What is BOTOX?

BOTOX is a neurotoxin medication used to treat contracted muscles that can cause pain. At changepain, BOTOX is used to treat chronic migraines/headaches, contracted muscles, neuropathic and joint pain. 

  1. BOTOX for Migraines/Headaches: BOTOX can be used to treat and prevent migraines or headaches. BOTOX is injected into very specific muscles in the head and neck that may be contributing to your migraines or headaches. The benefits of BOTOX may include reduced intensity, frequency, duration, and sensitivity of migraines or headaches. 
  2. BOTOX for Contracted Muscles: BOTOX can be used to help contracted muscles relax. Sometimes contracted muscles can impair function or put pressure on nerves causing pain anywhere in the body. An example of this is for temporomandibular joint pain (TMJ) or for spasticity following a stroke. 
  3. BOTOX for Neuropathic Pain: BOTOX can be used to treat diabetic peripheral neuropathy, trigeminal neuralgia and even conditions like sciatica. This is separate from its effect on muscle relaxation. 
  4. BOTOX for Arthritis: BOTOX has been studied in osteoarthritis and shown to decrease inflammation and pain when injected directly into the joint. This is injection has no effect on the strength of the joint, and the pain-relieving effects can last for over a year. 
How will I know if it will help?

A changepain physician who offers BOTOX treatment needs to assess you first and may recommend trialling the procedure if he or she thinks it may help you. 

How much does it cost?

Some extended health plans and other insurers may cover some or part of the cost of treatment. Please check with your insurer to find out if you are covered. The pharmacy may be able to help with any forms for insurance coverage. 

The Pharmacare website states that BOTOX for migraine headaches is NOT covered by Pharmacare. 

We may be able to ask for Special Authority for Pharmacare to cover the cost of this treatment for specific conditions like muscle spasticity. 



BOTOX is injected into contracted muscles, absorbed by the nerves that control the muscle causing them to temporarily weaken and help them relax. BOTOX is believed to also work by altering pain signals from muscles to the brain. For neuropathic pain, the absorption is the same, but the effect is only on nerve that provide sensation, so there is no muscle relaxation associated with this technique.

A solution containing BOTOX is injected at specific skin, joint or muscle points. The number of injections during a treatment session depends on the pain area. For example, the PREEMPT migraine/headache protocol involves 31 injection sites, whereas treatment for a single contracted muscle might only need 3 injection sites.

If BOTOX works well for you, we expect migraine, headache, or muscle pain relief to begin within 2-4 weeks after it is injected. Pain relief can last up to 3 months or more. For some patients, we may need to try BOTOX 2-3 times before we know if it will help you.

We first require you to be assessed by a changepain physician who offers BOTOX treatment to confirm that he or she thinks it may help you. You will then book another appointment to come to changepain for BOTOX treatment.


changepainTM does not carry BOTOX medications; it needs to be ordered from a pharmacy specifically for you. Please follow these steps to make sure you bring the medication to your appointment:


    1. Contact changepain reception and tell us you want to proceed with a BOTOX trial.
    2. We will make sure a prescription for BOTOX has been sent to the BioScript pharmacy (if you have another pharmacy of preference, please give us their contact information).

      BioScript Pharmacy: 604-214-3784

      8171 Ackroyd Road, Richmond BC

    3. You must contact the pharmacy to pay for the BOTOX vial and make the arrangements to pick up the medication.

    4. Once you have the medication in hands, please contact changepain so we can book your appointment.

    5. Please bring your BOTOX vial on the day of your appointment in a bag of ice to keep cool. This medication should be used within 6 hours when it is at room temperature. In case you forget the medication, you will still need to pay the injection fee, and reschedule your appointment.

Mild side effects (may last up to 6 weeks after the treatment):

  • Pain, tenderness or bruising at the site of injection
  • Skin reactions such as a rash
  • Malaise (generally feeling unwell)
  • The spread of BOTOX to nearby muscles can cause them to become weak temporarily (For example, drooping eyebrows).


Rare side effects: 

  • Severe allergic reaction
  • With long term use of BOTOX, Muscle atrophy

Other possible complications depend on the actual areas treated. Your doctor will discuss these with you.

We require 48 hours’ notice to cancel or reschedule your appointment. If less than 48 hours’ notice is provided, we will charge the full injection fee.


We do not give refunds. This includes if the procedure must be stopped for safety reasons or if there is no benefit from the procedure.

Please contact our Private Pay Services Coordinator

Call 604-566-9101, ext. 105 or


Cost of Initial Assessments - Non-MSP Medical

Private Medical Consultation (PMC) Multidisciplinary Private Assessment (MDPA)
Description Expedited, focused assessment to determine fit for non-MSP covered services requested:
IV Lidocaine Infusion, Ketamine Therapies, Prolotherapy, BOTOX, Platelet Rich Plasma (PRP).
Comprehensive functional and medical assessment with a multidisciplinary report addressing the biopsychosocial issues identified.
Care Team Pain Specialist Pain Specialist
Functional Movement Specialist
Duration 30 minutes 2 hours
Cost $450.00 $3,500.00

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Cost of Initial Assessments - Allied Health

Assessment Duration Cost
Chiropractic Initial 60 minutes $165.00
Physiotherapy Initial 60 minutes $160.00
Kinesiology Initial 45 minutes $90.00 (+ tax)
Counselling Initial 90 minutes $250.00
Acupuncture Initial 45 minutes $140.00
Ketamine Counselling Initial for Ketamine Assisted Psychotherapy 60 minutes $250.00

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