Botox injections for migraines: What to expect

Looking through my much neglected blog, I noticed that people seem to like reading the post about my colonoscopy-prep more than anything else.  Not that I blame anyone for being attracted to that post… pooping fire and then having a stranger shove a hose up your butt is one of those experiences that binds us ALL together.  Plus, as I think we can all agree, poop is funny.  However, I thought a small fragment of people may have read that post because it really provides an unedited, unabashed experience of what it’s like to go through colonoscopy-prep.  Perhaps that was useful to some people.  Hence, here is my experience with Botox injections.

I’ve gotten Botox injections for chronic migraines a lot of times now… hmm… I haven’t counted, but let’s say something like 10 times.  If you are considering getting Botox injections for chronic migraines or some other chronic headache condition, you may be feeling the same way I felt before getting my injections… some combination of scared, skeptical, vain, and cautiously hopeful.  Those are all good things to feel, all of them make sense.  But I think I can take away a bit of the mystery for you and explain exactly what you can expect, and hopefully, a bit of the fear involved will dissipate at the very least.  Actually, maybe the best way to go about this is to tell you what you’ll expect in one section, and then give you some side tips in another section.  Here we go…

Part I: Botox injections 101:  HELLO!  WELCOME to this is what it’s like to get Botox injections!  Woohoo!  Seriously, woohoo, this shit might really help you.  I have two other migrainey friends who have success with Botox injections, and indeed, I’ve come across zero people who’ve had NO positive changes after the injections.  So you’re on a good path here.  First, you’ll need to find a good doctor to do the injections.  This should be someone who is a migraine/headache specialist and/or a neurologist.  People who do plastic surgery work may try to trick you into thinking they can do the injections… ignore them.  Find a neurologist who knows what’s up.  Botox injections given for aesthetic reasons are completely different.  They use much higher doses of the medicine and they do not inject the same muscle groups all the time.  Indeed, people accustomed to giving Botox injections for aesthetic purposes may be dandy with a needle but they are used to purposefully paralyzing portions of the face.  That’s not what you want.  You want someone who understands the underlying muscle groups and how they respond to Botox injections related to migraines.  I can’t stress this enough.

Once you’ve found your doctor, you will need to call your insurance company and bitch for a while.  Most companies will pay for the Botox injections on a trial basis.  They want to ascertain whether or not it works for you, so basically, you have to tell your doctor exactly how many migraines you get a week and how bad they are (you are typically covered by insurance for Botox injections if you have 15 out of 30 days a month with migraines, or thereabouts).  Then after the injections, they ask you again, and basically they’re looking to see any improvement.  Good news is, if the injections improve your migraines, most insurance companies will continue to pay.  Don’t be afraid to fight them for it.  Oh and… don’t tell the insurance companies I said this, but feel free to exaggerate a tiny bit about how much the injections have helped, so long as they have helped.  Insurance companies may try to screw you out of a really useful treatment if it hasn’t fulfilled their standards of what is “helpful”.  As any migraineur knows, ANY amount of improvement is a great relief.  I have noticed that doctors will either tacitly permit exaggeration when you fill out forms, or actively tell you to exaggerate.  But all of this is for the second round of injections, so just remember that for your second appointment.  Back to the first appointment: Assuming you get through the labyrinthine vortex of insurance debacles, you’ll make your appointment to get the shots.  Make sure you contact your health insurance company AGAIN to see if they are sending your doctor’s office the Botox prescription in a timely manner.  Trust me.

BUM bum BUUUUUUUMMMMM the day has arrived.  Go to get your injections with a hair tie if you have long hair.  Wear a shirt that has a wide neck and/or is stretchy, unless you don’t mind changing temporarily (some of the shots are on the top of the back).  Don’t wear makeup, or if you do, bring more with you to the appointment because you’ll need to fix it later.  If you care what your hair looks like after this, take a brush or comb.  If you are nervous, which you probably are if this is your first time, you can certainly bring a loved one along to hold your hand.  The doctors are generally accommodating of this.  I used to bring music along, as well, to calm me.  I no longer need it, but it was really helpful when I was more nervous.

