I was in car accident Oct 2008 and have been digging my way to some relief I can live with. I just joined this forum, which my husband found researching some of my conditions, including occipital neuralgia, cervical dystonia, chronic daily headaches, post-traumatic migraines, post-concussive syndrome. I have been on many meds and started Botox injection therapy July 2009. I get injections every 3 months (they don't do them before every 3 months because you might become tolerant and the medication wouldn't be as effective, not to mention that your insurance won't pay for it sooner than that). Before I started with the Botox, you get a diagnostic test to see if Botox will be effective. Sorry to say the diagnostic tests are extremely painful, especially depending on where your sites are. The dr. basically uses a machine like a scanner that locates where the muscles are in constant spasm, overlapping one another -- and marks the spot. This is where the injection will go when you actually have Botox treatment. The treatments aren't bad -- sometimes painful if done in a sensitive area (like the occipitals in my head). You will be told that relief should come within 10 days to 2 weeks. I'm always at the 2 weeks after Botox for any relief.

Sad news is that my Botox starts wearing off about a month before my next injection. So that means that 4 weeks before and 2 weeks after for the Botox to work -- I have 6 crappy weeks and that's when my pain medication increases dramatically. I moan in my sleep, can't put my head on a pillow, need to hold my head in sheer pain.

I'll also mention side effects. After the first shots, within a few days I could not lift my arms up. The muscles were all put to sleep. It wore off after about 3 weeks. Side effects on second shots also -- couldn't bend my head down. I couldn't support my head moving. Brushing teeth or looking down was difficult, but the relief I got from the pain was worth it. That also wore off after a few weeks. After each injection therapy, the nurse would call me to see how I made out, what side effects, was it helping, etc. And then they adjusted the medication for the next round 3 months away.

Although Botox has helped tremendously, I still have pain when it's working -- but that pain is so much more manageable than those 6 weeks when it's not.

I'm seeing a chiropractor tomorrow -- just for consult -- and will ask about NUCCA treatment.

Good luck.