Migraine Management

The Two Types of Treatment Options

There are many ways to manage Chronic Migraine; most medications are either acute or preventive. Headache Specialists often prescribe preventive medications for Chronic Migraine patients; however, a treatment plan may include acute and preventive treatment, so it's important to understand how they work to manage Chronic Migraine.¹

Acute medications:¹,²

  • Taken when a migraine or headache is starting or has already begun
  • May stop or reduce pain but does not prevent a headache or migraine

Preventive (or prophylactic) medications:¹,²

  • Taken to prevent headaches and migraines from occurring

BOTOX® is a preventive treatment

BOTOX® is the first and only preventive treatment approved by the FDA for adults with Chronic Migraine (15 or more headache days a month, each lasting 4 hours or more). BOTOX® therapy is not approved for adults with migraine who have 14 or fewer headache days a month.³

If you have Chronic Migraine, a preventive medication like BOTOX® may be an option for you.

Proven Results

BOTOX® is proven to significantly reduce headache days every month

BOTOX® prevents up to 9 headache days a month(vs up to 7 for placebo)¹

It may take several weeks to see a response. In clinical trials, patients showed a response at their 4-week evaluation. After 2 treatments (at 24 weeks), BOTOX® was proven to reduce headache days each month vs placebo.¹

Not knowing when a headache or migraine will occur can be challenging. While other treatments may help you once you already have a headache, a preventive medication like BOTOX® therapy is approved to help prevent headache days.

BOTOX® therapy is injected by our headache specialist every 12 weeks. After 2 treatment sessions you may be able to start experiencing fewer headache days too!

What To Expect From Treatment

Whether you're considering BOTOX® treatment, or have already received treatment, here's what you need to know.

Your first treatment

For Chronic Migraine patients, the FDA has approved a specific dose and injection pattern for BOTOX® treatment—31 injections are given over 7 key areas of the head and neck once every 12 weeks to prevent headache days.¹

Here's what to expect during your first treatment:

Injections to 7 key areas of the head and neck¹

Very fine needles are used for 31 total injections

Injections feel like tiny pinpricks—you may feel mild discomfort

The most common side effect in Chronic Migraine clinical studies was neck pain experienced by 9% of BOTOX®patients (vs 3% in placebo)¹

Other side effects include headache, migraine, slight or partial facial paralysis, eyelid drooping, bronchitis, musculoskeletal stiffness, muscle weakness, pain in 1 or more muscles, ligaments, tendons, or bones, muscle spasms, injection-site pain, and high blood pressure

This does not cover all the possible serious side effects of BOTOX®. Please see the Important Safety Information including Boxed Warning and Medication Guide and talk to your doctor.

BOTOX® Injection SitesMedication Guide


When to expect results

In clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks), BOTOX® prevented up to 9 headache days a month (vs up to 7 with placebo injection).

Why commit to 2 treatments?

Committing to 2 treatment sessions is important in order to see how BOTOX® is working for you, since BOTOX® showed significant reduction in headache days at 24 weeks. Talk to your doctor about your progress, and as you start to see changes in the amount of headache days you’re having each month, keep track with our Headache Diary.

What happens next: a 12-week treatment schedule

Based on your progress, you and your doctor will discuss re-treatment every 12 weeks. Remember: BOTOX® is a preventive treatment, which means it's taken to prevent headaches and migraines from occurring. So, it is recommended that treatment be given once every 12 weeks.

The best way for you and your doctor to know if BOTOX® is meeting your treatment needs is to give it time to work, so talk to your doctor, and stay on track.

Ways to stay on track 
Want to make sure you stay on schedule? Make your next appointment right after each treatment session—before you leave the office—so you don’t forget.

In addition, sign up for our Pathways to Prevention  program, and we'll send you treatment reminders, along with fitness, diet, and healthy living tips from the editors of Prevention® Magazine.

Feeling your progress is one thing, seeing it on paper is another. As you begin to have fewer headache days, use our Headache Diary to track your progress, and see how far you’ve come!

How much does it cost?

Most insurance plans cover the majority of the cost of BOTOX®.

  • If your insurance covers all costs, you pay nothing out of pocket for BOTOX®
  • If your insurance covers some of the costs, you can use the BOTOX®Savings Card to help cover remaining out of pocket expenses. (Please ask our office staff for more information on the BOTOX Savings Card.)

*Coverage and out-of-pocket costs vary. Must meet eligibility criteria to qualify. 59% of new patients pay $100 or less per treatment. According to the data on file of all submitted explanation of benefits in the system from October 2012 through October 2013 for commercially insured Chronic Migraine patients (N = 4835). The program is available for patients receiving treatment every 12 weeks. Patients should understand their out-of-pocket costs before starting treatment.

Elizabeth's Story

Our Migraine Specialist:


Dr. Tambrea Ellison, MD

Dr. Tambrea Ellison, MD is a board certified physiatrist who is committed to improving the quality of life of patients. Dr. Ellison attended Valdosta State University where she received her bachelor’s degree in biology and was awarded “The Marjorie Biology Award”. She then received her doctorate of medicine from the Medical College of Georgia. Dr. Ellison completed residency in Physical Medicine and Rehabilitation at Johns Hopkins University. While there she received “The Hopkins Healer Award” for her outstanding service, professionalism, and compassion towards patients. Dr. Ellison then returned home to Georgia for continued training in Pain Management at Georgia Pain Physicians.

Dr. Ellison believes in a patient-focused, multidisciplinary approach to care. Her professional interests include musculoskeletal medicine, non-operative sports medicine, migraine management, and chronic pain management with a variety of interventional procedures, pharmacological therapy, physical therapy, and other modalities.

Dr. Ellison is an active member of the American Academy of Physical Medicine and Rehabilitation, American Academy of Pain Medicine, and the American Medical Association. In her free time, Dr. Ellison enjoys spending time with family, friends, and participating in personal fitness and an array of outdoor activities.


To make an appointment call (770) 997-0600