When you get to the office, they’ll take your vitals and you’ll sit in a regular ol’ doctor’s office, sweating your balls or ovaries off and wondering why the scale said such a god awful number.  While you sit there worrying, you’ll probably see a set of needles and alcohol swabs laid out before you.  Hey guess what?  Those are going in your head!  Most doctors set all of this up in advance so they don’t have to refill needles or anything like that.  After all, they have exactly 31 shots to give you and it wouldn’t be fun for you if you had to sit there waiting in between shots for the doctor to suck more Botox out of a bottle into a syringe.  This set up is also used very often because the doctor may wish to use different sized needles.  The needles that go into your face are going to be SUPER tiny.  Not so tiny that you won’t feel them, unfortunately, but waaaay smaller than most needles you have seen in the past, most likely.  The needles they use for your neck and upper back are larger, but fear not, those shots are less painful than the face/head shots.

Finally your doctor will come in and have you assume the position.  Actually, there are two possible positions to begin with: sitting in a chair or laying belly up on an examination table.  Either way, they will then proceed to sterilize your face where they’re gonna inject you.  It’s just a bunch of alcohol, no big deal.  Here’s where they’re gonna inject you:

Botox-injetion-sites-MigraineAll the places where they have the little white dots… that’s where they’re gonna stick you with a scary needle!  Seriously, it’s not that bad.  They start with the front of the face injections, always with the one between your eyes.  Then very quickly, they will move onto the rest of your face.  See the injections labeled “C”?  If you are worried about retaining some movement in your eyebrows (you will definitely lose a little bit of movement no matter what), talk to them about those injections and see if they can get them as high as possible, even at the hairline.  A very good injector will be able to accommodate you.  Here’s what I was afraid my face would look like after Botox injections:


But really, here’s what my face can do (well only SOME of what it can do) with the Botox injections, which only impact your forehead in terms of facial movement:

V__246B V__459CV__A51E  V__5788 V__938F

See??  I can move things!  It’s not so bad.  Note how I can even move eyebrows individually.  I’m fancy like that.  As for the pain of the face injections, I find them the most unpleasant, but everyone has their “favorites” and least “favorites”.  They are really not too painful.  Think of it this way: when you get a shot, you are generally getting a lot of fluid going into your body.  These injections use very little of the Botox so the injections themselves are extremely quick.

After the face is done, your doctor will sanitize the sides of your head and the back of your head (shown in the middle two pictures of injection cites, letters “D” and “E”.  I find the “D” injections a bit unnerving because they are basically on some muscles that have to do with your jaw.  It’s weird and sometimes you’ll hear peculiar sounds since the injections are so close to your ear, but this is totally normal.  And finally, the doctor will take care of the last injections, the “F” and “G” injection areas seen in the right-most picture.  If you have long hair, the doctor may ask you to put it high up on your head with a hair elastic for D-G.  The doctor may use a slightly larger needle for the “F” and “G” injection sites, but trust me, you won’t be able to tell the difference.  Those area of your body are way less sensitive than your face and head.  In fact, those injections barely hurt at all in my experience.

YOU’RE DONE!  Your doctor will periodically wipe blood off your face (remember: the face bleeds very easily so if you have blood dripping down your face, it’s totally okay and normal… kind of bad ass).  They may also rub the areas where you’ve gotten your injections vigorously, which is also normal.  This is to distribute the medication.  If they don’t do it, you’ll still be fine, you’ll just look a little lumpier for a short time (an hour or two).  Your doctor will now make sure you’re not going to pass out or something, which is unlikely unless you have a needle or blood phobia, and then you will go home (or even to work… now you see why I recommended bringing makeup and/or a brush or comb if you’re going to work).

Okay, now for Part II.  The tips and tricks that doctors may or may not tell you.

1. After your injections, take an Aleve immediately (remember: take Aleve with food, it can be abrasive to your tummy).  If your doctor permits you, you might consider taking a muscle relaxant as well (many migraineurs have muscle relaxants prescribed to them so it wouldn’t be a new medication or anything like that).  I find the Aleve (naproxen sodium) is EXTREMELY useful right at this moment because the injection areas may get tender and slightly swollen.  Not really visibly swollen, but tender enough that taking some preemptive Aleve can make all the difference in your recovery.

2. You may feel a bit woozy, which is not because the Botox has been injected poorly, but just because you had a lot of adrenaline pumping through your veins when you were getting all those injections, and now you’re coming down from that delightful, terror-ridden high.  I’ve noticed that after the injections I’ll just feel a little tired, very much the same feeling I get if I take one Benadryl.  But everyone’s different.

3. Sometimes people get a kind of “Jack Nicholson Effect” from the injections when they’re first given, which goes away in a day or two.  This only happened to me the first two times I got injections for some reason.  Basically the outermost portions of your eyebrows lift up, and it’s kind of hilarious.  To think that some people do this on purpose….

