For anyone who’s experienced a migraine, the prospect of preventive treatment is sure to be appealing. Migraines are extremely painful headaches which can produce symptoms such as nausea, dizziness and sensitivity to light. A migraine can make daily tasks such as driving, going to work and doing household chores very difficult, if not impossible, to accomplish. As such, even the occasional migraine can be a miserable experience, and for those who suffer them regularly, both short- and long-term quality of life can be significantly decreased. Luckily, an excellent preventive treatment is available through a procedure some may find surprising — Botox injections. To learn more about this potentially life-changing treatment for chronic migraines, we spoke to Dr. Santiago Mazuera, head of Sinai Hospital’s Headache Clinic.
The first step in understanding Botox injections for migraine relief is learning who qualifies for the procedure. Dr. Mazuera explains that the process begins with a consultative appointment, during which he works with patients to determine if they are in fact experiencing chronic migraines. A diagnosis of chronic migraines, says Dr. Mazuera, is given to patients experiencing at least 15 headache days per month for more than three months. Once a patient has received a diagnosis of chronic migraines, Dr. Mazuera or fellow Headache Clinic provider Colleen Dearing, CRNP, help ensure that patients receive insurance coverage for the Botox treatment by taking account of the “more traditional” treatment options they’ve already tried, such as daily use of pain-relieving medications. Once these criteria are met, patients can receive treatment and start enjoying relief from their migraines.
The actual process of undergoing Botox injections for chronic migraines is simpler than it may seem, usually only requiring a quick, 15-minute visit to Sinai Hospital’s Headache Clinic. There, Dr. Mazuera performs local injections of botulinum toxin, commonly known as Botox. “It’s injected in the muscles around the forehead, on the sides of the head, on the back of the head, on the upper neck and the shoulders.”
Botox is widely known for its cosmetic applications because it “inhibits or stops the movement of the muscle,” Dr. Mazuera explains, “thereby making the skin smooth.” But when it comes to migraines, inhibited muscle movement is only one aspect of the treatment’s effectiveness. “It doesn’t only inhibit the substance that is going to cause the muscle to contract, but it’s also going to block the release of this protein called CGRP, that results in patients having migraine attacks,” says Dr. Mazuera.
The intervals between treatments are based on how long Botox remains in the patient’s system. “It’s about twelve weeks, the duration of the effect of Botox in the system, and that’s why we schedule the patients every three months to get their next round of injection.”
For many of Dr. Mazuera’s patients, the results of routine Botox injections for chronic migraines are nothing short of life-changing: “They’re able to go to work, they’re able to go on vacation, they’re able to take care of their families without always being afraid of having a migraine.” With no limit on the number of treatments one can receive and few negative side effects, many of Dr. Mazuera’s patients continue with the injections for years. The minor risks associated with the procedure include headaches, tiredness and muscle soreness in the injection areas, as well as heavy or droopy sensations in the brows. Dr. Mazuera notes, however, that these side effects are “very uncommon.”
In contrast to its risks, which are markedly few and minimal, the benefits of Botox injections for chronic migraines are plentiful. The procedure is not only accessible — covered by nearly every insurance provider when the proper criteria are met — but also has the proven potential to help patients reclaim their lives from migraines. Dr. Mazuera shares that he’s treated patients who can now return to work, who are no longer draining their medical leave and who can even enjoy a glass of wine at a wedding — just a few examples of the drastic life improvements that this treatment can manifest for patients.