Every three months, I get Botox for my migraines. My latest appointment is today. I never look forward to getting the injections, but I do look forward for the results. Typically, Botox is injected into muscles of the forehead, scalp, neck and shoulders. It’s not that pleasant of a procedure, but it usually takes about five minutes.

Exactly why Botox works is not known, but it’s believed that the injected Botox is absorbed by pain receptors in the muscles’ nerves. The medication then deactivates those pain receptors and blocks pain signals that the nerves send to the brain, that’s why the procedure is officially known as denervation. Those nerves in the head that cause migraine pain are basically turned off for a period of time.

Migraine pain does not go away permanently, however. After several months, the nerves sprout new pain fibers, and the headaches tend to return. The Botox effect usually lasts about 2½ months, which is why I’ve had an increase in migraines for the past two or so weeks. Some migraine specialists will give the Botox injection every 2-2½ months, but my neurologist does not do this because eventually, the bodies immune system adapts to the Botox and makes the procedure ineffective. By keeping it to 3 months, they are prolonging the long term effectiveness of the Botox.

The injections are mostly not that painful, just a quick prick, except for those in the back of the head, those hurt a lot because they are given closest to the occipital nerve. However, the injections become more painful over time. As the nerves sprout new pain fibers, they become more sensitive each time they come back. This makes the procedure more painful each time it’s performed. No matter how much it hurts for the five minutes of the procedure, it’s worth it for the lessening of the migraine pain for most of the 3 months until the next set of injections.