I mean, he’s a stunning man and all, it’s just not an eyebrow look I’m trying to emulate.

4. Whatever, if Jack Nicholson makes an appearance on your face, it goes away pretty quickly.  And then you will need to wait about 1-2 weeks before the Botox is FULLY working.  In other words, if you’re still getting the same exact amount of migraines right after the injections, don’t worry.  You MAY find that the injections wear off a little bit before the insurance company is willing to pay for them again (the FDA has approved Botox injections for chronic migraine every 90 days).  Therefore, be extra careful to avoid your migraine triggers around the time the injections will wear off, and around the time when you get your injections.  Keep your stress levels down, stop huffing paint, that sort of thing.  And if you can schedule your injections to NOT coincide with your menstrual cycle if you happen to menstruate, that is helpful as well, because your hormonal levels go bonkers when you’re menstruating and that in itself can bring on a migraine.  For all the above reasons, make certain you get these injections in exactly 90 days, or as close as possible to 90 days.  You do not want to wait longer because the efficacy begins to decrease.

5. Botox injections sometimes only work a little bit the first time, or not at all.  This does NOT mean it won’t work the second time.  In fact, the injections have had a cumulative impact on me.  At first it helped a little, but over time I went from 3-4 migraines a week to 1 or fewer migraines per week!  Which is the difference between having a life and not having a life… it’s a big difference.

6. You might get tiny bruises from your injections.  Get over it, they’re small and they go away.  😛

7.  People are gonna make all kinds of jokes about Hollywood and facial rejuvenation whenever you talk about the Botox injections.  You will have to appease them and/or tune it out.

8.  You are not gonna look like a freak after getting these injections.  AGAIN: they inject far less into your face than they would have if the injections were for cosmetic purposes.  The only time you’d have to worry is if you have someone injecting you without experience injection Botox for migraine treatment.  So just don’t do that, silly!  The most common sign that the injections have been done incorrectly is if the upper lids of your eyes begin to droop a bit.  But remember, even if this happens (it has never happened to me because I see reputable doctors), it will go away within 3 months time.

9.  Finally, a word of encouragement: Botox injections and their alleviation of migraine pain was discovered when a woman suffering from chronic migraines got injections for cosmetic purposes and noticed that her migraines almost completely went away.  The doctor found that rather astonishing and the company that creates Botox saw an opportunity to tap into the sick community rather than being limited to mostly the plastic surgery community.  Studies were done, positive results were found, and voila, here we are.

If you’re thinking about getting Botox injections because you have frequent migraines, give it a shot (haha, sorry… puns are fun).  Seriously, you should do this.  I feel dumb about how long I waited to try it.

Good luck!

Disclaimer: I am not a doctor, but I am a migraineur, and I have gotten these injections from three separate doctors.  So while I can’t give you medical advice officially, I’m slightly better than “oh I heard that guy my second cousin dated three years ago said Botox injections rock…”.


51 responses

  1. I found this while searching for POSITIVE stories online from migraine suffers regarding their experience with botox, and …. to admit my vanity, what I could expect to look like AFTER. It’s usually people who are the 1% that experience droopy lids, terrible reactions, etc posting in forums. I found your account to be 100% accurate, helpful and refreshing – so thank you! I just had my first round 3 days ago and I’m quite hopeful that my headache days will be reduced and I’ll really enjoy the youthfulness of my face!

  2. Great post!! I’ve been getting Botox injections for migraines for years and this is an extremely accurate description of the process. It’s definitely helped decrease the frequency of my migraines and I hope others who are feeling hopeless will benefit as well. Thanks so much for sharing!

  3. I’ve had my first Botox injections 2 weeks ago at first I thought it was working but now I’m back to getting migraine everyother day . Do they give you a smaller amount at first to see how you react and then more the next time . I’m so disappointed as I’ve had migraine for 5 years and was sure this would work

    • No, generally it’s the same amount each time. Though my neurologist sometimes doubles the amount in the back of the head. But I very strongly recommend that you don’t get too discouraged yet if it didn’t work this first time, because that doesn’t necessarily mean the Botox won’t work for you. Sometimes it takes two or three times before the Botox works if it is going to work. My first time getting the injections it didn’t really work that well. The second time it started to work a bit, third time was much better. All of it worked best in conjunction with prophylactic meds (amitriptyline at first, but then I switched to topamax; plus I take vitamin D and magnesium every day). Hang in there!!!!

