The Risk Of Side Effects Is Low
“Botox injections can occasionally trigger a headache, muscle weakness and neck pain, but this is rare,” Kerry Knievel, DO, director of the Jan & Tom Lewis Migraine Treatment Program at Barrow Neurological Institute in Phoenix, Arizona, tells Health. “Eyelid and eyebrow asymmetry and droop can happen, but to prevent this we recommend that patients refrain from rubbing their foreheads or wearing a hat for 24 hours after their injections to prevent the Botox from spreading from the area we intend for it to be.”
In fact, Botox’s limited side effects are part of its appeal. “It’s not addicting. You don’t have to take a pill every day. It doesn’t work for everyone, but it does work for a significant amount of people. That’s why Botox is amazing,” says Dr. Bashir.
Common Side Effects Of Botox
Botox can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Botox in clinical trials. These side effects can vary depending on which condition the drug is being used to treat.
More common side effects in people taking Botox for overactive bladder include:
More common side effects in people taking Botox for strabismus include:
More common side effects in people taking Botox for urinary incontinence caused by a neurological disorder include:
More common side effects in people taking Botox for blepharospasm associated with dystonia include:
- drooping eyelids
- eye inflammation
More common side effects in adults taking Botox for spasticity of the bladder include:
- pain in the extremities, such as hands or feet
More common side effects in children taking Botox for spasticity of the bladder include:
- upper respiratory tract infection
More common side effects in people taking Botox for chronic migraine include:
For more information about the conditions that Botox can be used to treat, see this article.
Boxed Warning: Spread Of Toxin Effects
This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.
After Botox is injected, the drug may sometimes spread to other parts of the body. This can lead to a serious condition called botulism, which may cause symptoms such as:
- muscle weakness
- difficulty breathing
- loss of bladder control
Its possible for botulism to occur hours, days, or weeks after receiving Botox. If you experience any of the symptoms above after having a Botox injection, you should talk with your doctor.
Rarely, the difficulty swallowing or breathing that botulism can cause can be life threatening. If you already have trouble swallowing or breathing, you may have an increased risk for these problems. Call your doctor immediately if you have trouble swallowing or breathing after receiving a Botox injection. If you think your symptoms are life threatening, call 911 or your local emergency number.
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What Are We Seeing In This Image
The possible impact of botulinum toxin injections at the location and relation between the suboccipital muscles to the C1 vertebra the Atlas, and the C2 vertebra the Axis and the path of the occipital nerve is illustrated. Upper cervical spine instability at C1-C2 can cause pressure on the base of the spine resulting in the contraction and spasm of the suboccipital muscle. This can cause headaches, migraines, and occipital neuralgia.
Who Is It For
Botox is licensed and approved in the UK for people with chronic migraine . Your neurologist or headache specialist will offer this treatment if you have already tried three migraine preventive treatments without them helping to improve your migraine. They will also want to check that you are not using painkillers and triptans too frequently.
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Is Therapeutic Botox Treatment Painful
Not really. A tiny needle is used for Botox injections. You may feel a momentary pinch or burning sensation that will quickly disappear.
A series of injections are usually given during each treatment, and it typically takes 10-15 minutes to complete.
Most patients can return immediately to their regular routine.
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A common Bad Botox result is the Spock Brow, where the tail of the brow is unnaturally high and spiked and the medial brow is unnaturally low.. “Baby Botox can be focused into the usual areas where you would have traditional Botox, the frown lines, forehead, and crow’s feet, … The sideeffectsof both types of Botox are pretty similar. While already a generally safe experience, Baby Botox has even fewer sideeffects than regular treatments. These can include bruising around the.
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The risk of developing lung disease in patients with reduced lung function is increased in patients receiving BOTOX. Bronchitis and upper respiratory tract infections have been reported. Bronchitis was reported more frequently in adults receiving BOTOX for upper limb spasticity. Upper respiratory infections were also reported. Side-effectsofBotox Cosmetic are generally mild and short-lived. These can include pinpoint bleeding, bruising, and tenderness along the treatment area. Swelling is also common. In just a few days, most of these issues will have resolved. Some patients may experience nausea, headaches, or flu-like symptoms following their Botox injections.
Getting Botox Treatment Paid For By Insurance
In general, the FDA-recommended dosage of 155 units costs between $300 to $600 for each treatment. Because Botox is FDA approved for chronic migraine, its covered by most plans, including Medicare and Medicaid. Allergan offers a Botox Savings Card, which offers patients reduced fees.
Please note that before your insurance company will approve Botox as a treatment for your chronic migraine, you typically must have tried and failed to respond to two other preventative treatments. These might include anti-seizure medications, antidepressants, or blood pressure medications that are typically used to prevent migraine.
