How damaging is brief shoulder/neck massage 6 hours after Botox for migraine? What if's longer massage and 36 hours?

I recommend getting aftercare instructions from your doctor. Typically, as long as the person isn’t massaging the treatment site, you should be fine. If you’re concerned, you may wait 72 hours. See an expert. Best, Dr. Emer

Botox injection for migraine headache prevention is relatively higher dose as compared to cosmetic injection. It is advisable to avoid massaging the area including the neck muscles and traps for at least 24 hours to avoid spreading the neurotoxin to non intended areas including the nerves which can potentially cause unintended denervation. Doing massage after 36 hours should be fine but I would like to still be on conservative side by avoiding deep massaging on injected area especially in the neck region.

Ideally, there should be no vigorous manipulation of the area for 24 hours after your Botox, however the neck and shoulder muscles are relatively large and the slight spread that could occur during a brief 3 minute massage is unlikely to cause you any difficulty. A massage 36 hours post Botox should be fine. I would suggest considering changing providers to one that includes excellent pre and post care as part of their service to you. Best, Dr. Tkatch