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Botox has become a popular solution for treating headaches in recent years. While it does seem to ease some headache symptoms, unfortunately, Botox for headaches may be doing much more damage than good. Before we explain, let’s define Botox.

What Is Botox?

Botox is a drug created using a natural neurotoxin (botulinum toxin) that, in small doses, weakens the connection between the muscles and nerves, relaxing the muscle. However, in large doses, it poisons the connection and causes paralysis. Most well known as a cosmetic drug that smooths lines and wrinkles on the face, a little over a decade ago, it was discovered that it had the ability to ease headaches when injected into the muscles of the head and neck, and after clinical trials, it received FDA approval for this purpose.

We see many patients at the Centeno-Schultz Clinic who’ve been treated with Botox for headaches elsewhere. For about two to three months following a Botox treatment, their headaches improve; however, over time they get much worse. So if you’re looking for short-term headache relief, Botox may work a time or two, but if you want a long-term solution for the pain, not only is Botox not the answer, it may, in fact, be causing more damage in the process.

Botox Injections Damage the Muscles

As mentioned, the treatment using Botox for headaches involves injecting the Botox into the muscles of the head and neck. Once believed to be a blood-flow problem in the brain, over the last couple of decades, the research has shown time and time again that many headaches stem from a neck issue, not a blood-flow issue..

Headaches can be a result of pain in the upper neck joints; however, it’s usually a bit more complex than just labeling it as pain. When there’s been some type of neck trauma, this can cause the upper neck muscles to atrophy, or shrink. The muscles in the upper neck have big jobs to do: they not only stabilize the head and neck, but they also protect the joints, ligaments, spinal discs, and nerves in the neck. If these critical muscles can no longer function as intended, bigger muscles (e.g., neck extensors, trapezius, etc.) work overtime to pick up the stability slack, something they aren’t designed to do. Over time, these muscles begin to hurt and become tight, but what does this have to do with headaches? Some of the nerves that branch off the cervical spine in the neck travel past these chronically tight, inflamed, and/or painful muscles on their way to the head, and can become irritated as well.

Botox injections actually can relax these tight overworked muscles, but the problem is, by relaxing them, it then stops them from being able to pick up the stability slack, leaving the neck joints, ligaments, discs, and nerves unprotected and vulnerable to continuous damage.

Isn’t the Effect of Botox on the Muscle Reversible?

You may have heard claims that Botox’s effect is completely reversible, that the muscles return to normal when Botox is discontinued, but there is a lot of research suggesting this isn’t true and that Botox actually does long-term damage to the muscle. Let’s take a look at a few studies over and above using Botox for headaches.

  • One study researched hip muscle Botox injections for sciatica and found not only atrophy of the muscle but a decrease in the thickness of the muscle.
  • Botox muscle injections, in another study, worsened the muscle’s ability to provide feedback to the brain by damaging its embedded sensors.
  • One study actually found permanent damage in the opposite muscle (not injected with Botox). This is likely because damage to one part alters the neurology and biomechanics of the opposing part.
  • Finally, an animal study found that Botox damaged the muscle attachment to bone as well as reduced density in the surrounding bone.

Does treatment using Botox for headaches result in muscle damage? The evidence certainly suggests this is the case. While Botox may be a quick-fix for headache relief, understand that the effect is only temporary and it may be creating muscle damage and neck instability issues in the process. See your interventional orthopedic physician who will investigate and address the cause of the headaches instead of just focusing on the quick-fix that won’t last.

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