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Nerve Block vs Botox for Migraine: Which Works Best?

A chronic migraine headache is a disorder where a person feels a pulsating sensation in one or both sides of the head for more than 15 days. It may be a result of external stressors or inflammation of the blood vessels and release of chemicals that trigger pain sensation. While medications can help, pain management with nerve block procedures and Botox injections may provide better and longer relief.  

But between an occipital nerve block and Botox treatment, which works best for chronic headache pain? Botox is a preventive treatment that blocks nerve endings from sending pain signals to the brain. Nerve block injections target the greater occipital nerves to suppress pain that is felt at the back of the head and neck. Both are effective pain relief methods but choosing the right treatment will depend on the assessment of your doctor on your migraine symptoms.

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Comparison of Nerve Block and Botox as Migraine Treatment 

The management of migraine pain may differ based on the symptoms that a person experiences during a migraine attack. In some cases, migraine medication and prescription drugs are enough to repress the dull ache and throbbing feeling for a temporary period. But when the traditional approaches don’t seem to work, a headache specialist may suggest getting nerve blocks or Botox.

A nerve block is also known as a greater occipital nerve block or peripheral nerve block. As its name suggests, the treatment controls pain that originates from inflamed or damaged nerves. When used for migraine treatment, the procedure involves a shot of medications, local anesthetic, and steroid injection into the greater occipital nerve.

The goal of a nerve block is to temporarily shut down the nerves from processing pain signal indicators. The common targets are the greater and lesser occipital nerve which are located at the back of the neck area just above the spinal cord. It can also affect the trigeminal nerve which causes myofascial pain as another sign of migraine.

Using a nerve block for a chronic headache disorder helps as an acute and preventive therapy. It functions as an acute treatment to stop headache from worsening and provides instant relief that can last for days to weeks. It’s also effective for migraine prevention since the injection can decrease pain transmission which in turn reduces the recurrence of severe headache.   

On the other hand, a Botox treatment requires sessions of botulinum toxin injection to the muscle areas in the head and neck. For years, Botox has been widely used in therapeutic medicine for cervical dystonia, neck and muscle spasm, excessive sweating, and overactive bladder.

It was first used for chronic migraine back in 2010 where a group of researchers sampled the botulinum toxin type A (Botox) injection to migraine patients. It is said that the neurotoxin can block the pathways of chemicals responsible for pain signals so they won’t reach the nerves in the head and neck. Their trial showed that a migraine sufferer who received Botox had drastically improved their condition with a lesser number of headache days.

Today, Botox is offered as a preventive migraine treatment. Patients will need an average dose of 155 Botox units injected intramuscularly into seven treatment areas. The injection sites are found in the forehead, the top of the nose bridge, the temples, the neck, the back of the head, and above the shoulder blades at the back.

Which Migraine Types Do They Treat?

Nerve blocks and Botox don’t work for the same migraine headache types. A chronic migraine headache is a form of primary headache that occurs over the same period for more than 15 days per month. Meanwhile, an episodic migraine is usually the diagnosis for headache that lasts for no more than 15 days and can be caused by extreme stress and fatigue.

Botox has only been approved for the chronic migraine type. Studies are still ongoing about its efficacy for episodic headache, tension headache, and cluster headache (localized headache pain that occurs in cluster periods).

An occipital nerve block is the primary treatment for occipital neuralgia which is a condition when the occipital nerves are injured or irritated. People with occipital neuralgia often experience a disabling head pain that shoots from the neck to the top of the skull. Nerve blocks may also treat a cervicogenic headache where throbbing pain accompanies sudden movements of the neck.

Finding the Best Migraine Headache Treatment 

The good thing about nerve block and Botox treatments is that they are safe, effective, and nonsurgical procedures for migraine management. Compared to a nerve decompression which is considered as a migraine surgery, nerve block and Botox only require injections to targeted areas to relieve pain.

But before proceeding with a procedure, it’s best to first weigh the pros and cons of each treatment to help determine whether they are right for you:

Nerve blockInstant pain relief since injections can immediately take effect within a few minutes Can be used in between Botox treatments for migraine Can lessen the need for daily migraine medications Results can last for several months Injection site reactions such as soreness, bruising, and bleeding Slight dizziness after the procedure Risks of infection and allergic reaction to the medication
BotoxNo downtime Effectively cuts down on the frequency of migraine days Can be used for long-term migraine therapy Results can last for several monthsMay take 2 to 4 weeks to feel the relieving effects Comes with minor pain and swelling at the injection site May also experience neck pain, muscle weakness, and slight headache as a side effect Rarely, adverse effects may include droopy eyelid, allergic reaction, difficulty breathing and speaking

People with migraine induced by occipital neuralgia may get nerve block injections three to four times per year (depending on doctor’s recommendation). Meanwhile, Botox is typically administered to first-time patients in 2 treatment sessions which are 12 weeks apart. If you’re reacting positively to Botox, your doctor may then suggest getting injections for 4 times a year to maintain its effects.

Learn more: What You Should Know About Treating Migraines With Botox

Get Quality Face, Body, and Wellness Treatments at aNu Aesthetics 

Migraine prevention starts by minimizing your exposure to triggers and stressors, as well as adapting to a healthy lifestyle. Treatments like nerve block and Botox can also help repress chronic pain and migraine symptoms that can affect your productivity and quality of life.

Here at aNu Aesthetics, we offer a wide range of medical spa and wellness services to help our clients achieve their cosmetic goals and maintain their optimal health. We prioritize the safety of our patrons and guarantee that every treatment and injection are done properly by our trained doctors. Call us now to inquire more about our products and services.

Say Goodbye To Your Wrinkles and Fine Lines

With just a few simple injections, our providers can erase your wrinkles and fine lines in no time with Botox. Call us today to book your appointment.


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