At Central CosMedic, Dr Danielle Waxman offers assessment and preventive treatment for chronic migraine, for patients across Havelock North, Hastings, Napier and the wider Hawke’s Bay.
Living with frequent migraines can affect work, family life and your ability to plan ahead. For people with chronic migraine, migraine injections are one option that may reduce how often migraines happen. This page explains who the treatment is for, how it works and what to expect.
Chronic migraine is when you have headaches on 15 or more days a month, with at least 8 of those having migraine features, for more than three months. Migraine symptoms can include throbbing head pain, nausea, and sensitivity to light and sound.
Chronic migraine is different from occasional migraines or everyday tension headaches, and it is managed differently. A careful assessment is the first step to finding the right approach for you.
This treatment involves a series of small injections of a prescription medicine into specific muscles of the head and neck. It is thought to work by calming the nerve pathways involved in migraine pain, particularly those in the trigeminal nerve system, which plays a key role during a migraine attack.
Because it is a prescription medicine, treatment is only available after a consultation with a doctor. It is used to help prevent migraines rather than to treat a migraine that has already started, and it usually works alongside your other migraine care rather than replacing it.
Injections are given at set points across areas that commonly hold tension or are involved in migraine, which may include:
Treatment is only offered after a consultation, and only when it is a sensible option for you.
Dr Waxman takes a full health history, including any medications you take and other treatments you have tried, and asks about the pattern of your headaches.
She checks whether your symptoms fit chronic migraine, whether anything else should be looked at first, and whether this treatment is right for you. Keeping a headache diary beforehand can be helpful.
You will hear the potential benefits, risks and side effects in plain terms, along with the costs, before you decide anything.
If you go ahead, you agree a plan together, including how you will track your headaches and when to review how the treatment is working.
An appointment usually takes around 20 to 30 minutes. A number of small injections are given with a fine needle, and most people feel only a brief sting with each one. You can usually return to your normal activities straight away.
The effect usually starts within 3 to 12 days, with the full effect around 7 to 10 days after treatment. It wears off gradually, and treatment is usually repeated every 3 to 9 months. Responses vary, and it can take more than one round of treatment to see whether it is helping, which is why tracking your headaches is useful.
Common side effects include tenderness or bruising where the injections were given, a mild headache, and neck pain or stiffness. Less commonly, some people notice temporary muscle weakness, such as a drooping eyelid or eyebrow. These effects wear off as the treatment does.
This treatment is not suitable for everyone, including during pregnancy or breastfeeding, or for people with certain nerve or muscle conditions. Your health history is reviewed before anything is recommended, and Dr Waxman will talk through the risks and potential benefits so you can make an informed decision. If you have any concerns after treatment, contact the clinic. If you have a sudden, severe headache that feels different from your usual migraines, seek urgent medical care.
Botulinum toxin injections are prescription medicine for the treatment of frown lines, horizontal forehead lines and crow’s feet round the eyes. Botulinum toxin injections have risks and benefits. Ask your doctor if botulinum toxin injection is right for you. If you have side effects, see your doctor. You will need to pay for your botulinum toxin injection and clinic fees will apply. For details on precautions & side effects consult your doctor or go to www.medsafe.govt.nz. Botulinum toxin injections lasts about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals.