    • I’m so glad, Alice! I was very nervous my first time. My boyfriend came with me… I remember I was sweating profusely and everything. Eek! But I was totally fine and it changed my life so much. You’ll do great. 😀 I’m excited for you to try this out and I hope it works for you.

  4. Thanks for the post. Going in for my first treatment in a few days. Sooo looking forward to finding a solution and am hoping this is it!! Praying it works….

  5. I have plates in my neck which has led to a neck full of arthritis. This in turn has led to continuous muscle spasms that no muscle relaxer has touched. I’ve tried all the meds. Fioricet helps the most. I tried nerve ablation in my neck as it was magic for my low back (I also have rods in my back from scoliosis and bad arthritis in my low back at the ripe old age of 30!). Yesterday I got my first Botox injection. My doctor is a pain specialist and he gave me Valium to take before for my nerves. The injections weren’t as bad as I expected. The crunching noise of the meds injected into my head was almost worse. The ones in my upper neck/skull base triggered eye tearing and hurt the worst. He then said he had 4 more injections worth of Botox. He said he could throw it out or use in in other trigger points along my spine. So I got two areas that constantly have knots injected. Anyway this morning I have a terrible migraine and my jaws feels really tight! Any tips on how to help? Also how long do you think this headache will linger? I’m supposed to work the next 2 days!

    • Well first if you haven’t called your doctor already, you should, and see if he has any advice. Also just to make sure you’re okay. To me this sounds normal. I’ve also had short term negative immediate responses to the injections now and then. It’s not that unusual since they’re injecting into all theses super sensitive areas. This happens to me especially if I wait too long in between injections.

      Ice on the areas where you had the injections and feel particularly bad–maybe for you the areas where you got the extra injections and the jaw–that will be helpful, because part of your problem may be swelling in the regions, triggering extra nerve responses. There’s just a lot of crowding there. If you can safely take Aleve, that will bring down swelling, too. This is what I would advise in addition to whatever you normally do to abort migraines. For your jaw, you may also want to very, very gently rub in circles on the region. I know exactly the feeling you’re talking about there. I used to get that feeling but don’t anymore. It’s difficult to make it go away at will (time fixes it) but basically I’ve tried ice, heat, and really gentle circular rubbing. You are REALLY not supposed to rub hard in the area because then you move around the Botox so don’t do that. And don’t worry, the feeling goes away, I promise!

      Next time if it’s possible get your injections right before you don’t have to work for a couple days to see if you have this response again, so you can recover if need be. You’re probably saying, “YES I KNOW” but I’m throwing it out there just in case. Some people have almost no or no negative short term reaction (even when I have the short-term unpleasant side effects it is irrelevant to me because the long term impact is so good for me), and if you keep getting the injections you might find that your response changes over time. Less tenderness in the jaw, and you can mitigate the migraine potentiality by taking something like Aleve prior to the injections. Again, if that’s a medication that’s safe for you to take. I don’t know what other meds you take or if you have any stomach problems (it can be a little abrasive on the stomach). Hang in there, Danielle!

  6. Thank you for this blog! I feel much more comfortable with the idea and it’s good to know what to expect! I’m getting the botoxnin two days. I hope it works as well as it did for you!

  7. I had a craniotomy to remove a large and very strategically placed tumor in 2011. I had suffered from random migraines and cluster headaches for years before surgery and they continued after surgery ever worse. I heard of botox but dismissed it as “hogwash”. I have a family so I refused opiates for pain. Just not my idea of a life! None of my doctors ever offered me botox, ever! I finally got fed up with the sleepless nights and the nausea, not to mention the actual pain, and pushed for something more. I was referred to a neurologist on my plan that just so happens to be a migraine specialist. He gave me the once over with a “nerve blocker” that works great but only lasts a day or 2. A week later I had my first botox treatment. That was 1 week ago. Today was a day that started exceptionally well and has now become like all the others. I NEVER wake up without a headache of some kind and today I did. I don’t remember the last time I slept longer than 4 hrs and last night I did! Now that it’s afternoon I’m really starting to hurt again, though. Could anyone tell me please, is this a sign that the treatment is starting to work? Please and Thank you!

    • Here’s my take, based on my experience. It is possible that’s a sign it’s helping you. But here’s the thing: The Botox injections don’t take full effect until several weeks in. And even then, it can take two or three treatments before you will find whether or not it works for you. Therefore you shouldn’t worry if it isn’t performing up to snuff. Try to hang in there and if it reaps any benefits this time around (as it seemed to for a few hours, which is great!) count it as a bonus. I know that even a very short break is a GREAT feeling. I’m keeping my fingers crossed for you!

