Chronic Migraine Treatment With Botox, Here in Rockville
When you have a headache more days than not, you plan your life around it. Botox is FDA approved to prevent chronic migraine, and Dr. Spiegel gives it here in the office. He also looks at what keeps the headaches coming, like neck and jaw tension, posture and sleep.
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What Is Botox for Chronic Migraine?
Botox is a purified protein given as small, shallow injections in the forehead, temples, back of the head, neck and shoulders. It calms the nerve signals involved in migraine, so many people get fewer headache days. It's for adults with chronic migraine, which means a headache on 15 or more days a month. Treatments repeat about every 12 weeks, and most people need two rounds before they can judge how well it's working.
What Happens When You Come In?
Botox works best as part of a plan. Here's how it usually goes.
Full History and Exam
A 90-minute first visit covering your headache pattern, what you have tried, and your neck, jaw and posture.
Headache Diary
You track headache days before you start, so you and Dr. Spiegel can see what changes.
Botox Treatment
31 small injections, about 15 minutes, no downtime. You can drive yourself home.
Request a visitFollow-Up and Support
Repeat treatments about every 12 weeks, plus hands-on care for the neck and shoulders if it helps.
Osteopathic care ยท AcupunctureBotox is one piece of the plan. Dr. Spiegel also looks at triggers like tight neck muscles, jaw clenching and poor sleep, because treating those can mean fewer headaches too.
Is Botox a Good Fit for Your Migraines?
Botox is approved for chronic migraine in adults. It is not meant for occasional headaches.
Often a Good Fit
- Headaches on 15 or more days a month, for at least 3 months
- Daily preventive pills that did not help or caused side effects
- Migraines that keep you from work, family or sleep
- Tension in your neck and shoulders that comes with the headaches
- You want a treatment you only think about every 3 months
Talk With Us First
- You are pregnant, breastfeeding or planning a pregnancy
- You have a nerve or muscle condition, like myasthenia gravis
- A new, sudden or "worst ever" headache, which needs to be checked right away
A sudden, severe headache, or a headache with weakness, confusion or trouble speaking, is an emergency. Call 911.
What Does Recovery Look Like?
There is no real downtime. Most people go back to their day right after. The injection spots can be a little sore or tender for a day or two.
Common side effects include neck pain, a headache, and in a small number of people a drooping eyelid or brow that fades as the Botox wears off.
Back to normal activity
Some people start to notice fewer headaches
Effects start to wear off, time for the next round
A fair point to judge how well it works for you
Who Is Dr. Spiegel?
Dr. Neil Spiegel, DO, MBA is an osteopathic physician who treats chronic pain without relying on opioids. For migraines, he combines Botox with hands-on care for the neck and shoulders and a look at sleep, stress and other triggers, so you are not only treating the headache.
What Do People Ask About Botox for Migraines?
Does Botox Work for Migraines?
For chronic migraine, yes. In the two trials that led to FDA approval in 2010, 1,384 adults were studied, and people who got Botox had fewer headache days than people who got a placebo. Results vary, and many people need two treatments before they see the full effect.
How Often Do I Need Botox for Migraines?
About every 12 weeks. The effect wears off over about 3 months, so treatments are scheduled ahead.
Does It Hurt?
The needles are very small. Most people feel quick pinches, and the whole treatment takes about 15 minutes.
Is This the Same as Cosmetic Botox?
It is the same medicine, but the dose and the injection spots are different. Migraine treatment covers the forehead, temples, back of the head, neck and shoulders.
What Are the Side Effects?
The most common are neck pain, headache and soreness where the shots went in. A small number of people get a drooping eyelid or brow that fades. Serious side effects are rare, and Dr. Spiegel goes over them with you first.
Is It Covered by Insurance?
We don't bill insurance, but we'll give you a claim form if you have out-of-network benefits. Many plans cover Botox for chronic migraine, so ask your plan what they need.
Request an Appointment
Tell us about your headaches, and our team will reach out to schedule your visit with Dr. Spiegel.
Get Back More of Your Days
Book a visit with Dr. Spiegel in Rockville, MD.
Not ready to book? Start with a free 15-minute call