• Dr. Michael Massie

The Treatable Migraine

I’ve lived in Calgary for years now, and I finally feel like I belong because I had my first chinook headache!

As a person who never has headaches, I assumed it was a brain tumour and started mentally planning the distribution of my estate. My brother would get my beloved cactus and my mother would get all my kettlebells (simply because it would be funny seeing her trying to lift them). After the initial panic, a few Tylenol, a trip to the masseuse, and some sinus rinses, I was back lifting the kettlebells myself and moving on with my life in very nice chinook weather.


Unfortunately, not all headaches are so easy to manage. The particularly hard to treat type I see in my practice all the time are migraines. Migraines are a specific subtype of headache that comes with pain to one side of the head, often with nausea, visual changes and difficulty tolerating light and sound. It’s essential to diagnose migraines accurately by these symptoms because often people will conflate the term migraine with a bad headache. There are several types of headaches that can all be severe, including tension, sinus, cluster, rebound, post-traumatic and others. So, just like different types of infections might need different treatments despite all being infections, different types of headaches require different treatments despite all being headaches.


This brings me to the treatment that I do every day for patients with chronic migraines, medical Botox® therapy. You already knew I was going to say this, though, didn’t you? Botox® for headaches isn’t exactly a secret, and people know about it more and more because it works. However, while most people have heard of it, few know what it entails, so that’s what I want to walk you through.


First off, all that patients need to do is book an assessment with me at Rejuvenation. There is no charge for the visit if you have Alberta Health, and we can assess together if you are a good candidate for treatment. We will discuss your symptoms and see if they match a true migraine diagnosis. Then, we can discuss the needs of your insurance provider; typically, they need to know that your headaches have been happening for more than half the days of the month for longer than the last three months. If all those criteria are met, we are good to schedule treatment. We can discuss non-Botox® options as well, but part of the treatment plan will almost surely be the Botox® therapy.


At your treatment visit, we will follow the treatment plan provided with medical Botox®. You can expect several small injections that most patients find only the slightest discomfort with. Patients will receive 3 injections to the area between the eyebrows, 4 to the forehead, 4 to the temples, 3 to the back of the head, 2 to the high neck, and 3 to the trapezius muscle on both sides. If headaches have a particular location within these sites, we will often inject another dose to that site in what we call “Following The Pain”.


After that, you are done! It takes up to 2 weeks for the full effect, and while more than half of patients find improvement after the first treatment, and even higher numbers find development after a second treatment, so planning to commit to two treatments is what I highly recommend. The procedures are spaced three months and one day apart, and consistency provides the best results.


If you feel like migraines are affecting your daily life and you haven’t tried this treatment, you need to come by the clinic. The cost is minimal, and the benefits can be massive for our patients who have been suffering and stuck, taking too many pills without enough relief. Appropriate medical Botox® from one of our skilled providers can honestly be the silver bullet you’re looking for. It’s worth a shot!