07:09am Sunday 19 January 2020

Botox Injections Associated With Only Modest Benefit for Chronic Daily Headaches and Chronic Migraine Headaches

The findings are published in the April 25 issue of the Journal of the American Medical Association (JAMA).

Jeffrey L. Jackson, MD, MPH, professor of medicine in the division of general internal medicine, and section chief at the Clement Zablocki VA Medical Center, along with his Japanese colleagues performed a review and analysis to assess the association of Botox with reducing headache frequency in adults. 

“Our analyses suggest that botulinum toxin A may be associated with improvement in the frequency of chronic migraine and chronic daily headaches, but not with improvement in the frequency of episodic migraine, chronic tension-type headaches, or episodic tension-type headaches. However, the association of botulinum toxin A with clinical benefit was small,” said Dr. Jackson.

Also, compared with placebo, there were more side effects associated with Botox: drooping upper eyelid, skin tightness, neck stiffness, muscle weakness, and neck pain.

Migraine and tension-type headaches are common, affecting up to 42 percent of adults sometime in their life.  Migraines are less common, with a worldwide prevalence of 8 to 18 percent, but are associated with greater disability.  Migraine headaches are responsible for $1 billion in medical costs and $16 billion in lost productivity per year in the United States alone.         

Botox injections were first proposed as headache treatment when it was observed that patients with chronic headaches receiving cosmetic botulinum injections experienced headache improvement. However, the medical literature on botulinum effectiveness for headaches has been mixed.

Dr. Jackson’s team found a reduction in the number of headaches per month from 19.5 to 17.2 for chronic migraine and from 17.5 to 15.4 for chronic daily headaches in patients receiving Botox injections.

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