BOTOX® for Migraines Long Beach: FDA-Approved Headache Relief | Dr. Shahnoos Mahdavi

Hello, My Dears –

If you’re reading this, chances are good that you know the relentless burden of chronic migraines or persistent headaches. The throbbing pain, the sensitivity to light and sound, the nausea, the days lost to darkness: I see you, and I want you to know there is hope.

As a board-certified internist and the director of Novel U Wellness and Med Spa here in Long Beach, I’ve had the privilege of helping countless patients find relief from chronic migraines through BOTOX® treatments. This isn’t just cosmetic BOTOX®: this is FDA-approved, life-changing medicine that addresses the root causes of your migraine pain.

Today, I want to answer the questions I hear most often from my patients about BOTOX® for chronic migraines. My hope is that this guide empowers you with knowledge and perhaps opens a door to the relief you’ve been seeking.

What exactly are chronic migraines, and how are they different from regular headaches?

Chronic migraines aren’t just “bad headaches.” They’re neurological events that can truly dominate your life.

Medically, chronic migraines are defined as having headaches 15 or more days per month, with at least eight of those days meeting migraine criteria. These migraines come with:

• Intense, throbbing or pulsating pain (often on one side of your head)
• Sensitivity to light (photophobia) and sound (phonophobia)
• Nausea and sometimes vomiting
• Visual disturbances called auras (seeing flashing lights, zigzag lines, or temporary vision loss)
• Disability that prevents you from working, socializing, or functioning normally

Regular tension headaches, while uncomfortable, typically present as a dull, pressing sensation without the debilitating symptoms of migraines. If you’re experiencing frequent, severe headaches that significantly impact your quality of life, you may qualify for BOTOX® for chronic migraines treatment.

Q: How does BOTOX® for migraines work? I thought BOTOX® was just for wrinkles!

Many people don’t realize that BOTOX® has extensive medical applications beyond cosmetic use! In fact, BOTOX® received FDA approval for chronic migraine treatment back in 2010 after rigorous clinical trials demonstrated its effectiveness.

Here’s the beautiful science behind it: BOTOX® for migraines works very differently than cosmetic BOTOX® for wrinkles. While cosmetic BOTOX® relaxes muscles to smooth lines, BOTOX® for chronic migraines blocks the release of pain neurotransmitters: specifically something called CGRP (calcitonin gene-related peptide): which plays a crucial role in migraine development.

When we inject BOTOX® into specific head and neck muscles following the FDA-approved protocol, it prevents these pain signals from reaching your brain. We’re essentially interrupting the migraine pathway before the headache fully develops. It’s treating the neurological aspect of your migraines, not just masking symptoms.

This is why BOTOX® for headaches can be so transformative: we’re addressing the root mechanism that triggers your migraines.

What does the BOTOX® for migraines treatment involve? Will it hurt?

BOTOX® for chronic migraines follows a very specific FDA-approved protocol. We administer injections across seven key areas of your head and neck:

• Your forehead (frontalis muscle)
• Your temples (temporalis muscles)
• The back of your head (occipitalis muscles)
• Your neck (cervical paraspinal muscles)
• Your shoulders (trapezius muscles)
• The bridge of your nose (procerus muscle)
• Between your eyebrows (corrugator muscles)

I use very fine needles to inject small amounts of BOTOX. The entire migraine BOTOX® procedure takes about 15 to 20 minutes.

Now, about the pain: I’ll be honest with you, my dear. You’ll feel the injections as quick pinpricks. It’s not comfortable, but most patients find it very tolerable. The needles are incredibly fine, and each injection is brief. If you’re nervous, we can apply numbing cream beforehand, though many patients skip it.

The beautiful part? There’s no downtime. You can return to work, drive yourself home, and resume all your normal activities immediately. We do recommend avoiding strenuous exercise for 24 hours and not lying completely flat for 4 hours after treatment.

The treatment is repeated every 12 weeks to maintain your headache relief.

How long does it take to feel the results from BOTOX® for migraines?

This is so important to understand because managing expectations is crucial for success. BOTOX® for migraines is not like taking an acute headache medication that works in hours. This is preventive treatment, and it takes time.

Here’s the typical timeline:

After your first treatment: You might notice subtle improvements within the first week or two: perhaps your headaches are slightly less intense, or you have a few more good days. However, many patients don’t experience significant migraine relief until after their second treatment at 12 weeks.

By your second treatment (12 weeks): This is when most people start seeing meaningful improvement. Your brain and body are responding to the treatment, and those pain pathways are being interrupted more consistently.

By your third treatment (24 weeks): Most patients who respond to BOTOX® for chronic migraines report substantial improvement: we’re often talking about a 50% or more reduction in monthly headache days! Imagine going from 20 headache days per month to 10 or fewer. That’s life changing for many of my patients!

