See how it is done
Botulinum toxin type A (Botox) is best known cosmetically, but it has well-established uses in pain medicine. By temporarily quieting the nerves that signal certain muscles to contract, it can break a cycle of chronic muscle-driven pain.
We use Botox for chronic migraine (more than 15 headache days per month), cervical dystonia (involuntary neck muscle contractions), post-traumatic headache, and myofascial pain that has not responded to trigger-point injections or physiotherapy.
Effect builds gradually over 1 to 2 weeks and typically lasts about 3 months. Repeat treatment every 12 weeks is the standard schedule.
OHIP coverage
Botox for chronic pain falls outside the OHIP fee schedule. Some indications (notably chronic migraine) are reimbursed by private insurance plans. We provide a receipt with the medical indication clearly stated.
What this treats
- chronic migraine (≥15 days/month)
- cervical dystonia
- post-traumatic headache
- temporomandibular (TMJ) muscle pain
- refractory myofascial pain
Conditions this treats
Common diagnoses we use this procedure for. Tap one to read more.
Before, during, and after — what to do
Before your appointment
Eat a normal meal before your appointment — there is no fasting required for most injections. Take your usual medications unless we have specifically asked you not to. If you take a blood thinner (aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, etc.), tell us in advance — we may need to adjust the timing. Bring your OHIP card and any imaging reports we asked for.
On the day
Wear loose, comfortable clothing — easy to roll up sleeves or pant legs, easy to lie face-down on the table. Plan to be at the clinic about 45 minutes total. You can drive yourself unless we told you otherwise. If you are anxious about the procedure, tell us — we will walk you through every step.
After the procedure
You may feel some soreness at the injection site for 1–3 days. Ice helps; so does Tylenol or ibuprofen if you can take it. Avoid heavy lifting or vigorous exercise for 24 hours, then resume normal activity as comfort allows. The therapeutic effect of the injection usually starts within a few days and reaches full strength by 2 weeks.
When to call us: Call us right away — or go to the nearest emergency department — if you develop a high fever, severe new pain, redness or swelling at the injection site, weakness in a limb, or loss of bladder or bowel control. These are rare but worth knowing.
What happens on the day
The procedure itself takes about 15 minutes, plus a little time to get you positioned and a short rest afterwards. Most people feel relief lasting about 3 months.