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The sudden onset of a migraine means a dark room, bed and a cool towel for many sufferers. It probably means the end to the possibility of having a productive day, as well. Now, think of the consequences on your life if you suffer chronic migraine – a condition defined as having a headache 15 or more days a month with at least eight of them considered a migraine. That’s a lot of productivity lost and a lot of pain felt.

In an effort to help those who suffer from chronic migraine, RiverView Health recently began offering Botox injections by Pain Management Specialist Panjini Sivanna, MD. Dr. Sivanna, who has practiced at RiverView for the past 10 years, offers Botox injections at RiverView’s Specialty Clinic in Crookston.

Botox has been in the news since 2002 when it was approved by the Food and Drug Administration (FDA) to temporarily treat cosmetic issues from frown lines to crow’s feet in adults. Along with helping erase unwanted lines and wrinkles, patients began to realize their Botox injections were also helping with their frequent migraines. In 2010, Botox was approved for the treatment of chronic migraine.

Beyond a Headache

A migraine is much more than a bad headache. A migraine is a neurological disease with extremely incapacitating symptoms, including severe throbbing recurring pain, visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Attacks usually last between four and 72 hours.

In the U.S. more than 39 million men, women and children are affected by migraines and one billion worldwide. Eighty-five percent of chronic migraine sufferers are women. Migraines also tend to run in families; about 90 percent of migraine sufferers have a family history of migraine.

According to statistics by the Migraine Research Foundation, 90 percent of sufferers are unable to work or function normally during their migraine, which leads to healthcare and lost productivity costs associated with migraine estimated to be as high as $36 billion annually in the U.S.

Depression, anxiety, and sleep disturbances are common for those with chronic migraine.

Many people find that there are usually some signs that a migraine attack is on its way. The signs can reveal a pattern in symptoms and provide preventative tools for managing migraine. Identifying your triggers will bring you closer to effectively managing your migraines and avoiding future attacks. While everyone has different triggers, a few common culprits affect a large number of people living with migraine. Some common triggers according to Johns Hopkins University include:

• Alcohol
• Weather changes
• Lack of sleep
• Schedule changes
• Dehydration
• Hunger
• Certain foods
• Strong smells
• Teeth grinding at night
• Menstruation

15 Minutes Every Three Months

Botox is the first FDA-approved preventative chronic migraine treatment.

“There are a number of scientific papers confirming the usefulness of Botox injections for headaches,’’ shared Dr. Sivanna, a physician of 43 years. “I’ve seen it help a lot of people, more than two-thirds who try it.’’

Botox is a form of botulinum toxin, a neurotoxin produced by the bacteria that causes botulism. When the Botox botulinum toxin is purified and used in tiny doses in specific areas, it temporarily reduces muscle contractions for approximately three months. Botox is reported to prevent eight to nine headache days and migraine/probable migraine days a month.

Treatment only takes about 15 minutes and is done in a regular clinic exam room. Dr. Sivanna uses a very fine needle and injects Botox into shallow muscles in about 25 sites on the neck and head just beneath the skin. If you are prone to migraine on one side of your head more than the other, as most people are, he will concentrate on that side. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.

Botox prevents migraine headaches before they start, but takes time to work.

“Three treatments are given three months apart,’’ he shared. “Some patients feel improvement a few weeks after the first treatment. For some it takes longer. If no relief is felt after three months, we do not continue treatment. Treatment is continued about every three months for those who experience relief from Botox.’’

The most common side effect to the Botox treatment is neck pain.

Botox for chronic migraine is covered by most insurance.

If you suffer chronic migraine and would like to see Dr. Sivanna you must first get a referral from your health care provider or chiropractor. Once you have a referral, call RiverView’s Specialty Clinic at 218-281-9553 to make an appointment.

Pictured above: Dr. Sivanna gives a Botox injection. Pictured below: Dr. Panjini Sivanna.