Thinking about getting Botox for migraines? Want to know what it’s really like? In this tell-all series, I share my personal experience and all the need-to-know details about this treatment.
My First Chronic Migraines
When I was first diagnosed with chronic migraine in 2018, daily headaches left me barely functional. The first medication I tried, Aimovig, a CGRP inhibitor, gave me my life back. I still had headaches. But the pain lessened and faded to the background.
The relief didn’t last.
Days vs. Waves of Pain
With my neurology providers, we talk about “headache days” in averages. But in my experience, my headaches came in waves, not single days. I might get severe pain more often for a few weeks, followed by weeks or months with less pain.
My nurse practitioner mentioned Botox as an option during several bad waves. But the waves didn’t last long enough for me to seriously consider it.
Deciding to Try Botox for Migraines
Until they did. Around last December, the bad waves got worse and lasted longer. They shifted from being the exception to being the rule. That’s when I decided to try Botox.
For more than a week, I counted down the days till my appointment with Jose Posas, MD, at UVA Health.
My Appointment Day Finally Comes!
I walked into my appointment in late August with a huge smile. I was so sick of dealing with my migraines. I was excited, not nervous.
When Posas came in the room, he had a friendly, calm presence. That helped me stay relaxed through the whole appointment. First, he explained the procedure and answered my questions.
How Does Botox for Migraines Work?
Botox for migraines works partly by blocking pain signals. It also keeps the muscles where it’s injected from contracting, so they’re less stiff and sensitive to pain.
You get 31 injections in the forehead, back of the head, top of the shoulders, and around the temples. This targets 7 muscle groups shown by research to be associated with migraines, Posas explains.
Will It Change How My Face Looks?
I’d seen this side effect mentioned in a few migraine groups on Reddit and Facebook. Someone complained it made their eyelid droop.
Posas confirms it’s a possibility. He says it could raise the ends of my eyebrows. I consider this for a second before asking, “Will it be even?” He smiles and answers, “Yes, I’ll make them even.”
How Long till I See Relief?
Not gonna lie; the answer bummed me out. Everyone is different, but it often takes until your second, third, or fourth round of injections to see a big difference. And injections are spaced 3 months apart. A small percentage of patients are early responders and get relief with the first round. “I’m keeping my fingers crossed for you,” Posas says.
31 Rapid-Fire Injections
I lay face-up on the exam table. “We’re starting with 3 in the forehead,” Posas says. He does these in rapid succession. There’s slight sting and he tells me to breath in fully for 6 seconds and out for 6 seconds. “Those are the worst, so I like to get them out of the way first,” he explains.
Need Help With Your Migraines?
The team at UVA Health helps me and many other patients manage this tricky and painful condition.
I admit, I was surprised when he did the first injection and immediately went in with the second and third — no pause. But honestly? I think it’s a brilliant strategy. There’s no time to get anxious; it’s over before you know it.
The 3 in the forehead were indeed the worst. But even those feel like just a tiny prick. The shots are shallow and done with a 30-gauge needle, which is pretty small. On top of migraine pain, these feel like pouring a drop of water into the ocean.
What stands out the most about my appointment is how incredibly fast it went. On my way to the parking garage, I noticed a very slight sting at some of the injection sites. And thought how I might notice it more if I didn’t already have pain there.
The Week After Botox for Migraines
It’s been a week since my appointment, and my eyebrows still look the same! I finally stopped checking after a few days.
My migraines are still in full force. But it does feel better knowing there’s a good chance the Botox will help in the future. Even if I have to wait a while. That makes it a bit easier to cope with the pain and other symptoms.
