27 doctors weighed in:
Where do you inject botox for migraines?
27 doctors weighed in

Dr. Mike Bowman
ENT - Head & Neck Surgery
12 doctors agree
In brief: Depends...
On the location of the migraine.
Seek a specialist in migraines who does Botox to make sure you get the best treatment recommendations for your headaches. If done by a specialist in headaches, insurance often covers this.

In brief: Depends...
On the location of the migraine.
Seek a specialist in migraines who does Botox to make sure you get the best treatment recommendations for your headaches. If done by a specialist in headaches, insurance often covers this.
Dr. Mike Bowman
Dr. Mike Bowman
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Dr. Jason Hall
Surgery - Plastics
4 doctors agree
In brief: On or off-label?
The FDA approved indication has 31 different sites that are injected.
However, "off-label" injections, which can be just as or more effective, depend on physical examination findings and the distribution of your headaches. Typically, 6 sites can be injected in this way. However, "off-label" injections are not covered by insurance and should only be done by experienced headache surgeons.

In brief: On or off-label?
The FDA approved indication has 31 different sites that are injected.
However, "off-label" injections, which can be just as or more effective, depend on physical examination findings and the distribution of your headaches. Typically, 6 sites can be injected in this way. However, "off-label" injections are not covered by insurance and should only be done by experienced headache surgeons.
Dr. Jason Hall
Dr. Jason Hall
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Dr. Qamar Khan
Pain Management
4 doctors agree
In brief: Head/Neck Muscles
Generally there are muscles in the head and neck that are treated to give your relief from your migraines.

In brief: Head/Neck Muscles
Generally there are muscles in the head and neck that are treated to give your relief from your migraines.
Dr. Qamar Khan
Dr. Qamar Khan
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Dr. David Rosenfeld
Pain Management
3 doctors agree
In brief: 31 sites total
The recommendation to cover all sites is 31 injections of 5 units each.
This is not a cosmetic procedure. There are clear points in the neck and occipital plus the temporal muscles and forehead that need to be injected.

In brief: 31 sites total
The recommendation to cover all sites is 31 injections of 5 units each.
This is not a cosmetic procedure. There are clear points in the neck and occipital plus the temporal muscles and forehead that need to be injected.
Dr. David Rosenfeld
Dr. David Rosenfeld
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Dr. David Rosenfeld
Pain Management
1 doctor agrees
In brief: 31 sites
To completely treat all possible sites a total of 31 injections are performed.

In brief: 31 sites
To completely treat all possible sites a total of 31 injections are performed.
Dr. David Rosenfeld
Dr. David Rosenfeld
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Dr. Tapan Joshi
Pain Management
1 doctor agrees
In brief: Head muscles
Depend upon the distribution of headache.
.........Mostly in temporal, frontal muscles are included rest depend upon the distribution.........

In brief: Head muscles
Depend upon the distribution of headache.
.........Mostly in temporal, frontal muscles are included rest depend upon the distribution.........
Dr. Tapan Joshi
Dr. Tapan Joshi
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Dr. David Rosenfeld
Pain Management
In brief: Well defined sites
There are 31 defined sites to completely cover the involved muscles in the neck and scalp.

In brief: Well defined sites
There are 31 defined sites to completely cover the involved muscles in the neck and scalp.
Dr. David Rosenfeld
Dr. David Rosenfeld
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Dr. Tad Heinz
Surgery - Plastics
In brief: Trigger points
These migraine triggers need to be localized with the patient so the Botox can eliminate the starting focus of the headache.
This may be just right or left of the medial brow, in the corrugator muscle, or in the occipital muscles at the nape of the neck. Dosages in the 20 to 40 unit range have been effective for 3 to 6 months for my patients.

In brief: Trigger points
These migraine triggers need to be localized with the patient so the Botox can eliminate the starting focus of the headache.
This may be just right or left of the medial brow, in the corrugator muscle, or in the occipital muscles at the nape of the neck. Dosages in the 20 to 40 unit range have been effective for 3 to 6 months for my patients.
Dr. Tad Heinz
Dr. Tad Heinz
Thank
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