Botox® for Chronic Migraines and Headaches

Botox® (onabotulinumtoxinA) is an FDA-approved treatment for chronic migraines — headaches that occur 15 or more days a month, with at least 8 days of those migraines lasting 4 hours or more.

Botox® works by blocking pain signals and relaxing the muscles around the head and neck that are involved in migraine attacks.

Botox® is a preventive treatment — it helps reduce the frequency, severity, and duration of migraine headaches over time.

Your provider may recommend Botox® if you:

• Experience chronic migraines with significant impact on daily activities
• Have not found adequate relief from oral migraine medications
• Are seeking preventive, non-opioid migraine therapy
• Have recurrent tension-type headaches contributing to chronic migraine patterns

Botox® helps prevent migraines before they start, not just treat them once they occur.

The procedure is performed in an outpatient setting and typically takes 15–20 minutes.

• A fine needle is used to inject small amounts of Botox® into specific muscles across the head, neck, and shoulders — typically about 31 injection sites.
• Common injection areas include the forehead, temples, back of the head, upper neck, and shoulder muscles.
• No anesthesia is required beyond topical numbing if desired, and you can return to normal activities shortly afterward.

• Some patients notice mild soreness, bruising, or tightness at the injection sites.
• Botox® typically takes about 7–14 days to start working, with maximum benefit around 4–6 weeks after injection.
• Results usually last approximately 3 months, after which repeat treatments are recommended for continuous migraine prevention.
• Over time, Botox® treatments often lead to a noticeable reduction in the number of headache days and an improvement in quality of life.