Headaches and Botox Injections
ByDr. Larry A. Johnson, D.C.
Most people are unaware that the use of Botox
for the prevention of migraine headaches came
about purely by accident. It all happened
through the use of Botox by plastic surgeons.
Patients undergoing plastic surgery, who were
also experiencing headaches, noticed that
their injections of Botox helped with their
migraine headaches.
Botox, also known as botulinum toxin,
is a neurotoxin (a toxin that attacks
nerve cells). It was originally approved
by the FDA for use in conditions where
hyperactivity of muscles was an underlying
problem of related health and medical
conditions. The theory is that Botox weakens
or paralyzes muscles by inhibiting the
release of acetylcholine. Acetylcholine
is an ester of choline that is thought
to play an important role in the transmission
of nerve impulses at synapses and myoneural
(muscle-nerve) junctions. By inhibiting
the release of acetylcholine the nerves
cannot cause a muscle contraction, thus
relaxing the muscle. Botox is administered
by being directly injected into the affected
muscles.
There are differing theories as to how
Botox works to eliminate migraine headaches,
but the exact reasoning remains unclear.
One theory is that muscle tension and
spasms are a cause of migraines and by
eliminating the muscle tension with an
injection of Botox it will also eliminate
the cause of the headaches. If given Botox
before the headache begins it is possible
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 increased
amount it causes pain and possibly headaches.
Botox may affect these nerve cells, inhibiting
their transmission, causing a lessening
of the perception of pain. Many researches
think that migraine headaches are a result
of inflammation of blood vessels. However,
muscle tension may also play an important
role in the cause of headaches.
When researchers test a medication's
effectiveness they usually test it through
a double-blind study. This means that
some patients are given the medication
being tested while others are given a
placebo. A placebo is an inactive substance,
such as sugar, that is given in place
of the medication that is being evaluated.
Some tests have been performed that did
not involve double-blind studies, but
showed that Botox could prevent migraine
headaches. One double-blind study involving
Botox and headaches showed only a small
positive effect.
Initial studies may not have shown the
full effectiveness of Botox for the prevention
of headaches. The injections were not
placed in the typical locations of the
headache pain, but in areas normally injected
during plastic surgery. In subsequent
studies, using larger doses and injecting
into more specific localities for the
headache pain, the results were improved.
These tests were concerning migraine headaches.
However, with tension headaches, or muscle
tension headaches, the studies have shown
improved results. This is to be expected
due to the weakening or paralyzing nature
of Botox on the muscles that are experiencing
tension.
When being injected with Botox for the
prevention of headaches it may take several
weeks before the injection takes effect.
For this reason it is usually necessary
to have it injected no more often than
once every 3 months or so. People that
have Botox administered for the treatment
of headaches typically need it injected
every few months. If there is too long
of an interval between injections the
headaches may be experienced by the patient.
However, the question arises about the
safety of these regular injections of
a neurotoxin. Since 1989, when it was
first used as a headache treatment, it
has appeared to be fairly safe. Most migraine
headache medications are taken orally
and eventually end up in the blood stream.
Because of this common symptoms of migraine
headache medication will be dizziness
and drowsiness among other symptoms. Since
Botox is injected directly into the muscle
tissue and does not get absorbed into
the blood system as does the typical headache
medicine there are fewer side effects.
Most commonly, the only side effects of
injecting this neurotoxin is pain in the
area of injection for a couple of days
or drooping of the eyelids for a few days.
Studies are still being performed on
this medication and as yet the FDA has
not approved it for the treatment of headaches.
However, physicians do prescribe it to
their patients and if you think you are
a candidate to use it you should discuss
it with your doctor. If you do not respond
to other headache medications it may be
something to talk with your physician
about. As the studies continue the effects
and safety issues involving this medication
should become more clear.
About The Author
Dr. Larry A. Johnson, D.C. has patented
a popular chiropractor-recommended cushion
for the home treatment of headaches, both
tension and migraine. Visit http://www.soothe-a-ciser.com/chronic-headaches.html
for more information.