  8. I had my first Botox treatment 3 weeks ago, after being urged to do it by my neurologist for more than a year. After the treatment I had a very bad heachache..worse than usual, and then woke up every day with a headache for the next week.. My forehead area continues to feel stiff (as if there is concrete in there. )I called the doctor and they said it would take 2-3 weeks for the Botox to start working (and that it never causes a Headache!) . She gave me 2/1 taper of prednisone, and the headaches went away for a week. I thought maybe the Botox was starting to work, but this morning (week 3 after treatment) once again woke up with a headache. I use Imitrex for headaches, but can only take it 2 times a week. I’m quite frustrated, and saw your blog, and am wondering if you have heard of an experience like mine?

    • I have specifically had this experience before a couple times, yes. My headaches are particularly bad around the occipital nerve and sometimes if the doctor does a good job injecting close to the nerve (which helps best in the long term to really get the medicine close to the nerve), it means the nerve will be crowded with Botox and it gets irritated in the short term. It’d get irritated if you did anything to it, like hit your head lightly (literally just a nudge, anything), so I’m talking about the doctor doing nothing wrong. But it takes very little to irritate a nerve, especially someone like a migraineur…which is why I have no idea why your doctor says people with chronic migraines “never” get migraines after injections. Please. That happens all the time, it’s nothing to worry about. It sounds ridiculous because you’re getting the injections to get RID of the migraines, but you have to consider the long term. I had bad headaches some of the first few times I got injections, in particular, because the Botox hadn’t fully “kicked in” yet… the effects of the Botox take several months (not weeks, you only get a small effect after 2-3 weeks). The overall impact of the injections is that they dramatically decrease migraine frequency, but if someone sticks needles into your head and you’re prone to headaches you might get a headache. I think your doctor is either incompetent, or I hope (more likely) is just trying to cover their ass. For what it’s worth, I rarely get a bad headache after my injections anymore. I usually just go straight to work and look slightly odd/spotty.

      The stiff feeling is a little too vague for me to say if it’s normal or not. You may be describing muscle paralysis, which is normal. But if the Botox isn’t dispersing properly, that’s not normal. Trust me, you’d know if this is the case, because you’d see giant welts on your face. If you don’t see giant lumpy welts on your face, don’t worry.

      • Thank you so much for your detailed response! No welts, all looks normal, and stiffness is diminishing. So I guess it is muscle paralysis. It seems my headache frequency has increased to daily, often mild ones . According to your response I may have to wait many more weeks to see an overall improvement? Thanks again for the encouragement! Any other information or resources that you can recommend would be welcome.

      • On Botox’s website, answer to the question “When will I see results”: “In clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks), BOTOX® prevented up to 9 headache days a month (vs up to 7 for placebo). You may start to feel results as early as 4 weeks. Over the course of 2 treatment sessions, you should notice a reduction in headache days.”

        On Botox’s website, “Other side effects of BOTOX include”: “dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.” (emphasis added)

        Here’s also data from a chart on Botox’s website:

        Other side effects in the
        clinical study included:

        (In 687 patients) BOTOX®, left column
        (In 692 patients) Placebo, right column

        Headache 5% 3%
        Migraine 4% 3%
        Partial facial paralysis 2% 0%
        Drooping eyelids 4% < 1%
        Bronchitis 3% 2%
        Neck pain 9% 3%
        Musculoskeletal stiffness 4% 1%
        Muscular weakness 4% < 1%
        Muscle pain 3% 1%
        Musculoskeletal pain 3% 1%
        Muscle spasms 2% 1%
        Injection site pain 3% 2%
        High blood pressure 2% 1%

        Botox has buckets of info on how people are impacted by this drug because–and this is just my opinion–they are probably super excited by the fact that they are selling a poison that does something other than make people look (sort of?) prettier/younger. The medicinal benefits of Botox are a point of pride for them. Read every shred of data they provide. Here's a link to their "chronic migraine" section, in case you haven't been there before:

        One final question: Is your neurologist also a headache specialist? In my personal experience, if not, they may not know what they're talking about. They may be perfectly capable of injecting you well, though! The injection sites are very precisely indicated and neurologists are highly trained, but they don't all specialize in headaches.

      • Thanks again for all of your help. I will take a look at the links you sent. My Doctor is neurologist who specializes in headaches and runs the Headache Clinic at the Scripps Clinic in San Diego where I receive my all of my medical care. She should be fully qualified. I called today and was able to make an appointment to see her next Friday. That gives me another week (it will be 4 weeks post treatment) to see how things go…I’ll keep you posted!

