The injected toxin hailed as a method to erase face wrinkles can also soothe headaches, indicate studies presented at a U.S. medical conference. It is called botulinum toxin type A, or Botox for short. But many headache sufferers might call it a miracle.
Botox is a purified form of the toxin that causes botulism food poisoning. Several studies presented at a recent American Headache Society conference in Seattle, Washington show that injections into the head, neck and shoulders eliminate pain in many cases where other medications fail.
Physician Todd Troost of Wake Forest University School of Medicine in North Carolina said one of Botox's biggest advantages for his patients is its lack of side effects compared to other treatments. "They had essentially no side effects, and we find now that this will probably be our main treatment for people with chronic daily headaches unresponsive to other treatment regimens," Dr. Troost said.
In Dr. Troost's study, 134 people with previously untreatable headaches, either migraines, chronic daily headaches or tension headaches, Botox injections every three months. Overall, 84 percent reported improvement.
At the Houston Headache Clinic in Texas, 112 patients given Botox experienced a 75 percent drop in the number of days with pain. Mayo Clinic research in Scottsdale, Arizona found that more than half of 48 migraine patients experienced a 50 percent or greater reduction in disability after Botox injections.
Another Houston study, this one at Baylor College of Medicine, compared Botox injections with water injections as placebos in two groups of people for 12 weeks. The study leader, Dr. William Ondo, said 53 percent of the Botox recipients reported at least moderate improvement compared to just seven percent in the water group.
"So our overall conclusion was that for these patients with chronic daily headaches, who are generally considered to be the most difficult headache patients to treat, the botulinum toxin injections seem to improve many of these patients and appear to be quite safe," Dr. Ondo said.
Researchers have also learned that more Botox appears to be better than less. Participants in the Wake Forest University study received from one to four injections. While overall, 84 percent of the patients got relief, Dr. Troost said the figure climbed to 92 percent for those who got four shots.
"It seemed to be very effective in some people, particularly when we did multiple injections," Dr. Troost said.
But Mayo Clinic researcher Eric Eross found that while some patients made great progress in his study, others made none, suggesting that Botox is not for everyone. He also found that frequent use of other pain medications at the same time can interfere with Botox's effectiveness.
"We know that in other studies with other prophylactic agents, analgesic overuse can warrant a prophylactic agent ineffective. So we wanted to see if that was the case with Botox as well. So we compared those patients who were not overusing analgesics to those folks who were overusing analgesics. We found out that you are three-and-a-half times more likely to respond to Botox if you are not overusing an acute medication," he said.
Botox helps headaches the same way it smoothes facial wrinkles. It relaxes muscles. The doctors have said it also works another way, by blocking the action of a substance that is associated with pain.
Botox is as tough on the budget as it is on headaches. Each injection costs $1,000, but medical insurance often covers the treatments in the United States.