What to Expect from BOTOX® Treatment for Chronic Migraine
How BOTOX® for Chronic Migraine Is Administered
BOTOX® is a Health Canada–approved treatment for chronic migraine relief in adults who experience 15 or more headache days per month. At Chinook Medical Centre, we provide in-clinic BOTOX® treatments designed to help prevent migraines before they start.
Each session typically lasts 10 to 15 minutes and involves 31 small injections across 7 muscle areas in the head and neck — including the forehead, temples, scalp, upper neck, shoulders, and notably the trapezius muscles. These injections use a fine needle, and most patients describe the sensation as light pinches.
The standard dose is 155 units, but in many cases, healthcare providers optimize dosing up to 195 units by administering additional injections based on the PREEMPT protocol to target predominant pain areas. Treatments are administered every 12 weeks, and patients can return to normal activities shortly after.
When Will I See Results from BOTOX® Migraine Treatment?
Most patients begin treatment with at least 3 cycles spaced 12 weeks apart to fully evaluate BOTOX® efficacy. Many individuals notice initial relief within 4 to 6 weeks after the first treatment, with full therapeutic benefits typically apparent by week 24, after the second or third treatment.
Clinical studies show BOTOX® reduces headache days by 8 to 9 days per month on average for chronic migraine sufferers. In addition to fewer migraine attacks, patients often experience less severe pain, reduced need for acute medications, better response to other treatments, and improved tolerance to migraine triggers.
At Chinook Medical Centre, we personalize your treatment plan to suit your migraine history, symptoms, and goals — ensuring compassionate care throughout.
Frequently Asked Questions
What are the key facts about BOTOX® and Chronic Migraine?
Chronic migraine is defined as experiencing 15 or more headache days per month, with at least 8 days showing migraine characteristics. Since its approval in Canada in 2011, BOTOX® has helped over a million people manage chronic migraine worldwide. At Chinook Medical Centre, treatments typically take about 10 to 15 minutes and are offered every 12 weeks. Dosing may be optimized between 155 to 195 units based on individual patient needs and the PREEMPT protocol.
What is BOTOX®?
BOTOX® (onabotulinumtoxinA) is a purified protein derived from natural sources and is a Health Canada–approved preventive treatment specifically for chronic migraine. Unlike acute medications that treat symptoms after a migraine starts, BOTOX® works preventively by blocking nerve signals that trigger migraine attacks, helping to reduce headache frequency and severity.
How is BOTOX® different from other treatments?
BOTOX® is one of the few preventive therapies specifically approved for chronic migraine and is administered every 12 weeks. It has been shown to reduce headache days by an average of 8 to 9 days per month. Treatments are done safely in clinic settings like Chinook Medical Centre, where dosing can be personalized—starting with 31 injections (155 units) and, if needed, up to 40 additional units for pain areas including the trapezius muscles.
Could BOTOX® be right for me?
If you experience chronic migraine with 15 or more headache days per month, preventive treatment such as BOTOX® may be suitable. Many patients with episodic migraine may also require preventive therapy depending on the severity, disability, and impact on quality of life. Consult a physician at Chinook Medical Centre to determine if BOTOX® is right for your individual needs.
What is BOTOX® treatment like?
A typical treatment session lasts about 10 to 15 minutes and involves 31 small injections across 7 muscle areas in the head, neck, shoulders, and trapezius muscles. Injections use a fine needle and patients often describe them as mild pinpricks. Treatment is performed at Chinook Medical Centre, starting with at least 3 treatment cycles spaced 12 weeks apart to properly evaluate effectiveness, followed by maintenance treatments every 12 weeks.
What is a BOTOX® appointment like?
During your appointment, a trained healthcare professional will deliver the injections targeting migraine-related muscles, including additional areas as needed following the “follow the pain” protocol. Most patients report the injections feel like minor pinpricks, and you can resume daily activities immediately after.
What are injections like?
Injections use fine needles placed just under the skin into shallow muscles. The procedure is quick and generally well tolerated. Chinook Medical Centre ensures a comfortable and professional experience.
Can I still take acute medications?
Yes. Acute medications can be taken alongside BOTOX® if recommended by your healthcare provider, to manage migraine attacks that occur despite preventive treatment.
Will BOTOX® help with anything else?
While BOTOX® is approved and administered for chronic migraine, it is also used for other medical conditions. At Chinook Medical Centre, injections for migraine target specific muscles known to contribute to headache pain.
When will I feel results?
Some patients notice initial improvement within 4 to 6 weeks of the first treatment. Full benefits are typically achieved after 2 to 3 treatment cycles (approximately 24 to 36 weeks). Consistent treatment is important to maintain results.
Why is it important to stay on schedule?
Maintaining regular treatments every 12 weeks is crucial for sustaining migraine prevention. Chinook Medical Centre helps patients stay on track by scheduling follow-up visits at the time of treatment.
What should I know about safety?
The most common side effect is neck pain. Other less common effects include temporary muscle weakness or mild discomfort at injection sites. It is important to discuss your medical history and any concerns with your Chinook Medical Centre provider before treatment.
What is the difference between migraine and chronic migraine?
Chronic migraine involves 15 or more headache days per month, each lasting 4 or more hours, with migraine symptoms on at least 8 of those days. Episodic migraine occurs less frequently. Both can significantly impact quality of life, and many patients with episodic migraine may also require preventive therapy depending on severity and disability.
Why should I see a specialist at Chinook Medical Centre?
Our physicians specialize in migraine care and provide personalized treatment plans based on your symptoms and history. Seeing a migraine-focused provider helps ensure you receive the most effective and up-to-date therapies.
What should I share with my doctor?
Track your headache frequency, duration, severity, and impact on daily life. Share all current and past treatments, including acute and preventive therapies. This information helps your provider create the best care plan tailored to your needs.
Does insurance cover BOTOX®?
Most insurance plans cover medically necessary BOTOX® treatment for chronic migraine. Chinook Medical Centre staff can assist you with insurance verification and questions during your consultation.
How much does it cost?
Costs vary depending on insurance coverage and individual plans. Our team can help you understand your benefits and any potential out-of-pocket expenses before treatment begins.
What is the difference between acute and preventive treatments?
Acute treatments are taken to relieve migraine symptoms after they start. Preventive treatments, like BOTOX®, are administered regularly to reduce the frequency and severity of migraine attacks before they begin. For more patient resources, visit Migraine Canada or the unbranded site MigraineHelp.ca.
For detailed medical information, see the BOTOX Therapeutic Product Monograph.
Meet the Team
At Chinook Medical, we’re more than just a team of professionals – we’re a dedicated family driven by our passion for healing and our commitment to exceptional patient care.
Dr. M. EMADI
MD, CCFP
Dr. Rania Hanna
MD, CCFP
Dr. Zahra Mirkarimi
MD, CCFP
Dr. Anas Al-Adhami
MD, CCFP
For detailed medical information, see the BOTOX Therapeutic Product Monograph.
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