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Can Botox Prevent Headaches?
By Dr. Larry A. Johnson, D.C., Thu Dec 8th
Most people are unaware that the use of Botox for the preventionof migraine headaches came about purely by accident. It allhappened through the use of Botox by plastic surgeons. Patientsundergoing plastic surgery, who were also experiencingheadaches, noticed that their injections of Botox helped withtheir migraine headaches. Botox, also known as botulinum toxin, is a neurotoxin (a toxinthat attacks nerve cells). It was originally approved by the FDAfor use in conditions where hyperactivity of muscles was anunderlying problem of related health and medical conditions. Thetheory is that Botox weakens or paralyzes muscles by inhibitingthe release of acetylcholine. Acetylcholine is an ester ofcholine that is thought to play an important role in thetransmission of nerve impulses at synapses and myoneural(muscle-nerve) junctions. By inhibiting the release ofacetylcholine the nerves cannot cause a muscle contraction, thusrelaxing the muscle. Botox is administered by being directlyinjected into the affected muscles. There are differing theories as to how Botox works to eliminatemigraine headaches, but the exact reasoning remains unclear. Onetheory is that muscle tension and spasms are a cause ofmigraines and by eliminating the muscle tension with aninjection of Botox it will also eliminate the cause of theheadaches. If given Botox before the headache begins it ispossible to eliminate the headache before it even starts.
When muscles spasm it can irritate nerves that innervate them.When these nerves send signals to the brain in an increasedamount it causes pain and possibly headaches. Botox may affectthese nerve cells, inhibiting their transmission, causing alessening of the perception of pain. Many researches think thatmigraine headaches are a result of inflammation of bloodvessels. However, muscle tension may also play an important rolein the cause of headaches. When researchers test a medication's effectiveness they usuallytest it through a double-blind study. This means that somepatients are given the medication being tested while others aregiven a placebo. A placebo is an inactive substance, such assugar, that is given in place of the medication that is beingevaluated. Some tests have been performed that did not involvedouble-blind studies, but showed that Botox could preventmigraine headaches. One double-blind study involving Botox andheadaches showed only a small positive effect.
Initial studies may not have shown the full effectiveness ofBotox for the prevention of headaches. The injections were notplaced in the typical locations of the headache pain, but inareas normally injected during plastic surgery. In subsequentstudies, using larger doses and injecting into more specificlocalities for the headache pain, the results were improved.These tests were concerning migraine headaches. However, withtension headaches, or muscle tension headaches, the studies haveshown improved results. This is to be expected due to theweakening or paralyzing nature of Botox on the muscles that areexperiencing tension. When being injected with Botox for the prevention of headachesit may take several weeks before the injection takes effect. Forthis reason it is usually necessary to have it injected no moreoften than once every 3 months or so. People that have Botoxadministered for the treatment of headaches typically need itinjected every few months. If there is too long of an intervalbetween injections the headaches may be experienced by thepatient. However, the question arises about the safety of these regularinjections of a neurotoxin. Since 1989, when it was first usedas a headache treatment, it has appeared to be fairly safe. Mostmigraine headache medications are taken orally and eventuallyend up in the blood stream. Because of this common symptoms ofmigraine headache medication will be dizziness and drowsinessamong other symptoms. Since Botox is injected directly into themuscle tissue and does not get absorbed into the blood system asdoes the typical headache medicine there are fewer side effects.Most commonly, the only side effects of injecting thisneurotoxin is pain in the area of injection for a couple of daysor drooping of the eyelids for a few days. Studies are still being performed on this medication and as yetthe FDA has not approved it for the treatment of headaches.However, physicians do prescribe it to their patients and if youthink you are a candidate to use it you should discuss it withyour doctor. If you do not respond to other headache medicationsit may be something to talk with your physician about. As thestudies continue the effects and safety issues involving thismedication should become more clear. About the author:Dr. Larry A. Johnson, D.C. has patented a popularchiropractor-recommended cushion for the home treatment ofheadaches, both tension and migraine. Visit his site about headaches - tension andmigraine for more information.
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