  9. If that is the case then my guess is as good as yours about your doc telling you people don’t get headaches from injections, because that’s one qualified doctor! Maybe she thinks the statistics are anomalous. And also my experiential knowledge is anomalous, and yours. 😉 (I still think she’s covering her ass)

    OOoooo maybe she’s just trying to make sure you’re not panicking, since anxiety can make headaches worse. Anyway, I look forward to seeing what she says. I’m glad you’re in good hands, my doc was involved in a Headache Clinic, too, those are people you can trust! 😀

  10. Just to clarify. It was a NP in the Doctor’s off who told me that Botox didn’t’ cause headaches. So Doctor is in the clear. 🙂

  11. Getting my first shots tomorrow after two years of trying so many other things including spinal taps every three months. Nervous and excited to be painfree. I don’t even remember what that’s like.

  12. Thank you for the blow by blow account on what happens. Much appreciated as I go in for my 1st injections tomorrow. We’re hopeful. I suffer from common migraines as well as hemiplegic migraines and I have chronic neck pain so maybe these will help with that as well…

    • Good luck on your injections!! Great thing about them is that some are down on the neck, too, so they very well might positively impact your neck pain. I had to look up hemiplegic migraines. Phew that sounds awful. Hang in there and remember that the injections don’t kick in right away, sometimes it takes a few months (or more than one series of injections) before kicking in.

      Oh btw I just saw a new rheumatologist randomly the other day, and had to list my meds. I mentioned that I did Botox injections for chronic migraines and she said, “OMG me, too! Aren’t they amazing???” Turns out she has chronic migraines, too. I meet a new person who has success with these injections all the time. Be hopeful!

  13. Thank you! I have 15 to 17 a month and I have HIGH hopes for my first treatment tomorrow. I really appreciate your detailed article. Needles aren’t an issue.

    • Do you mean generally weak, or the muscles on the face? I do generally feel a little woozy, but I think it’s just a response to adrenaline shooting through my body for a long time.

  14. This article was EXACTLY what I was looking for n after getting the treatment found it to be VERY accurate. Thnku very much.

    • Maryann, my doctor, who’s a pioneer in using Botox for migraines, told me I may not get any relief on the first round of treatment. However, I did! Before the injections, I was waking up with a migraine 5-6 days a week. Since my treatment over a month ago, I have not had a morning migraine 😀! I’ve had a few during the day, but it’s been a godsend. A few days after treatment my neck hurt. It felt like I had been working out. Lol. That goes away in about a week. Botox has been a real lifesaver!!

  15. I am sooooooooooooooooooo glad I found this!!! I’m going for my first round of botox today for my migraines. I am in pain at some level every single day and I’m a cranky bitch most days (thank goodness my husband loves me). I am nervous AF but I’m going in with an open mind and I’m full of hope. Thank you for this well written blog !!! you made me giggle

  16. Thank you for your article
    I have been getting Botox for years but from the wrong Dr. Just had them again two days ago from a good Dr. My problem is I have had terrible headaches now which I never had before. They told me it would take a week. Just hope they will subside.

    • It has now been a week and migraines are getting worse. After reading all the previous emails l guess I have to be more patient. I hate to bother the Dr. but I would hate to think I have to face this pain for another 2-3 weeks
      Reading all the emails sent to you, gives me courage to keep my chin up

  17. Oh thank God, I’m having injections in the morning. It is currently 1:30 am where I’am And I’ve been having anxiety of the unknown. I don’t know anyone personally that I could talk to, that has gotten Botox. I’m not so worried about getting the shots themselves but the after effect. Reading this totally took my fear away. Thank you! I’m going to bed now. PEACE ✌️

  18. Thanks for the article. I go tomorrow’s for my first time of trying Botox and I’ll admit I have worked myself up quite a bit. A lot of mine is the unknown, the needles in the forehead and basically all over. Your article helped me a lot so thank you. I think my blood pressure has dropped a couple of points.

  19. Thank you for your blog. Just got first injections. You described my experience exactly. Got a bad migraine 3 days later and it made me feel less hopeful, you gave me my hope back. As far as the Jack Nicholson look, rocking it right now and dont mind at all! Thank you for the hope you gave back to me.

  20. Thank you for this. Im getting my first round of botox for migraines next week and didn’t know what to expect. My neurologist is doing it for me and i think i will take some music with me. Good idea!
    Hoping this works. Thanks again.

