A New Approach to Botox

My recent trip to urgent care for my muscle spasm yielded a very interesting conversation with a fellow migraineur. The doctor who was working at the time happened to be a D.O. who used to have frequent migraines. A quick look at my history revealed my status as a chronic migraineur and so she wanted to tell me about how Botox significantly reduced her migraines.

I explained that I had tried it before and it hadn't been effective. Honestly, I just wasn't interested in having a conversation about it. I was there for my spasm and the matter is quite complicated. But since she's a doctor I heard her out and I'm glad that I did. 

Apparently she had gone to a plastic surgeon long before Botox was being used for migraines and asked to get injections in her specific trigger points. She had discovered on her own that she was able to stop a migraine if she caught it early with an injection of lidocaine into the painful spot where it seemed to manifest from. This gave her the idea to seek out Botox injections in those points for a more long term solution. And it worked.

So instead of getting a prescribed number of injections in prescribed locations she only gets them in her specific trigger points. She emphasized that it has to be given in the exact right spot and she says that as the patient you really know when the doctor is in the right spot because it's pretty painful. She has been doing this regularly for many years and has had continued and consistent positive results.

I am fascinated by this notion. Doctors have been attacking trigger points with various methods as treatment for many years. There are nerve blocks, nerve decompression, topical ointments, acupuncture, acupressure, nerve stimulators, etc. Even traditional Botox as treatment for migraines is centers around these areas. I've heard so many stories from people who have tried Botox with such varied results. Sometimes it works for a while and then stops, or responds differently to each new round and I have to wonder what makes up that difference. I would think the same person, getting the same injections, from the same doctor should get consistent results.

This conversation got me wondering if the difference is that sometimes those injections are better placed than other times. If the doctor is injecting into a prescribed area that isn't relevant to your migraines perhaps it has no chance to work. If the doctor sometimes happens upon the right point that might produce better results. If a precise location is really that important, that could partly explain why experiences can be so varied despite other consistent variables. 

This method has been very effective for this doctor, which certainly doesn't mean it will work for me or you but I think it's worth exploring.

I still have questions. I don't know if my insurance will cover an office visit with this plastic surgeon or if they will cover Botox injections done by him in an unconventional manner. I don't know what it would cost if they don't. I would like to talk with a migraine specialist about this. And I'm super curious what you guys think of it. What do you think?