Botox injections are considered one of the most promising new headache treatments. Due to the toxin's method of action--essentially inhibiting nerve excitation in neuromuscular junctions--it's much more likely to be an effective treatment if your headaches are the result of neuralgia or similar extracranial stimuli.
If you don't know whether your headaches may be the result of neuralgia, rather than just finding out if Botox helps you may want to give nerve block injections a shot. If they end up helping then there's good reason to suspect that neuralgia is playing a role. If it is, in addition to nerve blocks and botox injections, you have many good treatment options. At the more extreme end you might end up trying having a nerve stimulator implant. Several of us on this board, myself included, have tried this. There are also more conventional drug treatments.
More broadly speaking in terms of NDPS, in most cases you just need to keep trying treatments. In general, interventional acute treatments can be very helpful (IV DHE or Lidocaine infusion, for example) in addition to the right daily medication regiment. When it comes to preventative medications Neurontin is known as one of the most effective options for NDPH. There's another one that is considered particularly useful for NDPH--it's either topirimate or methylsergide, I can't remember.
Personally I've suffered through NDPH for more than seven years now and I've tried just about
everything. I'd be happy to try to answer any further questions that you might have. One very important consideration when it comes to NDPH is remembering to be patient, especially when it comes to trying new treatments. Particularly when trying a new medication it's important to give it time--in the case of a new daily med, sometimes several months. While it is discouraging when nothing seems to be working and you don't want to waste time on something that isn't helping, it's much better to take your time now than to be wondering whether you gave something a fair shot in the future. You probably already know this but it's a very common difficulty--one that I've certainly had problems with.
Best wishes for better health,
DX: NDPH, Recovered(?) CRPS
RX: Lamictal, Namenda, Nardil, Piroxicam, Oxycontin, Clonazepam, Rozerem, Ambien CR, Magnesium (800 mg/d), Riboflavin (400 mg/d), Fish Oil (2000 mg/d)
PRN: Ketamine nasal spray
, Toradol IM, Celebrex, Lodine, Zofran, Phenergan,
rarely: Migranal, DHE IM, Reglan, Provigil, Maxalt, ZomigI can be contacted personally via email at firstname.lastname@example.org.