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How Botox Is Given
Botoxs form is a powder that comes in a single-use vial. The drug is mixed into a liquid solution. For preventing headaches in adults with chronic migraine, the medication is given as intramuscular injections. Youll receive these from a healthcare professional.
Because intramuscular injections are given directly into a muscle, you may be wondering where they are injected for migraine headaches. Here are the Botox injection sites:
- between your shoulder and neck on your right and left sides
- at the back of your neck, by the base of your skull on both your right and left sides
- the back of your head, behind each ear
- the middle of your forehead, above each eye
- the lower part of your forehead, right above your nose
- the lower part of your forehead, near the inside edge of each eyebrow
- behind each temple, above the ear
The Clinical Benefit Is Comparable To Cgrp
Botox is considered a preventive, not abortive, medication for debilitating migraine attacks. Even for those with chronic migraine, though, the effect may only be “small to modest” when compared with placebo, says Jeffrey Jackson, MD, author of a 2012 study.
JAMA. Press Release: Botox Injections Associated With Only Modest Benefit for Chronic Daily Headaches and Chronic Migraine Headaches. 24 April 2012)
Bruloy E, Sinna R, Grolleau J, Bout-Roumazeilles A, Berard E, Chaput B. Botulinum toxin versus placebo: a meta-analysis of prophylactic treatment for migraine. Plast Reconstr Surg. 2019 143:239-250. doi: 10.1097/PRS.0000000000005111.
American Headache Society. The American Headache Society Position Statement On Integrating New Migraine Treatments Into Clinical Practice. Headache: The Journal of Head and Face Pain, 59: 1-18. doi:10.1111/head.13456
“In terms of efficacy, my clinical experience with Botox and CGRP monoclonal antibodies has been roughly the same,” said Cowan. “Once the monoclonal antibodies have been around longer, we will know more, but it is too early to tell.”
If Botox and CGRP monoclonal antibodies are such good preventive treatments on their own, do they work better together? After all, experts often recommend layering treatments as part of a multimodal treatment plan for people whose CM has been resistant to improvement with single preventive treatments.
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How Often Should You Get Botox To Prevent Migraine
The frequency of your Botox treatments may depend on how often you experience migraine attacks. For first time patients, a doctor may start you on 2 treatments which are 12 weeks apart. In each session, a total of 31 units will be injected in 7 treatment areas in the head and the neck.
The results of the treatment are not immediate and it may take at least 4 weeks to start experiencing its effects. For preventive treatment of chronic migraine, your doctor may recommend getting Botox injections for 4 times a year. The treatment may be taken with a migraine medication to get better results for long-term pain-relief.
The Side Effects Of Botox For Migraines
OnabotulinumtoxinA, which is commonly referred to as BOTOX® , is no longer used solely by aging film and television celebrities who wish to sport a more youthful appearance. BOTOX® is becoming more accepted as a treatment for migraine headaches. In many cases the success rate is impressive, with the majority of sufferers finding their headaches reduced in severity and/or frequency. In some cases, migraines have become a thing of the past.
Although there are associated side effects, most migraine patients enjoy the therapeutic effects of BOTOX® without having to worry about side effects. Since BOTOX® is made from a substance that is potentially toxic, it is important for migraine sufferers to be mindful of these potential side effects.
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Reduce Any Side Effects On The Day Of Your Botox Treatment
- Bring your preferred type of over-the-counter NSAIDs with you on the day of your BOTOX® treatment. These will help to reduce your bodys production of prostaglandin, which is the hormone that causes pain and inflammation.
- Carry a frozen ice pack with you in a small cooler, to prevent it from thawing. Wrap it in a cloth or towel to avoid direct contact with the skin, and use it immediately after receiving your injections to prevent bruises from developing. This will not only reduce pain and inflammation, but it also constricts the blood vessels to lower your risk of bleeding.
- Avoid taking part in non-essential physical activities for the 24 hours immediately following the treatment, because moving around more than necessary can make the toxin spread to other areas of your body, causing adverse side effects. Take it easy, get plenty of rest, and restrict your activity to a minimum.
How Much Does Botox Hurt
People with different pain tolerance -” rel=”nofollow”> 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.
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You Can Technically Get Botox For Migraine And For Cosmetic Reasons At The Same Timebut You May Not Want To
This is where it gets a little murky, and opinions vary depending on who you ask. The manufacturer of Botox recommends not exceeding 400 units in a three-month span. Since your neurologist will administer 155 units, technically you have wiggle room if you want to visit an esthetician for Botox, too. However, this can be problematic.
“There is a theoretical risk of developing antibodies to Botox if it’s given more frequently,” explains Dr. Donnelly. If you’d like to do both, it’s best to check with your provider before booking an appointment with your esthetician.
