Before Botox for Migraines
By Sara Calabro
Migraine sufferers began their weekends on a hopeful note. On Friday, the FDA announced that it has approved Botox for the prevention of chronic migraines.
However, the jury is still out on whether Botox actually helps migraines. One study published this summer uncovered no significant reduction in headache episodes between people who got Botox and those who received placebo injections.
Future studies may confirm Botox as a significant advancement in the treatment of chronic migraines, but until evidence is more conclusive, people should consider acupuncture.
Migraine Headaches Can Come from Trigger Points
Trigger points—sensitive nodules in the skeletal musculature that cause referred pain—are to blame for a high percentage of pain complaints. Acupuncture can release these nodules, causing a significant reduction in pain. This is especially noteworthy for migraine sufferers.
In her book Myofascial Pain and Dysfunction: The Trigger Point Manual, author Janet Travell says of her research, “those with upper body pain or headache were more likely to have myofascial [trigger point] pain than patients with pain located elsewhere.”
In other words, a lot of pain comes from trigger points, but especially migraine pain.
Migraines can be caused by trigger points in a number of different muscles, including the sternocleidomastoid, trapezius, digastric and other anterior neck muscles, suboccipital, cervical paraspinals, scalenes, and levator scapulae.
Often, more than one muscle is involved. A total pattern can form from overlapping pain referral patterns from different muscles, causing the pain to spread beyond the traditional pattern of just one muscle. This kind of multi-muscle referral pattern is common in migraines and chronic tension headaches.
Acupuncture Is a Safe, Low-Cost Treatment Option for Migraines
Since Botox essentially works by dulling nerve signals to the muscles, it carries the risk of those effects extending to nearby areas. This can result in life-threatening side effects such as difficulty swallowing or breathing.
Incidence of these side effects is low. According to the FDA’s press release on the approved migraine indication, “There has not been a confirmed serious case of spread of toxin effect when Botox has been used at the recommended dose to treat chronic migraine.”
Still, Botox requires introducing foreign substances into the body, which means adverse reactions are always a possibility.
It’s also expensive.
Allergan, the manufacturer of Botox, has not said exactly how much the migraine treatment will cost. But The New York Times reports that the recommended 31 injections, given at three-month intervals, will cost $1,000-$2,000 a pop. The FDA approval means that many insurance companies—but not all—will cover it, although those that do could require a hefty co-pay.
Even comparing the low-end estimate for Botox with the high end for acupuncture, around $100 a session, acupuncture still amounts to a significant cost savings.
Multiple acupuncture treatments are usually necessary to completely alleviate trigger points and address underlying causes of migraines. The number of required acupuncture treatments depends on a person’s migraine chronicity and severity, as well as constitution and lifestyle.
Typically, three-to-five acupuncture sessions results in noticeable improvement, and it is not uncommon for a trigger-point release to cause immediate migraine relief after just one treatment.
In addition to saving money upfront, migraine patients who opt for acupuncture over Botox may experience longer-lasting results, since acupuncture eliminates the problem rather than temporarily masking it. This ultimately saves even more money over time.
Until we learn more about the efficacy of Botox for migraines, acupuncture is a highly effective option that’s safer and significantly less expensive.
Photo by Sara Calabro