Injections for Migraine headaches
Neuromodulator (NM) treatment (therapeutic Botox) for Migraine Headaches
Neuromodulator (Botox) was approved by Health Canada for treatment of chronic migraines in 2011, specifically for adults who experience migraine headache symptoms on 15 or more days per month for 3 months, with at least 8 of those being migraines lasting at least 4 hours.Neuromodulator is a preventative treatment that can reduce frequency and severity of migraine headaches by blocking pain signals sent by sensory nerves in the head and neck.Treatment involves multiple injections in the head and neck into specific muscles (the PREEMPT protocol) every 12 weeks. The PREEMPT protocol is a specific dosing pattern for Botox, scientifically studied and proven to be effective for most patients in reducing frequency and severity of migraine headaches. Neuromodulator is injected into the glabella (frown muscles), frontalis (forehead muscle), temporalis muscles (lateral head muscles), occipital muscles (posterior head muscles), paraspinal muscles of the posterior neck, and trapezius muscles of the shoulders. Some patients notice an improvement after the first treatment, but significant improvement often occurs by the third session. Treatments every 12 weeks are needed to maintain relief. Treatment has not been shown to be effective for episodic migraine, only for chronic migraine.Side effects and risks are temporary but may include:
Tenderness, redness, swelling, or bruising at injection sites
Neck pain or stiffness
Initial increase in headaches
Flu- like symptoms (rare)
Asymmetry of brows
Heaviness of brows
Drooping of eyelid (ptosis)
Rarely visual problems, trouble speaking or swallowing, or difficulty breathing.
Eligibility, Coverage and Cost:
In Saskatchewan, the provincial health plan does not offer coverage for treatment.
Private health plans may cover all or part of the costs associated with the treatment of chronic migraine headaches.
Many insurance companies require that you have tried and failed other preventative medications before approving coverage for Botox and will require documentation of medications tried as well as the dates trialed.
Most insurance companies do not cover the injection fee, which is paid at the time of your treatment.
There may be a manufacturer support “co-pay” program that the pharmacy will help you access if eligible.
The neuromodulator (Botox) that is provided by your secondary health insurance is not intended for cosmetic use, only for therapeutic purposes in the treatment of chronic migraine headaches.
If you also wish to use a neuromodulator for cosmetic purposes, you can book it separately and pay for the cosmetic treatment in a separate transaction from your therapeutic appointment. Please review our information regarding cosmetic neuromodulators for treatment of fine lines and wrinkles.
At Midwest Laser Centre we provide therapeutic Botox treatment for chronic migraine headaches for those individuals who have been previously diagnosed with chronic migraine headaches. A referral by your family physician or neurologist is required.
An appointment is booked with the physician at Midwest Laser Centre to explain the treatment, side effects and risks, and to review your medical history, as well as fill out insurance forms.
Please bring to this appointment a detailed history of current and previous treatments you are using for migraines, including dates (you can find this on your Saskatchewan health record online).
Please bring your secondary health insurance forms.
A prescription for therapeutic Botox will be sent to the pharmacy, which sends the Botox directly to Midwest Laser Centre following a cold chain protocol to ensure its integrity.
After your secondary health insurance provider has approved coverage (usually about three to four weeks) we book an appointment for your first treatment at Midwest Laser Centre .
Common Questions
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Botox is approved for adults with chronic migraine, which means experiencing headaches on 15 or more days per month, with migraine features on at least eight of those days.
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Many patients experience fewer headache days, reduced migraine severity, and improved quality of life. Results vary, but most people notice a meaningful reduction in migraine frequency after a series of treatments.
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Some patients notice improvement within a few weeks, but it often takes two to four weeks to begin seeing benefits. Maximum improvement may not occur until after two to three treatment cycles.
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A typical migraine treatment involves 31 small injections placed in specific areas of the forehead, temples, back of the head, neck, and shoulders. The procedure usually takes about 10 to 20 minutes.
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Most patients describe the injections as a brief pinching or stinging sensation. The needles used are very small, and discomfort is generally mild and short-lived.
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Botox treatments for migraine are typically repeated every 12 weeks. The effects gradually wear off over time, so regular treatments are needed to maintain benefits.
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Common side effects include:
Neck pain or stiffness
Mild headache after treatment
Temporary muscle soreness
Injection site discomfort
Less common side effects include eyelid drooping or muscle weakness, which are usually temporary.
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When administered for migraines using the approved treatment protocol, the goal is migraine prevention—not cosmetic changes. Some patients notice a smoother forehead, but most retain their normal facial expression.
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In most cases, yes. Botox can often be used alongside preventive and rescue migraine medications. Your healthcare provider will review your medications and develop a treatment plan that is right for you.
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Many insurance plans cover Botox for chronic migraines when specific criteria are met. Coverage requirements vary and may include documentation of headache frequency and previous treatment attempts.
There are two parts to the cost of treatment – the portion of the cost of Botox not covered by your insurance is paid to the pharmacy, and a $250.00 injection fee is also paid at the time of each treatment.