Botox for Muscle Spasms?

Also, if you don’t mind me asking… who does that type of Botox for you? Neuro, pain management? And how different is it from typical migraine protocol? Like where the shots go for this?

Hey Dana! Oh hun- I'm so sorry to hear about these neck/trap issues you are having. Also so glad I can be of any help! Wild they can be seen under your skin! Are you saying you think they are related to or exacerbated by the migraine stuff? Or both? Cervical dystonia is sort of like that- it can be a free-standing condition but it is also known to be tied to migraine quite frequently. But I TOTALLY relate re: the pain being sometimes worse related to the neck than the migraine itself.

I wonder if you should be evaluated for cervical dystonia. I ask because Botox has been "cleared" (like researched/reviewed and cleared) to be used clinically for migraine and cervical dystonia (as well as for some other conditions). You asked a great question re: protocol because there are different protocols for each condition.

As to my doctor who does the procedure- he's a migraine specialist who went for additional training for cervical dystonia. So, he gives me BOTH types of injections in terms of location/protocol. Basically, it starts behind the ear (just about - around the occiput) and then goes all the way down the upper trap out toward the shoulder (maybe a couple in the mid trap? not sure...). He does some range of motion exercises with my head each time to see where I'm at in terms of spasms/tightness - then uses a longer needle in my right side- mid-neck- hard to describe but I'd say halfway down my neck between my earlobe and collarbone - and goes in with that deeper needle with a pretty good dose there. I think that part is fairly custom-placed and related to where you're holding tightness. I had to be diagnosed with cervical dystonia for this to be covered by insurance, btw.

I guess I'm not sure how frequently a migraine specialist also is qualified with the cervical dystonia (CD) thing. Either of your doctors will know about CD. I hope this info may help you. Maybe it was a matter of placement of the injections. Fingers crossed! Please let me know what they say. I'd be most interested to hear. Though I wouldn't wish this on anyone- so glad to be connected with you. Sending love! - Holly (migraine.com team).

Melissa, what type of doctor does these injections? Is it a physiatrist?

Hey Dana. In my case, it was an orthopedic surgeon. I'm not sure what kind of doctor would do Botox in your case, it's not something I'm familiar with. My suggestion would be to start the conversation with your neurologist or whoever is treating your migraine, since Botox if something they often do. If a different kind of specialist is recommended, they'd be able to point you in the right direction. -Melissa, team member