It is certain that Botox helps for a firmer forehead. But it is also effective in patients with extreme headaches, is the belief of two doctors in Emmen. “Our results don’t lie.”
Botox has been popular for years among men and women who want to get rid of their crow’s feet and wrinkled foreheads. What is less known is that treatments with the neurotoxic poison are also on the rise among a completely different group: people with extreme headaches. Every month, approximately fifty of them report to the JC Clinic in Emmen. They are convinced that for many people with migraine, tension headache and cluster headache, a properly placed injection can be the solution.
Just to be clear, say Jurjen Schortinghuis (MKA surgeon) and Mark Contini (basic doctor): they also do cosmetic procedures. But an increasing part of their agenda is taken up by headache patients. “That is something wonderful,” says Schortinghuis. “Help people get rid of their pain. Ultimately, that’s why you became a doctor.”
Grinding and clenching
Contini has been treating wrinkles for years by placing injections in the right places, especially on the face. Botox relaxes the muscles and blocks the nerve impulse, preventing the muscle from contracting. This is why it also works for non-cosmetic problems such as extreme teeth grinding and jaw clenching. This gives you enlarged jaw muscles. “If someone has that, we can immediately see it in the shape of the jaw,” says Contini.
A few years ago he had such a patient on the chair. A few weeks after the injections she reported to him. “She no longer suffered from clenching jaws, but the strange thing was that her chronic headaches were also gone,” says Contini.
“I saw this more often, started to recognize a pattern and that got me thinking. Would it also work the other way around: injections against headaches? In many cases the answer is: yes. I dare say that after hundreds of successful cases.”
His thesis is that many severe headaches are the result of excessive muscle tension in the face, often caused by stress. “If you remove that tension with Botox, the headache will also disappear.”
Scientific evidence for this statement is still lacking. It is also at odds with the idea that cluster headaches and migraines are seen as neurological problems. “We were also skeptical,” says Schortinghuis. “But our results don’t lie.”
In 2022, the doctors monitored what their treatment was doing for a while. “Of the first 150 headache patients that year, half were pain-free after three months. About 30 percent were ‘virtually pain-free’ and we have insufficient data on the last 20 percent. These are very good figures for people who suffered a lot of pain before.”
Botox in patients with chronic migraine
The JC Clinic is certainly not the only place in the Netherlands where botox is used against headaches. Neurologists also use Botox in some patients suffering from chronic migraine, but in accordance with a strict protocol the injection is mainly done on the top of the skull and in the neck.
Skepticism among neurologists
Botox can absolutely be effective against headaches, says neurologist Marc van Huizen van Treant, who is also head of the headache clinic at the hospital in Emmen.
But as far as he and other neurologists are concerned, Botox only helps a specific subgroup of patients with chronic migraine. “We assume a different mechanism than shutting down muscles,” says Van Huizen. “Because there is a lot of skepticism about that method within our profession and among other painkillers.”
The neurologist focuses on the neurotransmitters with Botox: pain signals are blocked with it. This will certainly achieve success, says Van Huizen. “Of the specific group of migraine patients who start Botox with a neurologist, about 40 percent return because they are satisfied with the results. This is not the case with the rest and they are then eligible for medication.”
For other headache patients, Van Huizen does not believe that Botox in the facial muscles can be the first solution. “It doesn’t make sense for cluster headaches. But if someone has both migraines and tension in the jaw muscles, then it can of course help against that muscle tension.”
Although their working methods and insights do not completely match, Treant neurologists sometimes do refer to the JC Clinic of Schortinghuis and Contini.
Van Huizen: “It is good to mention that in regular healthcare we work with diagnoses and associated indications to determine what a patient is dealing with. If this means that someone is not eligible for regular treatment, you can consider alternatives. Who knows, it might help.”
Contini and Schortinghuis believe that they are further ahead than other cosmetic clinics, because of the anatomical knowledge that Schortinghuis has as a dental surgeon.
“Many colleagues put the injection where it hurts, but muscles don’t work that way,” says the surgeon. He shows a picture of the muscle pack on the head and moves his finger from the jaw to far above the ear. “Sometimes you have to prick here to get an effect all the way there.”
‘The cause of pain has not gone away’
Knowing where to puncture is a very important part of their approach, both doctors say. They recognize that it is treating the symptoms.
“The cause of the pain has not gone away. The formula we use is: headache = muscle pain + tendon pain + psychological pain,” says Contini. “We can also do something about that tendon pain, for example with a local anti-inflammatory agent. But where it all comes from – and very often that is stress – the patient has to deal with that himself. I can tell you that this works much better once the headache is gone. We call this the holistic approach. The botox is just part of that.”
Schortinghuis and Contini no longer doubt that their Botox approach works. It just lacks scientific substantiation. “We already have permission from the University Medical Center in Groningen to start an exploratory study.”
If you suffer from a chronic headache, Schortinghuis advises you to contact your GP first. “First, other causes must be ruled out, such as high blood pressure.”
Henri: ‘I have become myself again’
The longest attack of cluster headache that Henri van der Veen (55) from Emmen ever had lasted 15 hours. “That was hell,” he says. The attacks usually lasted fifteen minutes, but sometimes much longer. He had been under treatment for his complaints for eight years by an ENT doctor, an internist and ultimately a neurologist.
“Tried everything, from injections to oxygen. You don’t want to know how many of those bottles I drank.” It helped somewhat, but a real solution to his problem was not found. Due to his cluster headaches, Van der Veen was completely unfit for work.
Eighteen months ago, he ended up in the chair of Jurjen Schortinghuis, in his role as a dental surgeon, for the removal of a tooth. Schortinghuis read Van der Veen’s file about his severe headaches and explained to him that he achieved good results for those problems in his private clinic.
“With Botox,” says Van der Veen. “I thought it was a strong story. Was very skeptical. But I thought: if it doesn’t help, it won’t hurt. Besides, I was so far gone at that point that they could cut off my arm, as long as the headache would stop.”
Not much later, Van der Veen was in the treatment room with Mark Contini. The first weeks after the Botox the complaints became worse, as the doctor had already announced, but then the pain decreased.
“I have been pain free since then. I now almost dare to believe that I have gotten rid of my headache. Really fantastic.” Van der Veen receives new injections every three months to maintain the effect. “I’m going to travel again and I’m going to do volunteer work in a nursing home. I’m also a lot better at it than before. I have become myself again.”
2024-03-10 07:02:00
#Doctors #Jurjen #Mark #patients #Henri #Emmen #rid #extreme #headaches #Botox #wasnt #confident #life
