Botox, or onabotulinumtoxinA, is an emerging and at times controversial treatment for migraine. Many patients have found relief through Botox treatment, although others have found that it wasn’t very helpful for them. Par for the course when it comes to migraine treatment.
But just why does Botox help – at least some patients?
The most obvious answer seems to be the way it relaxes muscles. Certainly if tense muscles were triggering migraine attacks, or if they were a part of the chain-reaction or vicious-cycle of migraine, we would expect to see some relief if those muscles were relaxed.
And that still could be part of the answer.
But the pain of migraine (in fact, even the pain of tension-type headaches), does not come from muscle tension. Sure, it could be a part of the cycle, but is that really enough to explain the relief that many get from Botox?
Dr. Alexander Mauskop from the New York Headache Clinic writes about his observations:
I have seen some patients who would report that injecting muscles around the head eliminated pain in the injected areas, but that they still had pain on the top of the head. There are no muscles on the top of the head and we usually do not inject Botox there, but in those patients who do have residual pain on the top, injecting Botox stops the pain. Recent research has shown that Botox in fact also exerts a direct analgesic (pain-relieving) effect. This is supported by my and other doctors’ observation that Botox also helps other types of pain, such as that of shingles or trigeminal neuralgia.
He goes on to point out that we need some solid studies to confirm what many doctors and patients are seeing.
He finishes by saying that Botox seems to help by reducing the pain messages that are being sent to the brain. Without the flurry of pain messages to the brain, the migraine chain reaction can’t begin. In fact, some patients report that, after Botox treatment, they sometimes feel like a migraine is about to start, but it never does.
If you’ve had Botox treatment, how does this compare with your experience? Leave a comment!