Migraine & Headache Treatment
Comprehensive Migraine Care — Including Botox — In One Practice
Migraines are more than bad headaches — they're a neurological condition that can be debilitating. At Dunn Family Medicine, we offer a full range of migraine treatments, including Botox injections for chronic migraine, all performed in-house in Steilacoom.
A Comprehensive Approach to Migraine
Effective migraine management usually requires more than one strategy. We start by understanding your migraine pattern — frequency, duration, triggers, associated symptoms, and what you've already tried. This gives us a clear picture of what type of migraine you have and what approach is most likely to help.
For patients with frequent or severe migraines, we discuss both acute treatments (what to take when a migraine starts) and preventive treatments (what to take or do regularly to reduce how often they occur). Many patients have only been offered one or the other — we look at both.
For patients with chronic migraine — 15 or more headache days per month — Botox is an FDA-approved preventive treatment that we offer in-house. You don't need to be referred to a neurologist for this. We perform the injections here, in Steilacoom, and manage your ongoing care.
We also integrate complementary approaches: acupuncture has good evidence for migraine prevention, and OMT can help with cervicogenic headaches. We also integrate complementary approaches: acupuncture has good evidence for migraine prevention, and OMT can help with cervicogenic headaches that overlap with or trigger migraines. Patients from Lakewood, DuPont, University Place, and across the Tacoma area come to us specifically because we offer this range of options in one place.
Treatments We Offer
- Botox (onabotulinumtoxinA) injections for chronic migraine
- Preventive medications — beta-blockers, topiramate, amitriptyline, CGRP inhibitors
- Acute treatment optimization — triptans, NSAIDs, anti-nausea medications
- Trigger identification and lifestyle modification
- Hormonal migraine management
- Acupuncture for migraine prevention
- Osteopathic manipulation for cervicogenic headache
- Sleep and stress management as part of prevention
Botox for Chronic Migraine: What to Know
Botox (onabotulinumtoxinA) was FDA-approved for chronic migraine prevention in 2010. It's one of the most well-studied preventive treatments available, with strong evidence for reducing migraine frequency in patients who qualify.
The treatment involves a series of small injections into specific muscles of the forehead, temples, back of the head, neck, and shoulders — 31 injections in total, following a standardized protocol. The procedure takes about 15–20 minutes and is performed every 12 weeks.
Most patients don't see the full benefit until after the second or third treatment cycle. We track your headache diary, monitor your response, and adjust your overall migraine management plan alongside the Botox treatments.
Botox for migraine is a medical procedure, not a cosmetic one. The injection sites and doses are different from cosmetic Botox, and the goal is entirely therapeutic.
Frequently Asked Questions
Who qualifies for Botox for migraines?
Botox is FDA-approved for chronic migraine — defined as 15 or more headache days per month, with at least 8 of those being migraines. It's typically considered after two or more preventive medications have been tried without adequate relief.
How does Botox for migraines work?
Botox is injected into specific muscles of the head, neck, and shoulders. It's thought to block the release of pain-signaling chemicals involved in migraine. Most patients receive injections every 12 weeks. It typically takes two to three treatment cycles to see the full benefit.
Is Botox for migraines done in your office?
Yes. Botox injections for chronic migraine are performed in-house at Dunn Family Medicine. You don't need a separate referral to a neurologist for this treatment.
What does the Botox injection process feel like?
The injections use a very fine needle and are generally well-tolerated. Most patients describe mild discomfort. The procedure takes about 15–20 minutes.
Does insurance cover Botox for migraines?
Botox for chronic migraine is covered by many insurance plans when criteria are met. As a DPC practice, we don't bill insurance for primary care services, but we can help you understand your options and provide documentation if you're seeking reimbursement through your insurer.
Medically reviewed by Dr. Angela Dunn, DO, FAAFP — Board-Certified Family Medicine Physician, Dunn Family Medicine, Steilacoom, WA.
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