Is Botox for Migraine Pain Worth It? We Asked 8 People for Their Honest Reviews
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Anyone who regularly suffers from migraine attacks knows just how debilitating this brain pain can be (and how hard it is to find lasting relief). Enter Botox—a surprising solution for some people who’ve tried OTC and prescription medications with little success.
While these injections are best known for smoothing wrinkles, they’re also FDA-approved to treat a variety of health conditions, including excessive underarm sweating and, yep, chronic migraine. “Although the products are labeled differently (Botox Cosmetic versus Botox Therapeutic), they’re identical,” Lauren R. Natbony, MD, medical director at Integrative Headache Medicine of New York, tells SELF. “The key differences lie in the dosing, injection sites, and number of shots.”
To understand how Botox works for migraine relief, it’s important to know what triggers these painful attacks in the first place. The exact cause isn’t fully understood, but experts believe these episodes happen when certain nerves in your blood vessels are activated (by stress, perhaps, or a lack of sleep), sending pain signals to your brain and causing inflammation. So injecting a paralytic like Botox around those nerves can block the signals from reaching your brain in the first place—which should in theory prevent migraine pain, Dr. Natbony explains. And even though it’s not a permanent cure, at the very least “it can reduce the frequency, duration, and severity of your attacks for about 12 weeks,” she adds.
Before you get your hopes up, there are a few things to keep in mind. First, Botox is only FDA-approved to work for “chronic” migraine, or attacks lasting at least four hours, 15 or more days a month. Not to mention, the process—which involves multiple injections (155–195 units) across your forehead, neck, and shoulders—can be pretty painful, Dr. Natbony says. And getting insurance to cover the treatment isn’t easy: “Most insurers require trial and failure of at least two other preventative medications, like antidepressants, anticonvulsants, and beta-blockers,” Dr. Natbony adds. (Without coverage, you could be looking at an out-of-pocket cost of around $1,000.)
Now you may be wondering: Is Botox for migraine really a game changer—or just another so-called solution that’s bound to disappoint? We asked eight people (some who paid thousands of dollars) to share their brutally honest experiences.
“It worked for six months, but the price makes it hard to justify.”
Name: Sophia F.
Age: 27
Price: $900
How many units? 30
Was it worth it? No
“I’ve suffered from bad migraine attacks for more than five years, and they’ve only gotten worse. Sometimes, they even last up to two days, making it really hard to work or do simple everyday things.
I’ve tried go-to treatments like acupuncture and was prescribed rizatriptan by my neurologist. Neither of those fully prevented episodes, which is why I decided to give Botox a try. For six months, I noticed a big improvement—it relieved a lot of the pain and even eased other side effects like dizziness and sensitivity to sound and light. After that time, my migraine attacks came back—but I didn’t have them as often. I’d say I get one every three to four months now. I have to be honest though: I don’t think I would do it again given the price tag.”
“I was migraine-free for about a year!”
Name: Carol J.
Age: 77
Price: Free (covered by insurance)
How many units? 60
Was it worth it?: Yes
“My doctor prescribed oral medications for my debilitating migraine attacks, but I didn’t get much relief. So he suggested Botox injections as an alternative, and they worked. They treat my symptoms of head pain, throbbing, and dizziness for about 9 to 10 months. I get the shots only once a year, which I consider a pretty low commitment.”
“The effects wore off way too quickly.”
Name: Karen D.
Age: 24
Price: Free (covered by insurance)
How many units? 150
Was it worth it?: No
“About two weeks after my appointment, I noticed the Botox effects kicking in: I wasn’t experiencing migraine attacks nearly as often (I used to have two or three a week). For the first time in years, I had a full month of no symptoms. None!
That was really nice. But based on what I read on Reddit and other social media posts, I expected the benefits to last a few months, at the bare minimum. Well, the throbbing, pounding, and nausea came back in full force five weeks later. I want to say that the initial month was worth it, but in my opinion, this treatment is a little too high maintenance (and short-term) for me to confidently consider it a holy grail.”
“Botox for migraine really changed my life for the better.”
Name: Jillian K.
Age: 56
Price: Free (covered by insurance)
How many units? 100 units
Was it worth it?: Yes
“I’ve dealt with terrible migraine attacks since I was 12 years old. They’re usually triggered by weather—specifically when it storms in North Carolina. Or if the barometer drops, I get migraine with aura [visual or sensory symptoms like seeing flashing lights]. I’ve tried plenty of preventative medications including prednisone, which unfortunately didn’t make a difference.
