Tell us about your symptoms and treatment experience. Take our survey here.

caret icon Back to all discussions

nerve block vs botox

I am considering a nerve block but i just cant make up my mind. I have tried botox 2 seperate times and wonder if maybe I should try it again . I just dont know what to do ,, I have had migraines since I was 3 years old and I and now 63 . Been on everything , had everything done atleast once. Any words out there ?

  1. Hi
    Thank you for reaching out and sharing your journey with us. I understand how frustrating it is to live with migraine disease.

    Botox can be a wonderful management tool - I've been getting it since 2016. For some of us (myself included) it can take three, four, maybe more rounds of Botox before we see an improvement in migraine frequency and severity. While not a cure, Botox can go a long way in helping manage migraine disease. Having a skilled doctor give us the injections is important. There is a specific Botox protocol for migraine, many doctors may claim they are experts at administering it but truly are not. It's frustrating because we want it to work immediately, we just want the pain to stop.

    Nerve blocks are a great option for temporary pain relief. Some people get a few weeks, others a few months. It may be an option to get you over the hump while waiting for another round of Botox.

    Here's the thing - even though it may feel like we've tried everything under the sun to manage migraine, that may not be the case. There are over 100 medications, supplements, devices, complementary therapies and lifestyle modifications that can be used to manage migraine disease and most of us are on a combination of these, I am. The other thing that can have a huge impact in our care is seeing a doctor who is a true expert in treating migraine and headache disease, let me explain. These doctors are different from general neurologists as they are certified in headache medicine, all neurologists are not. General neurologists may be fine doctors but have a hard time being experts in one area because they treat many conditions such as stroke, epilepsy, multiple sclerosis, Parkinson's and more. A true migraine/headache disease doctor treats migraine and headache all day, every day. Here is more information on how these doctors are different and how to find one;
    https://migraine.com/blog/really-find-headache-specialist/
    https://migraine.com/living-migraine/neurologist-vs-specialist
    https://migraine.com/living-migraine/change-thoughts-new-care

    I've given you a lot to go over so I'll stop for now! Will you let me know what you think? You're not alone - we're here for you! Wishing you a low pain day, Nancy Harris Bonk, Patient Leader/Moderator Migraine.com Team

    1. thank you ,,, yes its a lot! I have a dr appt friday to go over my options again, I think i will discuss botox again ! thanks


    2. Ok! Let me know what the doctor says! Nancy Harris Bonk, Patient Leader/Moderator Migraine.com Team

  2. @jagordon,
    Thanks for sharing. We are glad you are here. Nancy gave you some excellent information. Personally, I have never had nerve blocks, so I can't share any words of wisdom on that. I do get Botox injections, and they have been very helpful in managing my migraine symptoms. In my experience, I had to go through about 3-4 rounds of injections before I noticed any real relief. It may be worth giving it some time with Botox. You can talk to your doctor and see what he/she says about nerve blocks vs. Botox. Hopefully, more people will chime in on their experience with nerve blocks.
    Warmly,
    Peggy (Migraine.com team)

    1. I will say Nancy has provided you very good insight on Botox and the importance of finding the right doctor for you. I now have a headache specialist who knows a lot more than my general neurologist. I get both trigger point injections and Botox. I've been getting Botox for over a year now as well as a combination of VYEPTI IV infusions (both preventative medications) with a tiny bit of relief. In between both of those I also receive trigger point injections which are temporary but help with my neck and shoulders at least for a bit of time. I will say though I attempted Botox in 2019 and gave up too soon without giving it a fighting chance to possibly work. I also tried nerve blocks around the time and i didn't have any success with those again maybe not giving them a fair shot either! I am also someone who practically tried it all! I have chronic intractable migraine so for me I'm really just looking for even a little relief day to day. Please remember that everyone's journey is different and what works for some may not work for all. It is definitely great hearing each other's personal experiences. Thanks again for reaching out! I wish you a low pain day! Please let us know how your appointment goes!!
      Best,

      -Kim (Migraine.com Team Member)

      1. I too have been having Botox treatme nts, and was about to give up until the last month (after my 3rd month following my 3rd treatment) when the number of migraines dropped by 50%...from 15 to 16 per month to 8.
        It is so great to have fewer migraines!

        1. Excellent! Very glad you started to see results from Botox injections. You seem to be having fewer episodes and that is definitely progress. I, unfortunately, did not see any improvement with Botox, so I went the route of nerve blocks- so far so good. I have gotten relief which may last 2-3 months then another. My persistent daily headaches, migraines and nerve pain are better. I haven't stopped using abortive medication but certainly have seen fewer migraine episodes. Hope this helps Rebecca (community moderator)

        2. This is good news. I have heard that it can take as long as 4 months to start seeing a difference from Botox, so I'm really glad you were able to see those changes after all that frustrated waiting. I hope you continue to have lasting success with it! -Melissa, migraine.com team

      Please read our rules before posting.