I always tell my patients: please commit to at least two treatment cycles before deciding whether this therapy is working for you. The wait requires patience, but for so many people, it’s absolutely worth it. The reduction in migraine frequency, intensity, and disability can truly give you your life back.

Does insurance cover BOTOX® for migraines in Long Beach?

Because BOTOX® is FDA-approved specifically for chronic migraine treatment, many insurance plans do cover it when you meet certain criteria.

Typically, insurance companies require:

• Diagnosis of chronic migraines: 15 or more headache days per month, with at least eight headaches classified as being migraines.
• Failed preventive medications: You must have tried and not responded adequately to at least two preventive migraine medications (like beta-blockers, antidepressants, or anti-seizure medications).
• Proper documentation: Your provider needs to document how migraines impact your daily life, work, and functioning.

Your insurance will require what’s called “prior authorization” before approving coverage. We do not file insurance for patients at Novel U Wellness and Med Spa, so you will need to file the insurance paperwork yourself.

Without insurance, BOTOX® for chronic migraines cost typically ranges from $600 to $1,200 or more per treatment session here in Long Beach. However, there are also manufacturer patient assistance programs through AbbVie (the maker of BOTOX®) that can help reduce out-of-pocket costs for eligible patients.

It’s definitely worth exploring your coverage options. Many of my patients are surprised and relieved to discover their insurance covers this life-changing treatment.

What kind of results can I expect from BOTOX® for chronic migraines?

Let me share what the clinical studies show and what I see in my own practice, because the results can be truly remarkable.

In clinical trials and real-world use, patients receiving BOTOX® for migraines typically experience:

• 50% or more reduction in monthly headache days (if you’re having 20 headache days per month, you might get down to 10 or fewer)
• Decreased migraine intensity and severity (when headaches do occur, they’re less debilitating)
• Fewer days needing acute pain medications (less reliance on triptans, NSAIDs, or other rescue medications)
• Improved quality of life and daily functioning (ability to work, socialize, plan activities without fear)
• Reduced disability from migraines (fewer missed work days, canceled plans, or time lost to pain)
• Better sleep quality (less nighttime awakening from headache pain)

I have patients who tell me that BOTOX® for headaches has given them their life back. They can make dinner plans without fear of canceling. They can be present for their children. They can perform at work without constant pain. They can exercise, travel, and live without that dark cloud of the next migraine hanging over them.

Not everyone responds to BOTOX® for chronic migraines: about 70% of patients see significant improvement: but for those who do, it’s often transformative.

Can BOTOX® help with tension headaches and other types of head and neck pain?

Absolutely, my dear! While BOTOX® is specifically FDA-approved for chronic migraines, we see excellent results with other types of head and neck pain as well.

Tension headaches: BOTOX® for tension headaches works by relaxing those chronically tight muscles in your head, neck, and shoulders that create persistent pain. When these muscles stay contracted for extended periods, they trigger headache pain. The neurotoxin treatment breaks that cycle.

Cervicogenic headaches: These are headaches that originate from neck problems: perhaps from arthritis, disc issues, or muscle strain. When we use BOTOX® for neck pain, we target the cervical muscles creating referred pain patterns into your head.

Chronic neck and shoulder tension: Many of my patients carry stress in their neck and shoulders, creating muscle spasms and trigger points that refer pain upward into the head. Neurotoxin injections for muscle pain can provide tremendous relief.

Myofascial pain syndrome: This chronic pain condition involves tight trigger points in muscles. BOTOX® can help relax these areas and reduce pain.

The principle is the same across all these conditions: we’re relaxing chronically overactive muscles that create persistent pain patterns. By interrupting the muscle tension, we break the pain cycle and allow healing to occur.

While some of these uses are technically “off-label” (meaning not specifically FDA-approved for that particular condition), the safety profile and effectiveness are well-established through years of clinical use.

Are there side effects from BOTOX® injections for chronic migraines?

I always believe in being transparent with my patients about what to expect, so let’s talk about side effects honestly.

Common, minor side effects that typically resolve within a few days include:

• Soreness at injection sites (this is the most common)
• Mild bruising or swelling
• Temporary tenderness
• Slight headache (ironic, I know!)

Less common side effects that can occur but usually improve quickly:

• Neck pain or stiffness
• Temporary muscle weakness in the injection area
• Mild flu-like symptoms

Rare side effects include:

• Drooping eyelid if product migrates (this is temporary and resolves as BOTOX® wears off)
• Difficulty swallowing if neck injections affect deeper muscles (very rare with proper technique)

Serious complications are extremely rare when the treatment is performed by a qualified, experienced provider following the proper protocol.

Here’s what’s important: the FDA-approved BOTOX® for migraines protocol is very specific about injection sites and depths. When performed correctly by someone who understands facial and neck anatomy (like a board-certified physician trained in these techniques), the safety profile is excellent.

At Novel U Wellness, your safety is my absolute priority. We review your complete medical history, discuss any concerns, and I personally perform all injections following proper protocols.

