Few headaches are signs of serious medical conditions. However, headaches can cause throbbing, piercing or tight pain around much or part of the head. This pain can occur in the tissues covering the brain, the attaching structures at the base of the brain, or the muscles and blood vessels. A headache may be severe, disabling, infrequent or persistent. A chronic headache is one that that occurs frequently over a period of time, generally at least every other day or 15 days per month for a period of at least six months. Other types of headaches include migraine, cluster, tension, sinus, menstrual migraine, and headache due to rebound effect or overuse of medication.

Currently, the U. S. Food and Drug Administration (FDA) has not approved botulinum toxin for the treatment of any type of headache. When a drug is used for a condition that is not approved by the FDA, the use is considered off label.

• Seven in 10 people have at least one headache a year.
• Most headaches last for only a few hours, but some can last for weeks.
• According to the American Council for Headache Education, botulinum toxin cannot be considered a standard treatment for headaches.
• An Internet search found no reference to botulinum toxin as a treatment for headaches by the American Academy Neurology or National Headache Foundation.
• Medical help should be sought immediately if a headache lasts more than 24 hours, is severe or accompanied by other symptoms such as problems with any of the following:
  • Vision
  • Vomiting
  • Stiff neck
  • Fever
  • Shortness of breath
  • Dizziness
  • Unsteadiness
  • Slurred speech
  • Confusion
  • Drowsiness
  • Change in character

Will I live longer if I have this procedure?

No, scientific evidence does not show that botulinum toxin injections for the treatment of headaches prolongs life.

Will the treatment of headaches with botulinum toxin improve my quality of life?

No, scientific evidence has not confirmed that botulinum toxin injections for the treatment of headaches improves one’s quality of life.

Does the treatment of headaches with botulinum toxin make my symptoms better?

No, scientific evidence has not confirmed that botulinum toxin injections for the treatment of headaches will improves the symptoms of headaches.

How safe is this for me?

Published evidenced based studies have reported inconsistent results regarding the effectiveness of botulinum toxin in the treatment headaches.

Minor reported complications:

• Drooping of the eyelid for a few days if used improperly
• Headaches
• Mild pain at the injection site for a day or two

Major reported complications:

• Allergic reaction (hives; itching; rash; trouble breathing; tightness in the chest; swelling of the lips, tongue and throat)
• Blurred vision
• Chest pain
• Irregular heartbeat
• Loss of hearing
• Paralysis
• Trouble swallowing or speaking
• Weakness

A variety of medications are used to treat headaches. They vary in cost and can be obtained over-the-counter or prescribed by a physician.

Alternative treatments include:

• Avoid foods that may trigger headaches
• Devote at least 30 minutes every day to control and reduce stress
• Drink plenty of water
• Eat breakfast and eat at consistent mealtimes
• Exercise for at least 30 minutes three times a week
• Keep a headache diary to learn the pattern of headaches and the characteristics of any symptoms experienced before the headaches
• Maintain a normal weight
• Reduce the amount of caffeine and the use of artificial sweeteners in one's diet
• Take medication prescribed by a physician
• Take over-the-counter medication, but avoid overuse
• Wake up at the same time each morning

The cost for botulinum toxin injections can range from $300 to $800 per treatment and vary in different parts of the country and from physician to physician. The treatments may need to be repeated every three to four months.

The cost may or may not be covered by insurance.

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