Introduction
Migraine botox injection sites aren’t random; They’re a specific set of locations on the head, face, and neck that have the highest potential in creating relief for those who struggle with chronic migraines.
Living with chronic migraine can be exhausting and lonely. If you’re reading this, you may have tried different treatments and still feel stuck in a cycle of pain.
Botox (onabotulinumtoxinA) offers a proven preventive option for many people with chronic migraine. Unlike cosmetic Botox, the migraine Botox injection sites follow a specific medical map designed to calm pain‑related nerve pathways in the head and neck.
This guide explains the injection sites, what happens during treatment, safety tips, and how long it usually takes to feel relief. We want you to know what to expect if you choose Botox for migraines.
1. What Are the Migraine Botox Injection Sites?
For chronic migraine (15 or more headache days a month), Botox is injected at 31 specific spots in seven muscle groups in the head and neck. These migraine botox injection sites are based on the PREEMPT clinical trials, which showed it helps reduce headaches and improve quality of life.
Here is how the usual total dose of 155 units is given:
- Corrugator (between the eyebrows): 2 sites — 10 units
- Procerus (bridge of the nose): 1 site — 5 units
- Frontalis (forehead): 4 sites — 20 units
- Temporalis (temples): 8 sites — 40 units
- Occipitalis (back of head): 6 sites — 30 units
- Cervical Paraspinal (upper neck): 4 sites — 20 units
- Trapezius (upper shoulder): 6 sites — 30 units
Using this set pattern and dose, doctors try to calm the nerve pathways that may trigger migraines.These injection sites are specifically focused to treat the most common sites that can trigger and affect migraines.
2. Why This Specific Injection Map Matters
These listed migraine botox injection sites are not random; they target muscles that connect with nerves involved in migraine. The PREEMPT injection method is the only clinically proven approach, supported by large studies showing fewer headache days and better daily function than placebo.
There’s also an optional “Follow‑the‑Pain” strategy:
Doctors can use up to 40 extra units (for a total of 195 units) in additional spots based on your pain pattern. For example, they may focus on one side more if your headaches are uneven. Guidelines support this flexibility when needed, but for the most part, the migraine botox injection sites cover most of what you will need to find relief.
3. What Happens During the Injection Appointment
Most appointments last about 10 to 15 minutes and involve several small, shallow injections with a fine needle. Here is what patients usually experience:
- Sanitizing the skin: quick cleaning with an antiseptic.
- Forehead & Glabella shots: you may be asked to frown or raise eyebrows so the injector can find the right spots.
- Temples: you might gently clench your teeth to relax specific muscles.
- Back of head & neck: these are generally less sensitive than the face.
- Shoulders: occasional deeper pressure as the trapezius is a larger muscle.
Most people say the injections feel like a sharp pinch or bug bite, with mild discomfort that goes away quickly. Numbing is rarely needed unless you are very sensitive. Most migraine botox injection sites are relatively easy to access and get to, so there are rarely any problems finding the locations for the treatment.
4. Are Some Migraine Botox Injection Sites Riskier Than Others?
Yes, precision is important because Botox blocks nerve signals. Most side effects are mild and temporary, and often depend on how close the injections are to key muscles:
- Forehead injections: If placed too low, especially near the eyelid muscles, temporary eyelid droop (ptosis) can occur.
- Neck injections: Weakness or soreness in the neck can happen if deeper muscles are affected.
- Shoulder injections: Some soreness is common but usually resolves in days.
Choosing a trained neurologist or headache specialist helps minimize risks and maximize effectiveness. These should always be done under the supervision of a licensed medical provider who has extensive training in administering and treating migraines.
5. When Will I Notice Results?
Botox is not a quick fix; it works as a preventive treatment. Most people start to see benefits two to four weeks after treatment, as the medicine changes pain pathways over time. The best results often show up after two or three treatment cycles (six to nine months). This is why appointments are usually set every 12 weeks.
Many people, according to pooled PREEMPT data, report fewer headache days and better daily function compared to placebo. Once again, it all depends on how you respond to treatments to the individual migraine botox injection sites. It’s always essential to find a highly trained migraine specialist to help you guide your decision on how to pursue care and treatment.
6. FAQs About Migraine Botox Injection Sites
Can I skip some sites to avoid cosmetic effects?
Not if you want the full preventive benefit. The FDA-approved protocol requires injections at all 31 standard sites.
Will the injections bruise or bleed?
Small spots of bleeding can happen but usually stop quickly.
Will Botox smooth my wrinkles?
Some patients notice fewer forehead wrinkles as a side effect of injections in those muscles.
How often do I need injections?
Injections are needed every 12 weeks. The effect fades as nerve endings grow back.
What if migraine botox injections don’t work for me?
Injections aren’t for everyone, so if you’ve had injections and they haven’t worked for you, you may want to consider taking a different approach to finding treatment.
When Treating Migraine Botox Injection Sites Doesn’t Work…
If chronic migraine has affected your life and you feel like you have tried everything, it may be time for a new approach.
At The Neural Connection, we’ve worked with hundreds of migraine patients who have “failed” traditional treatments and have been able to help them find relief through other methods of care.
By focusing on creating personalized treatment paradigms, we are able to address the root causes of your symptoms to finally create long term healing.
Check out our 130+ 5-Star Google Reviews ⭐️⭐️⭐️⭐️⭐️ to see what our patients say about us!
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*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any home remedies or therapies.