Admittedly, I learned about Botox for this condition through online ads, and I’m glad I did: No attacks for over a year! I hadn’t realized just how much my life was negatively affected by my painful symptoms until trying these injections. Now, I rarely deal with migraine, and I’d recommend Botox to anyone looking for a different remedy.”
“I went from three to five migraine episodes per week to only one per month.”
Name: Cassie S.
Age: 42
Price: Free (covered by insurance)
How many units? 155 units
Was it worth it?: Yes
“My migraine attacks have always been debilitating, starting with a throbbing sensation, loss of vision, sensitivity to light, and nausea. I’ve experimented with every treatment option under the sun—beta-blockers, anti-seizure meds, antidepressants too. Nothing worked, and the side effects were terrible for me.
I first got Botox in 2017. 155 units were injected into my forehead, shoulders, jaw, and the back of my neck. Honestly, this decision changed my life. Before I started Botox, I was in bed for hours three to five times per week because of the pain. Now, I only deal with attacks once a month.
It might sound dramatic, but this remedy gives me the freedom to live my life without fear. My condition used to hold me back from being a present mother and made running a business extremely challenging. I was also scared to drive with my kids in the car, in case I felt the onset of a sudden episode. One thing to keep in mind, though: My insurance initially refused to pay for the shots until I could prove they reduced the frequency of my migraine attacks. So be prepared for a potentially tedious process.”
“Even though Botox didn’t work for my symptoms, I’d say it’s worth a try.”
Name: Hannah B.
Age: 25
Price: Free (covered by insurance)
How many units: 155 units
Was it worth it?: No
“I’ve dealt with chronic migraine for four years. The attacks are severe and accompanied by unbearable neck pain. I first started seeing a neurologist in 2020, along with a pain management specialist, and now I also see a headache specialist. I’ve been on multiple preventive medications including beta-blockers, anti-depressants, and anti-convulsants. None have been effective.
My pain management specialist suggested Botox as a last resort. I’ve received these injections three times now—twice in 2022 and most recently last March. Unfortunately, it didn’t work for me. First of all, it hurts: The process involves multiple shots in your forehead, neck, and shoulders. I’ve never had that many needles inserted in one sitting, so it was very overwhelming.
Overall, my symptoms didn’t get worse—but they didn’t improve either. And I still experience episodes frequently, so I personally didn’t see those ‘preventative’ benefits. This could be because I may have tension headaches (which Botox isn’t FDA-approved to treat) rather than migraine—my doctors aren’t sure. But different types of head pain require different solutions, and I’ve heard Botox worked wonders for other people. Maybe I’m an outlier.”
“For the price, I was expecting a longer-term preventative treatment.”
Name: Samir P.
Age: 33
Price: Free (covered by insurance)
How many units: 160
Was it worth it?: No
“I was really banking on Botox to keep my weekly migraine episodes from happening. One of my friends had an amazing experience, so I was optimistic when I found out my insurance would cover the treatment.
My neurologist told me to expect relief for two or three months, and during this time frame, the stabbing sensation in my head was way milder and more manageable than before. But from my friend’s rave review, I expected Botox to actually prevent attacks from happening in the first place—and that it did not do. I’m still hit with a familiar ache about once a week. I’m lucky I didn’t have to pay thousands of dollars, but I would never invest that much money for something that barely alleviated my symptoms. I know it’s hard to find a full-on solution, but I just felt the benefits weren’t long-lasting enough to impress me.”
“I still get migraine attacks, but not nearly as often. I consider that a win.”
Name: Kristen B.
Age: 30
Price: $1,300 for first session. Insurance is supposed to cover afterward.
How many units: 200
Was it worth it?: Yes—to an extent
“I remember taking Advil and Tylenol multiple times a day, almost every day, in high school because of my migraine. I was truly suffering, and my symptoms got even worse after I graduated and started working. Back in 2016, I was prescribed an FDA-approved medication called sumatriptan, which I soon found out I was allergic to.
After that terrible experience, I went to a pain management doctor who told me that because of my negative reaction, most meds would be off the table for me. So I started doing more research and ended up seeing a neurologist who recommended Botox.
Although I don’t get full relief, I can definitely say the shots improved the severity of my attacks—and how often I get them. Now, they feel manageable (whereas before, the pain was unbearable). As long as you understand Botox won’t get rid of migraine forever, I’d say it’s worth it.”
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Originally Appeared on Self
