For many people living with chronic migraine, tablets and lifestyle changes are not enough on their own. At Axon Neurology Headache clinic in Murdoch, we offer botulinum toxin type A injections (Botox) as an evidence‑based preventive treatment for eligible adults with chronic migraine. This treatment is funded by the Pharmaceutical Benefits Scheme (PBS) when specific criteria are met, which can significantly reduce out‑of‑pocket costs for patients across Perth and regional Western Australia.
What is Chronic Migraine?
Chronic migraine is defined as having headache on 15 or more days per month, with at least 8 of those days having migraine features, for at least 3 months. These frequent attacks often interfere with work, study, family life and social activities, and many people we see have already tried multiple medications and lifestyle strategies before considering botulinum toxin type A.
How does Botulinum toxin type A injections (Botox) help chronic migraine?
Botulinum toxin type A injections (Botox) is a purified protein injected in very small doses into specific muscles of the head and neck. For migraine, it is thought to work mainly by calming overactive pain pathways and reducing the release of pain‑signalling chemicals, rather than by “paralysing” muscles for cosmetic purposes. Large clinical trials and real‑world studies have shown that botulinum toxin type A can reduce the number of headache days and lessen the impact of chronic migraine for many people.
PBS funding and who might be suitable
A key point many people do not realise is that Botulinum toxin type A injections (Botox) can be PBS‑funded for chronic migraine in Australia when strict criteria are met. Under current PBS rules:
- The treatment is only approved for chronic migraine
- The person must have an average of 15 or more headache days per month, with at least 8 migraine days, over at least 6 months.
- They must have had an inadequate response, intolerance or contraindication to at least three recognised prophylactic migraine medications such as propranolol, amitriptyline, pizotifen, candesartan, verapamil, nortriptyline, sodium valproate or topiramate.
To continue on the PBS, there must also be a meaningful reduction in monthly headache days after starting treatment, which we monitor closely using headache diaries.
If you meet these criteria, Botulinum toxin type A injections (Botox) injections can be prescribed and administered under the PBS, which substantially lowers ongoing costs compared with private treatment.
Who provides the treatment at Axon Neurology Headache clinic?
At Axon Neurology Headache clinic, Botulinum toxin type A injections (Botox) injections for chronic migraine are provided by our neurologists with a special interest and training in headache medicine. One of our headache specialists will assess your eligibility, confirm your diagnosis, review past treatments and, if you meet the criteria, commence botulinum toxin type A (Botox) as a preventive therapy.
We also work closely with your GP, who can continue to support your overall migraine management, including acute medications and lifestyle strategies, while our team oversees your preventive treatment.
What happens during a Botulinum toxin type A injections (Botox) treatment?
A chronic migraine treatment session follows a standard, well‑studied protocol:
- A very fine needle is used to deliver small doses of Botulinum toxin type A injections (Botox) at multiple sites across the forehead, temples, back of the head and upper neck.
- The total dose and injection pattern are based on international chronic migraine protocols.
- The procedure usually takes around 10–15 minutes and is performed in the clinic.
- Most people find the injections uncomfortable rather than severely painful, and you can usually drive yourself home and return to normal activities the same or next day.
How often is treatment given and when will I notice benefit?
Botulinum toxin type A injections (Botox) for chronic migraine is given as a series of treatments every 12 weeks. It is a preventive therapy, not a one‑off cure, and its effect builds over time:
- Some people notice an improvement within the first treatment cycle; others see clearer benefit after the second or third cycle.
- We generally assess your response after at least two full treatment cycles before deciding whether to continue.
- If you experience a good reduction in headache days and severity, ongoing treatment every 12 weeks is usually needed to maintain the effect.
Possible side effects
When administered by experienced headache specialists, Botulinum toxin type A injections (Botox) is generally well tolerated. Possible side effects can include:
- Mild pain, redness or bruising where the injections are given.
- Temporary neck or shoulder stiffness, or a feeling of “heaviness” in the forehead or brows.
- Less commonly, short‑lasting weakness of neck muscles or slight asymmetry of facial expression, which usually improve as the effect of the injections wears off. This can be mitigated by moving the injection sites on subsequent treatments.
Before starting treatment, your headache specialist will review your medical history, other medications and any neuromuscular conditions to ensure this therapy is appropriate and as safe as possible for you.
How Botulinum toxin type A injections (Botox) fits into your overall migraine plan
Botulinum toxin type A injections (Botox) is itself a preventive treatment for chronic migraine. At Axon Neurology Headache clinic, we integrate it into a broader, personalised plan that also includes:
- A clear acute treatment strategy to use when attacks occur, aimed at early, effective relief while avoiding medication‑overuse headache.
- Ongoing support for lifestyle changes such as regular sleep, whole‑food‑based meals, good hydration, exercise and stress‑management techniques.
By combining preventive treatment with acute management and lifestyle strategies, we aim to reduce both the frequency and the impact of your migraines over time.
Booking an assessment at Axon Neurology Headache clinic
If you experience frequent migraines and wonder whether PBS‑funded Botulinum toxin type A injections (Botox) might be suitable for you, the first step is an assessment with one of our headache specialists at Axon Neurology Headache clinic in Murdoch.
During this appointment we will:
- Confirm your headache diagnosis and rule out other causes.
- Review the preventive and acute medications you have already tried.
- Assess whether you meet PBS and clinical criteria for Botulinum toxin type A injections (Botox).
- Discuss the potential benefits, risks and practicalities of treatment.
We are located in Murdoch and care for patients from across Perth and throughout Western Australia. If you or your GP would like to explore this option further, please contact our clinic to arrange a consultation.
Typical injection pattern used for chronic migraine Botulinum toxin type A injections (Botox) treatment. Exact sites and doses are individualised.