Treatment with botulinum toxin type A may help reduce the number of headache days you currently experience in connection with your chronic migraine.

This page will tell you more about chronic migraine, what the treatment is and how it may be able to help people like you who experience headaches and migraines.

Tell me more about chronic migraine

When you suffer from migraine, you probably feel you're totally alone. You're not. It's estimated that about 1-2% of people worldwide suffer from chronic migraine.

If you suffer from migraine headaches, you will know that they have specific characteristics and accompanying symptoms that are not seen with normal headaches. The pain of migraine headaches can be severe, and is often accompanied by excessive sensitivity to light, loud sounds or smells/odours, as well as nausea and/or vomiting.

People who are diagnosed with chronic migraine have usually been getting headaches on 15 or more days in every month for at least 3 months. As you know, experiencing headaches and migraines so frequently has a huge impact on your life and what you are able to do.


What causes a migraine?

Despite research into this area, it is still not exactly clear what triggers a migraine. Several things may work together to start the chain of events leading to a migraine. It is even possible that these things are different in different people.

However, the latest scientific research suggests that headaches and migraines are caused by confusing signals that are sent and received by the brain. Nerves that detect pain seem to become over-sensitive to harmless activities (such as brushing your hair), and tell the brain that the head is in overwhelming pain when it isn't.


How can the treatment help me?

Botox (botulinum toxin type A)

Botulinum toxin type A is a natural protein that is made by a certain kind of bacteria. The protein is removed from the bacteria and then specially prepared before use. This protein is the "active ingredient": in other words, it's the part of the medicine that does the work, and it can be helpful in medical conditions such as chronic migraine.


How might the treatment help?

The treatment is used as a preventative treatment in chronic migraine. This means that rather than stop your headaches once they have started, it aims to reduce the number of days on which you get headaches and improve the quality of life of patients suffering from chronic migraine.


How does Botox® work?

It is thought that the treatment blocks pain signals that indirectly block the development of migraine.


What does the treatment involve?

Before your treatment

Starting a new course of migraine treatment is a major step. As a guide, you should not receive the treatment if:

  • you have had a bad reaction to botulinum toxin type A treatment in the past
  • you have an infection at or around any of the areas to be injected
  • you are pregnant or breast feeding

It is possible that this treatment could affect your ability to drive or operate machinery. If this is a cause for concern, please let me know..

You should continue with your migraine diary. You should carry on noting down:

  • how many times you get headaches or migraines per month
  • how long they last
  • how severe they are

This will help you and me keep track of how well your treatment is working for you.


When you have your treatment

Your treatment consists of a set of injections that you will have in a hospital or clinic. I will inject tiny amounts of botulinum toxin type A into the muscles around your head, neck and shoulders. Each session will need 31 injections and will take about 15 minutes. If your headaches are worse in one particular area of your head, I will give you a few more (up to 8) injections in the area(s) where you have the most pain.

You will only need to have this treatment once every 12 weeks. As with any type of injection, you may experience some discomfort during your treatment session, but this should not last for long.


After your treatment

We may ask you to stay at the clinic for a short while, to check that you are comfortable following your treatment. You will also be asked to arrange your next appointment.

You may get some swelling on the skin at the places where you were injected, but this should disappear within a few hours. You should try not to rub the places where you have been injected for 24 hours after you receive your injections, in order to ensure your treatment has a chance to work properly.

Will I still need to take my painkillers or migraine prescription medicine?

Although patients may still get some headaches or migraines, they may happen less often and might not last for so long. So, some patients find they do not need to take quite so much of their headache medicines as they did before. I will discuss with you which medicines or painkillers are best to use while you are being treated.

What should I look out for after treatment?

Like all medicines, Botox can cause side effects, although not everybody gets them. In general, side effects occur within the first few days following injection and last only for a short time. In rare cases, they may last for several months or longer.


You should contact the hospital / clinic immediately if you experience any of the following:

  • Difficulty in breathing, swallowing or speaking
  • Hives, swelling including swelling of the fact or throat, wheezing, feeling faint and shortness of breath

Common side effects (occur in less than 1 out of 10 people but more than 1 out of 100 people who use the medicine): worsening of headache (3%); rash, itching; pain where the injection was given (3%); drooping of the eyelid (3%); muscle weakness (6%); neck pain (7%); muscle pain (2%), cramp; muscle stiffness (2%).

Uncommon side effects (occur in less than 1 out of 100 people but more than 1 out of 1,000 people who use the medicine): skin pain; jaw pain; difficulty in swallowing; swollen eyelid.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please inform the hospital / clinic.

If you have been affected by any of the symptoms mentioned above, please don't hesitate to give us a call.

We have a team of experts on stand-by who are ready to take your call at our Manchester (0161 907 2685) Clinic or our Blackpool (01253 308 031) Clinic.