The use of botulinum neurotoxin type A (Botox) for headaches: a case review.

Chiropractic care is a common treatment sought by patients with headaches. As some patients may not benefit from this care, chiropractors must be aware of alternative management options. Botox has more recently become a common treatment for headaches. A case of a 45-year-old female with chronic headaches and neck pain is presented. After lengthy trials of chiropractic manipulation, trigger point therapy, and acupuncture, the patient was treated with Botox-A. She experienced pain relief following the initial treatment that lasted up to 3-4 months and has since undergone subsequent trials of Botox with the same results. No side effects were experienced. As more health care practitioners are recommending Botox, the need for a better understanding of the evidence and criteria for referral for Botox treatment is required. As such, chiropractors should consider this alternative approach to managing headaches when chiropractic management is unsuccessful.