Can Botox Help Your Headaches?

Plagued by headache pain? New research suggests that Botox injections might benefit people who suffer from low cerebrospinal fluid (CSF) headaches -- a very specific condition. But the study also opens up the possibility that Botox is more broadly applicable in treating serious headaches than previously thought.

The study, co-written by Michal Cutrer, M.D., a Mayo Clinic neurologist, centered on a patient who had suffered from CSF headaches for more than 20 years. With CSF, headaches are caused by internal spinal fluid leaks, which lower the pressure in part of the brain and cause it to sag downwards when the patient is standing or sitting upright.

Though pain levels range from person to person, the patient from the Mayo Clinic study had dealt with debilitating headaches for half her life.

“She had extremely intense pain that would only improve when she lay flat,” Cutrer explained, “So she really had been disabled for years, and had been to many, many doctors.”

In search of something that would help, Cutrer began giving the patient Botox treatments. The effects, he said, were startling.

“Quite amazingly, the intensity of the headaches went from a disabling level of eight out of 10 on a visual pain scale, to three out of 10,” Cutrer reported. “That’s not pain-free, but she was able to function.”

Botox did not serve as a cure for the patient's headaches and Cutrer explained that her treatment will have to continue indefinitely; once she stops, the pain could return. But in his opinion, the outcome of the case study is encouraging.

“The implication for me is that we’re probably dealing with a non-specific treatment -- a treatment that’s more broadly applicable than just for chronic migraines,” he said. The Food and Drug Administration approved Botox injection for sufferers of chronic migraine, or people who have migraine on most days of the month, in 2010.

Botox made headlines earlier this week when its manufacturer, Allergan, settled for $212 million in a case relating to brain damage in a 67-year-old man. And concerns have been raised about the safety of the drug in the past.

But in speaking about his study specifically, Cutrer said that he believes a potential benefit of Botox is that it is relatively benign, at least in comparison to some of the other options facing people who deal with extreme headaches.

“In working on treating people with headaches for so long, I’ve had to deal with much heavier drugs,” he said. “In my experience, this has been one of the treatments that doesn’t appear to come with many systemic side effects.”