Overall, if you’re finding yourself planning your life around your migraines, you may want to make it a point to chat with your doctor about using this multitasking drug to reduce the frequency of the attacks. I know doing so has drastically changed my lifeand it might help you, too.
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Is Botox Right For Treating My Migraine Attacks
If youre 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 , on average, out of every month. If your migraine attacks arent chronic, its 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 isnt permanent. Youll 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 youve already tried other treatments. Even then, you may have a hard time getting approval from some insurance providers. If you dont have insurance, Botox can become costly, especially when you add up the cost of multiple treatments.
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What Can You Expect During A Botox Migraine Treatment
Treatment is pretty quick and takes about 15 minutes, Dr. Natbony explains. Your doctor uses a very small needle to inject Botox into 31 injection sites over your forehead, temples and the back of your head, neck and shoulders. Injections feel like little pinpricks, and there may be a brief burning sensation at the injection sites. Overall, the process is not especially painful. Most patients are able to return to their routine daily activities immediately.
The Most Common Side Effects Of Botox Treatment
The immediate side effects of BOTOX® treatment include a small, pea-sized bump at the site of each injection. This is caused by bruising to the blood vessels or an allergic reaction to the saline used in the injections. The bumps usually disappear after a few hours, as the fluid from the injection is absorbed into the system, but in some instances, they can last several days or weeks. If you scratch these, there is a possibility they can become infected and turn into small lesions. This may not be important if it occurs in a place like the back of your head, but it can be an inconvenience if it occurs on the forehead.
Some patients find BOTOX® treatment triggers a migraine attack, which means having to deal with headache pain right after the procedure.
Other side effects that take longer to develop include:
- A feeling of weakness in the muscles where the injections were administered
- Bruising, swelling or bleeding of the injection sites
- Feelings of drowsiness or dizziness
- Symptoms that resemble a cold or flu, such as a sore throat and runny nose
- Mouth and nose dryness
- Eyes that feel dry and scratchy, or have an unusual discharge
Most of these symptoms will dissipate over a couple of days, but if you start to develop any more serious side effects, you should seek medical attention immediately. These include:
If you develop any of these signs, it could be an indication of botulism poisoning, which is very rare but can be fatal if it is not treated.
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Have There Been Deaths Side Effects Or Serious Consequences Of Using Botox For Migraines
NO. No deaths have been reported when Botox is injected for migraine. Side effects are very rarely severe. The most serious side effect reported so far was a hospitalization for a severe migraine.
Remember that Botox can be injected in different places with different side effects. For example, injections in the neck muscle for dystonia may lead to difficulty swallowing, but the migraine injection zones should not produce this side effect.
Tips To Prevent The Side Effects Of Botox For Migraines
Having BOTOX® treatments is becoming widely accepted for migraine sufferers, and for many people, it has made a world of difference to the frequency and severity of their migraine attacks. Few patients experience side effects, but for those who do, its possible to prevent some of the side effects if you take the right steps. Each BOTOX® treatment consists of an average of 32 injections, although some patients require fewer than this, while others need more. Depending on your symptoms, the injections are administered into your forehead, temples, the back and sides of your neck, the upper shoulders, or the back of your head.
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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 cows 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
- Drooping on one eyelid, eyebrow or side of the mouth
Very rarely, if the toxin accidentally spreads into your body, other, more serious symptoms might occur over the course of hours or days. :
- Vision problems
- Inability to control the bladder
- Difficulty breathing
Botulinum Toxin A Does Not Afford Any Additional Benefit Over Acute Medical Withdrawal Alone In Study Patients With Migraine Headaches
A May 2019 randomized controlled trial outcome studying the impact of acute withdrawal, medication overuse, and botulinum toxin A in chronic migraine was published in the medical journal Brain by researchers at the Department of Neurology, Leiden University Medical Centre in the Netherlands. Here are the summary points.
Botulinum toxin A is widely used as a treatment of chronic migraine. Efficacy in studies, however, was only modest and likely influenced by unblinding due to Botulinum toxin A-induced removal of forehead wrinkles. Moreover, most study participants were overusing acute headache medications and might have benefitted from withdrawal.
What the researchers are saying is that studies may not be accurate because the Botulinum toxin A was given into the forehead and the blinded researchers started to recognize that some of the studys patients had fewer forehead wrinkles and thus assumed it was those patients who were getting the botox injections and this could have skewed results. Another problem identified was that many of the headache patients in this study were overusing medications.
The goal then of this study was to see if in a double-blind, placebo-controlled, randomized clinical trial whether add-on therapy with Botulinum toxin A enhances the effectiveness of acute withdrawal of medications in patients suffering from headaches.
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