How is BOTOX® for migraines different from taking preventive migraine medications?

This is such an important comparison, my dear, because understanding your options empowers you to make the best decision for your health.

Traditional preventive migraine medications (like beta-blockers, antidepressants, or anti-seizure medications):

• Taken daily as pills
• Work systemically throughout your entire body
• Can cause side effects like fatigue, weight gain, cognitive fog, dizziness, or mood changes
• Require remembering to take medication every single day
• May interact with other medications you’re taking
• Can take weeks to months to determine effectiveness

BOTOX® for chronic migraines:

• Administered every three months (just four times per year)
• Localized treatment targeting specific pain pathways
• Side effects are typically mild and localized to injection sites
• No daily pill to remember
• Fewer systemic effects on your body
• Can be used alongside other treatments if needed

Many of my patients come to BOTOX® for headaches after trying multiple oral preventive medications without success or because they couldn’t tolerate the side effects. Others simply prefer the convenience of quarterly treatments over daily pills.

For some patients, we use BOTOX® in combination with other preventive strategies for comprehensive migraine management. It’s not necessarily an either/or decision: we can create a customized treatment plan that addresses your unique situation.

Who is a good candidate for BOTOX® for chronic migraines?

Let me help you determine if this treatment might be right for you, my dear.

You should consider BOTOX® for migraines if you:

• Experience 15 or more headache days per month, with at least 8 being migraines
• Have tried at least two preventive migraine medications without adequate relief
• Find that your migraines significantly impact your work, relationships, and quality of life
• Want to reduce your reliance on acute pain medications (triptans, NSAIDs, opioids)
• Are looking for a non-daily treatment option
• Have chronic tension headaches or cervicogenic headaches
• Experience neck and shoulder pain that triggers headaches

You should NOT receive BOTOX® for migraines if you:

• Are pregnant or breastfeeding (we don’t have safety data for these situations)
• Have certain neurological conditions like ALS, myasthenia gravis, or Lambert-Eaton syndrome
• Are allergic to any ingredients in BOTOX® formulation
• Have an active infection at the proposed injection sites

During your consultation at Novel U Wellness, we’ll review your complete headache history, discuss previous treatments you’ve tried, assess your current medications, and determine whether you meet the criteria for BOTOX® for chronic migraines.

I take a holistic approach to your care, looking at all factors contributing to your migraines: stress, sleep, hormones, diet, posture, and more. BOTOX® may be a cornerstone of your treatment, but I also want to address any other contributing factors to give you the best possible outcome.

What should I do to prepare for my BOTOX® for migraines treatment?

I love that you’re thinking ahead, my dear! Proper preparation can help optimize your results and minimize side effects.

Before your appointment:

• Avoid blood thinners if possible: Stop aspirin, ibuprofen, naproxen, and other NSAIDs 3-5 days before treatment (check with me first if you take these for medical reasons). Also avoid supplements like fish oil, vitamin E, ginkgo, and ginger that can increase bruising.
• Stay hydrated: Drink plenty of water in the days leading up to your appointment.
• Wash your hair: You’ll want clean hair and scalp since we’ll be injecting the back of your head and neck.
• Come with a clean face: No makeup on the day of treatment.
• Eat beforehand: Don’t come on an empty stomach: have a light meal or snack before your appointment.
• Bring your headache diary: If you’ve been tracking your migraines, bring that information so we can establish a baseline.

After your treatment:

• Avoid lying flat for 4 hours: Stay upright to prevent product migration.
• No strenuous exercise for 24 hours: Gentle walking is fine, but skip the gym.
• Don’t massage the injection sites: Let the BOTOX® settle exactly where we placed it.
• Stay hydrated: Continue drinking plenty of water.
• Be patient: Remember, results take time. Continue taking your acute medications as needed for breakthrough headaches.
• Track your headaches: Keep a diary of headache frequency, intensity, and any changes you notice. This helps us assess your response to treatment.

Your Journey to Migraine Relief Starts Here

If you’re suffering from chronic migraines or persistent headaches that are stealing your joy and limiting your life, I want you to know that relief is possible. BOTOX® for chronic migraines is FDA-approved, well-researched, and has helped countless patients reclaim their lives from debilitating headache pain.

At Novel U Wellness and Med Spa here in Long Beach, I combine my background as a board-certified internist with advanced training in aesthetic medicine to provide compassionate, comprehensive care. I don’t just treat your migraines: I see you as a whole person, and I’m committed to helping you achieve optimal wellness.

Whether you’re exploring BOTOX® for the first time or you’ve been experiencing migraines for years and would like to explore new options, I’d be honored to discuss whether this treatment is right for you.

Book a consultation with me today. Let’s create a personalized treatment plan that addresses your unique needs and helps you live free from the burden of chronic migraines.

Wishing You Light and Love (and pain-free days!),

Dr. Shahnoos

Board-Certified Internal Medicine
Director, Novel U Wellness and Med Spa
Long Beach, California