have an ice pack on hand to soothe inflammation or pain afterward.

How often will I have to get Botox for migraine?

Treatments are recommended once every 12 weeks. The effect of Botox may start to wear off before that, but getting the treatment more often than that is not recommended.

Will Botox work to treat my migraines?

Individual results may vary, so there’s no way to know for sure. But there’s strong reason to believe that it might.

Multiple studies have shown that treating chronic migraines with Botox means fewer headache days each month when compared with placebo. It may take 10 to 14 days for the result of the Botox to start to take effect.

Some people don’t respond to this type of treatment for migraine, and it typically takes two treatment cycles to figure out if you’re one of them.

Botox for migraine can cause some uncomfortable side effects, like muscle weakness and a stiff neck. Fortunately, most of these side effects are mild and temporary.

Severe side effects are extremely rare, but they can happen. Only you can decide if the risk of these side effects is worth it to treat your chronic migraine.

If you’re curious about this treatment, find an experienced provider to help you determine if it’s right for you.