Headaches is one of my special interests – they can be a bit of a mystery and as a sufferer myself I also know they can be very debilitating too. There are a number of causes to headaches and just as many treatments for them – it’s a very deep deeeeeeep rabbit hole that one. And then there’s the importance of differentiating and diagnosing a headache from a cervicogenic headache or a tension headache to a migraine. When you’re blinded (literally) by a headache or migraine, the bottom of your skull feels like it’s stabbing your brain and your brain feels like it’s going to pulsate out of your skull – you’ll literally feel like doing anything to make it go away.
There are a number of treatment methods – obviously the usual manual therapy, deep neck flexor exercises to improve neck strength, dry needling and massage. Botox is a newer player in the field of headache treatment but becoming more popular these days.
What is Botox? Yes, it is the same drug used for cosmetic reasons i.e. getting rid of wrinkles. Botulism is the paralysis of muscles caused by high doses of botulinum toxin – the botox actually weakens the muscle for 3-4 months. Its use for headaches was actually discovered by coincidence when patients were using botox to reduce wrinkles around the face and found that their headaches reduced as well. Sounds like a bit of a miracle right? A couple of tiny injections – gets rid of your headaches and your wrinkles at the same time! Let’s dig a little deeper though:
- Botox has been shown to reduce migraine occurrence in 50% of people
- The treatment is required every 3 months so it’s useful if you forget to take your migraine medication
- If your headaches are caused by muscle referral pain around the base of your skull and across your forehead / temple – the botox will work to reduce muscle spasms
- It is supported by the PBS in Australia however there are prerequisites to receive this rebate
- According to studies there’s a 50% chance that the injections may not work
- The prerequisite to receive botox injections via Medicare are that you must suffer from headaches on at least 15 days per month of which 8 are with migraine and you must have tried conservative methods of treatment first
- The injections themselves can be painful – this will be dependent on the experience of the practitioner
- It will more then likely leave you with neck pain (which will subside)
- It takes at least 6-9 months to see if it is actually going to work for you
There’s quite a bit to consider when going down this route
- How much are you willing to invest into treatment if you don’t qualify via the PBS / Medicare?
- Will you health fund cover any of the cost?
- How much time are you willing to invest because there is a possibility that the injections aren’t going to work on their first round?
- Can you stand needles (multiple…) and how much pain can you manage?
- Are you out of options and this is all that’s left?
The thought has crossed my mind as to whether this is an option for for me. For me, right now, I know that if I continue to train and work on my upper back, neck and core strength that I can avoid the headaches. I have learned to understand my headaches and I realise that the more I sit the worse they are. I don’t think having botox is a long term sustainable solution for myself but it has been for others and could be for you.
Deborah Chen, Physiotherapist