Does It Hurt to Get Botox Injections for Migraines?
Key takeaways:
Botox injections are often used for cosmetic purposes. They can reduce wrinkles by temporarily paralyzing facial muscles.
Botox also has therapeutic uses. People use it to treat medical conditions including chronic migraines, muscle spasms, and excessive sweating.
When injected in small doses, Botox can block nerve signals in muscles. That causes the muscles to relax and temporarily prevents them from contracting.
Access savings on related medications
You’ve probably heard of Botox injections being used to reduce the appearance of wrinkles and fine lines.
But for years, Botox has also been approved to treat chronic migraines.
Migraines, a neurological condition, can cause intense, throbbing headaches, often accompanied by other symptoms, such as nausea and sensitivity to light and sound. For some people, migraines can be debilitating.
While some who suffer from chronic migraines rely on over-the-counter pain relievers to manage their symptoms, others take prescription migraine medications. And for some people, those medications include Botox injections. Botox is a neurotoxin that paralyzes muscles and has been proved to be effective in treating migraine-related pain.
Three people talked to GoodRx about what it feels like to get Botox injections for migraines and how long their relief lasts.
Minimal pain for moderate relief
Jimmy Pang, a 31-year-old physical therapist from Cupertino, California, started having migraines about 4 years ago.
“My eyelids started drooping,” he says. “I started getting pain in my face, which is definitely different than a normal headache. My ears were ringing. It was just this whole constellation of symptoms outside of a headache.”
While searching for relief, he remembers hearing about Botox being used to treat migraines. But it took him a while to pursue that option.
“I wasn’t all in, but [the chronic pain] was pretty bad,” Jimmy says. “At that point, I was willing to try anything.”
He says his main hesitation was the cost of Botox, which can be hundreds of dollars out of pocket if your insurance doesn’t cover it. He used a copay savings card to make the price tag more affordable.
His other reservation was the number of injections that it would take to complete the procedure. He received 31 injections.
Overall, he says the procedure was quick and easy.
“I don’t have too much of a problem with needles,” he says. “And as soon as I was in [the treatment office], it was done in like 3 minutes, so it really wasn’t that bad.”
It didn’t hurt much, either. “It feels like someone is just taking a pin and kind of poking you all over,” he says.
Jimmy received injections in his head, neck, and face. He had no negative side effects, but his relief was short-lived.
He’s open to trying Botox again, and he says he understands how frustrating it can be to find effective treatment.
“For people with migraines, don’t be too hard on yourself,” he says. “It’s something really tough to live with. We have to make a lot of compromises. It’s easy to feel like you’re falling behind. But you’re not.”
Aside from filling wrinkles, what is Botox used for? Therapeutic treatments include Botox injections to reduce migraines, muscle spasms, and excessive sweating.
How can you get Botox covered by insurance? The reason for treatment is a major factor.
Can Botox relieve my chronic migraine pain? It could. Botox has been shown to prevent migraines from starting.
Botox relief lasts longer than nerve blocks for her
Cheray Danna, a 34-year-old contractor special security officer in Maryland, has had migraines since she was in middle school.
“I tried a million different medicines,” she says. “I do not do well with medicine. I’m really sensitive with medications. And all the migraine medications made me feel super sick.”
When she heard about Botox as a potential treatment, like Jimmy, she was worried about the price. Before her insurance would cover it, she had to try a series of other treatments first. That included nerve blocks, which worked for her. But she says she prefers Botox because it works for longer.
“Every 4 months, I get the Botox,” Cheray says. “But the nerve blocks only lasted 3 weeks.”
The only downside to Botox, she says, is that it doesn’t work immediately. “It starts to kick in in like 3 days and then fully kicks in in about 3 weeks.”
For Cheray, going through the insurance approval process was fairly easy. Her neurologist does her Botox injections, and the practice has a Botox coordinator who works with insurance companies to get the treatment approved. “I didn’t really have to do anything other than just provide my information,” Cheray says.
“I get [Botox] above my forehead and my hairline. I get it right in the frowny part of my eyebrows, the base of my skull, my neck area, my temples, and in my traps [trapezius muscle],” she says.
The entire procedure takes only a few minutes. “They’re super fast, and it feels like just a little pinch,” she says.
For those who have never had Botox, the pinch isn’t the only thing to expect, Cheray says. She’s noticed that the sound can be weird, as well. When the needle goes in, it can sound like a crunch or a pop, she says.
Cheray has not noticed any side effects, except redness at first at the injection site.
She says she has to stay on schedule with her appointments. Otherwise, her migraines come back. And if she pauses treatment, it takes a few weeks to get back on a pain-free cycle.
Finding the right combination of treatments was the answer
Caryn McAllister — a physiotherapist in Connecticut and New York who has a doctorate in physical therapy — is a headache specialist. She also has personal experience dealing with headaches herself for most of her life.
Before she was diagnosed with chronic migraines, she had extreme tooth and jaw pain. That led to several dental procedures, including root canals, in an effort to relieve the pain.
After being treated by three different dentists and consulting with her neurologist husband, she was finally diagnosed with migraines, which she says were largely responsible for the widespread facial pain.
The first course of treatment for her migraines was migraine medications. For Caryn, that brought short-term relief.
“For me, every single migraine medicine works, until they don’t,” she says. She now supplements her migraine medication with regular Botox injections for prevention.
“If I don’t have a headache, then [getting Botox] doesn’t hurt that much,” she says. “If I’ve got a headache, it hurts. … Everything hurts more than it should. They’re really small needles, which makes it so it’s not as painful.”
The amount of pain you feel when you get a Botox injection also depends on the injection site, she says.
“The ones on the back of your head, to me, are not so painful,” she says. “The jaws are not so painful. But certain areas of your face can be a little more painful.”
Caryn used to have a fear of needles, but over time, she says, she has gotten used to them. Relief from Botox injections lasts her between 2.5 and 3 months.
For her, the most effective solution to migraines has been finding the right combination of treatments. In her case, that includes practicing stress management, staying hydrated, and paying attention to her diet and nutrition. She also avoids migraine triggers and gets enough rest.
Sometimes, she says, Botox is the thing that brings relief. Finding the right provider also makes a difference, she says. “Seeing a board-certified headache medicine physician and getting the right injector is really important.”
Frequently asked questions
For some people, Botox injections don’t hurt at all. Others describe injections as a pinprick, or a poking, pinching, or stinging sensation. Some people say certain injection sites on the body hurt more than others. Pain levels vary from person to person.
Those who have had Botox injections say the poking or pinching sensation of a shot is temporary. Side effects can include redness, swelling, and minor bruising. These usually go away in a few hours to a few days.
The bottom line
Botox for chronic migraines has been shown to be effective in reducing the frequency and severity of migraines for some people. Treatment involves multiple injections around the head and neck every few months. Common side effects, such as injection site redness and soreness, are usually mild.
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