  21. i’m going in for my 1st session tomorrow and i came across this blog by googling “botox injection sites for migraines” coz i wanted to see where they will be injecting me.. lol.. i didnt wanna look like a plastic faced person after my appt.. hahaha!… is it really 31 shots? is that the standard thing across the board? i’m not afraid of needles.. just wondering.. never really googled this til today.. haha.. i’ve googled weirder things.. just nothing pertaining to this.. lol.. i guess i’ve dodged this for the longest time.. my new neuro.. the botox guy.. put me on the supplement regimen.. magnesium/COQ10/B2 (once a day) along with gabapentin (2x/day).. i think the supplements.. specifically the magnesium hurts my stomach.. like ugh.. anyone else having this same problem!?! i have been on this for a month now and my migraines have just gotten worse.. like blah.. i feel like i have them probably every day or every other day.. the type that makes me nauseous.. and less appetite.

    • Yep regarding the Botox injection #, it’s standardized across the board. But some of the injections go very quickly and in similar areas, so they don’t feel like that many. Magnesium makes me have to go to the bathroom, which for me is a plus because otherwise I get constipated. I do think generally having some gastrointestinal response is fairly common but I’m not sure about pain; are you taking it on an empty stomach? If so, you may wanna switch that up. I’m on gabapentin, it’s good for me, helps with pain (occipital neuralgia pain, more than the migraines, tbh). So is topamax if you need to try something else, but that makes me nauseated and if you are already having tummy problems it may not be for you. Tizanidine is a good easy muscle relaxant for nighttime that’s fairly common for migraine use.

      • Thanks for the response! Appreciate it! I got my shots yesterday! They were great and not that bad! The worst ones, in my opinion were the ones on my scalp… lol… they felt the weirdest… i guess i’m tender-headed? Haha! As for the magnesium, yes, i take them on an empty stomach most days, as i take them before i leave for work, and no time for breakfast. My stomachache/potty breaks last ALL-Day though… it seems like… my doctor also took me off gabapentin and topamax and maybe imitrex… instead, he’s switching me to Trokendi, and got me trying out Treximet… also… he is wanting to do an Occipital Block on me in a few weeks on top of the Botox since my migraines are just getting worse and the gabapentin didn’t really do much when i was on it for about a month and a half….

    • I take the max allowed of magnesium for migraine as well as fibromyalgia. I cannot take them on an empty stomach without getting extremely nauseous. If I take them after a meal, I am fine. Good luck.

  22. Thank you for the detailed info sharing. I had my first shot today and strange but true, my neurologist did majority of the shots on my head. Yes, on the scalp. Is this normal? I am stressing abt this and actually feel woozy riggt now.

    • Oh yes, totally correct! Many of the standard injections are in the scalp. Some near the ear, several also on the back of the head. It’s rather disconcerting. I find sometimes I can hear a crunching during those injections on the side of the head. Eeeeek! 🤣 Don’t worry, that’s where your doc should be injecting. Forehead, sides of head, back of head, neck, a couple right next to the shoulders. And there are several injections near each other in each of those regions typically, so it feels like a lot (because it is a lot), but it is both normal/expected and not dangerous. Good luck!

  23. So I had my first set of injections 7 weeks ago with NO luck. I have had severe chronic migraines & toothpick migraines for years. I have tried countless meds and can’t remember what it’s like to have 1 day where I go to bed or wake up migraine free. I am beginning to think nothing will ever work and I will suffer the rest of my life. my neurologist still wants me to get the 2nd set of injections, she says I have a better chance of them decreasing / going away after the 2nd set, but to me it was one of the most painful things I’ve been through for it not to work… I am at a loss… I want to be rid of these horrid migraines so I can enjoy time with my baby when I am home with her instead of suffering and wanting to do nothing

  24. I am a more than 8 year chronic migraine suffer. I have been told by my neurologist that I basically have a migraine all the time; but that it ramps up and down. There is basically a constant like mental buzz that if it low enough, I can tune out. They can ramp up without warning or a trigger can send them flaring up. Nothing like waking up barely able to walk straight to the bathroom to take a naratriptan. I have had MRI, CT scans, blood tests and the spinal tap. I have tried the line-up of preventive and abortive treatments, which either did absolutely nothing, or the side effects were terrible, or sent my migraines over the top constantly.

