Botox only relieves some symptoms but does not fix the root cause of the problem. My headache specialist incorrectly told me I had "dystonia," (a muscle disorder) but actually I just had to work really hard at physical therapy to loosen my cervical tightness (some caused by fusion and some caused by years of incorrect posture). I have been spending decades tightening my jaw and had terrible posture. I finally, after 6 years of occipital headaches and shoulder pain, found a good physical therapist. She works on my C2, my ribs connected to the cervical joints, and gives me strengthening exercises. I'm still not out of the woods yet but I've gone 9 days without a headache now, when I was getting them every day. It's all about strengthening the correct muscles when you have this condition, learning how to sleep in a correct position, posture--it all fits together. It IS possible to get better. I wanted to write because I've spent many a night up with a headache reading forums but no one ever comes back with a solution. This won't help everyone with migraines but those who have cervical problems, it's worth a try. Sometimes physical therapists go deeper and try harder than doctors, who just throw pain medication and procedures at you. Believe me, I did the gamut, from stem cell replacement to accupunture to shots to rhistotomy. Good luck out there.