    I am 2 and 1/2 weeks into my 2nd migraine Botox session. Both times the injections themselves felt like getting repeatedly bee stung, they took my breath away. After the 1st treatment, I experienced a couple of days of body aches, like having the flu. Then I experienced a slight increase in both frequency and pain levels, then the last 3 weeks before the 2nd session was bad for me. I assume as my body was waning down from the Botox. While my neurologist said that in my case it probably would have been better if I had gotten the 2nd session in earlier; but since health insurance won’t approve that – not much we can do about that. Though the fact that again, I am experiencing an increase in frequency and pain, along with body aches – getting it any sooner in my case may not have helped. My neurologist did prescribe me a 7 day treatment of prednisone for the body aches, which didn’t seem to do much.

    If things continue as they are now, not sure if I will be open to trying a 3rd session.

    • This is certainly a disheartening read, and I am so sorry to hear of your bad experiences. I had not heard of this particular response to the injections. Not from anyone I know who receives the injections for chronic migraine. HOWEVER. Flu-like symptoms do seem to be a possible side-effect. Some light Googling reveals that. The Botox doesn’t enter the bloodstream unless they are done poorly, so this isn’t about Botulism (you don’t have to worry about that, the symptoms aren’t the same). The Mayo clinic lists “flu-like symptoms” as one of the possible side effects of Botox injections and I trust that source a lot. So it’s possible you’re one of the unlucky people who has this particular response. What I didn’t find was information telling me whether or not people who have this response initially get acclimated to the medication. I know that with other medications I take, I often experience decreased side effects, so it’s possible you won’t have the flu-like symptoms after a while, or, they will be lessened. But I simply can’t find info on this. I find the Botox website itself a little irritating, not that easy to navigate. I’m not finding their complete side effect list anywhere (and it has to be there somewhere). If your doctor receives the medication directly, they should also receive that giant pamphlet with the tiny writing all over it, which should have details about side effects on it. If so, I would be curious to see if the flu-like side effect abates over time for people who experience it.

      It really pissed me off to read some threads where patients complained of flu-like symptoms after Botox injections, and doctors saying it’s got to be something else/it’s all in their head. (rolling eyes) Yes, as always, we’re just making it up. Please. I’m just not interested in any doctor who is this daft. It’s true that correlation doesn’t always equate to causation, but there are several reputable medical resources that confirm flu-like symptoms are a possible side-effect of Botox injections and people administering the injections should familiarize themselves with what they’re administering rather than ignoring the complaints of their patients and putting on the stereotypical and all-too familiar air of doctor-y superiority those of us with chronic health conditions have come to fear and loathe.

      My experience with the injections themselves is that a few of them are quite painful, like the ones near my eyebrows, and the ones on the back of my head; those tend to be the areas where I get the most pain during headaches (I also have occipital neuralgia, so this is logical to me). It stings and hurts quite a lot, and in some cases has taken my breath away, but not to such an extreme as to keep me away because the Botox itself works for me, and it only hurts to this extent in specific places. I have gotten bee stings and many of the injections were not nearly as painful as bee stings. My suspicion is that your headaches are so bad and your head is so sensitive that the injections are all pure hell right now. IF you found headache relief and the constant headache cycle were broken, the injections themselves would likely become less painful, simply because your nerves wouldn’t be screaming before a needle and fluid started meddling around the nerves. Incidentally, whenever I get nerve blocks, I get them for the obvious reason that I’m in an unusually high amount of pain, and those injections always hurt more than other injections normally do because my nerves are on full-alert. I find it particularly frustrating that a treatment to alleviate pain CAUSES pain, at least initially, in the very area that hurts so much. (shakes fist at sky)

  25. Thank you for this really helpful information! I had my first treatment just over a week ago. The first seven days went pretty well, most of my pains cleared out and by day seven I was feeling quite good. A migraine hit on day eight but now that is gone and I’m hoping for continued improvement. I have also had muscle weakness in my neck when I lean forward but it seems to be getting a little better. I’m definitely rocking the Jack Nicholson look and unfortunately for me, I am very self-conscience about it so I hope the eyebrows settle down soon. I don’t look like myself! Thank you!

  26. Hi! I went through two rounds of the Botox injections, they were using it because i have unexplained migraines caused from a car wreck 4 years ago. when the new year rolled around this year my insurance aproved me for the year, well it was going to cost me $756 out of pocket, i simply can’t afford that so i didn’t get my injections. So my question is has anyone on here quit getting injections and if so what was your reaction if you had any? I’ve been getting waves of dizziness and blacking out spells. Any advice would be amazing! Thanks!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s