Migraine Headaches

What Are Migraine Headaches?

Migraines are debilitating headaches that cause throbbing or pulsating pain that is usually limited to one side of the head, but often times involves both sides of the head. Patient may also experience neck pain, light sensitivity, fatigue, visual disturbances, nausea, and vomiting. These headaches affect everyone differently, with some people experience mild to moderate migraines lasting for only a half hour, and others battling debilitating pain for hours or days. Migraine headaches are often hereditary, can result following head or neck injury  such a whiplash from a motor vehicle accident. Many patients suffer for many years until the right diagnosis is established given the variety of symptoms migraine patients experience. Certain factors like stress, anxiety, and poor sleep patterns can contribute to the frequency and severity of migraine pain.  Physicians at RA PAIN Services specialize in treatment of migraine headaches, and will be able to offer you a comprehensive migraine treatment plan after a thorough consultation. Treatments may include medications, physical therapy, chiropractic treatments, dietary modifications, nerve blocks, Botox, or cutting edge treatments such as a Radiofrequency neurotomy and occipital nerve stimulator. 

Should I seek treatment for my migraine headaches at RA Pain Services?

You should seek treatment for your headaches if they occur frequently and are obstructive to your day-to-day life. It is essential to have the appropriate evaluation and accurate diagnosis. Over the counter medications may be helpful for the occasional migraine, but prolonged usage of these medications can cause gastrointestinal bleeding and other side effects including rebound headache. We have Board Certified Neurologists and Pain Medicine specialists at RA Pain Services who specialize in evaluation and treatment of migraine headaches, and will be glad to provide you with a consultation. 

What types migraine headache treatments will my doctor recommend?

There are many treatment options that are available for migraine headaches. Treatment recommended will depend on the migraine severity, frequency, and other symptoms. Our goal is to improve patients quality of life, function, and minimize side effects that may occur with medications. Dietary and lifestyle modifications are very important, and will be strongly emphasized. Medications to treat migraine headaches may include specific abortive therapies or preventative medications, which will depend on the individual symptoms.  Many patients experience chronic headaches, which may be related to Cervical spine (Neck) conditions such as herniated discs, arthritis in the facet joints (Cervical spondylosis), muscle tension that affect the small nerve called Greater Occipital Nerve, that may result in debilitating occipital headaches and neck pain. Many patients who suffer with frequent headache find that occipital nerve blocks and botox injections are highly effective for reducing the frequency and severity of migraine headaches. There are other treatments that may be recommended, which will be determined during your consultation. Treatments may also referral for physical therapy, chiropractic treatment, or more advanced procedures performed under X-Ray guidance if headaches are determined to be related to cervical spine herniated disc or facet joint arthritis.  These treatments include Epidural Steroid injections, Cervical Facet joint blocks, or Radiofrequency Neurotomy. 

Who is a candidate for Botox treatment?

Botox treatment for chronic migraines is FDA approved treatment and indicated for patients suffering with migraine headaches greater than 15 days per month, lasting at least four hours per day, and no improvement with preventative medications. This is a very safe and effective treatment that is performed in the office, and patients are able to return to normal activity immediately after. Most patients report significant reduction in headache frequency and intensity, which on average will last three months, at which point the treatment can be repeated.

Migraine Dietary Triggers: which Foods to avoid?

Migraine headaches are often triggered by specific external factors such as poor sleep patterns, hunger, or specific food groups. By keeping a headache diary, it will be helpful to your doctors to identify specific triggers.  Most common dietary triggers to consider include Chocolatealcohol (red wine is the worst)aged cheeses (Cheddar, american), nuts (ex: Peanuts, almonds, cashews, etc.), peanut butter, avocados, soy sauce, smoked meats, artificial sweeteners, and too much caffeine.  Your doctor will discuss additional important lifestyle modifications during your appointment. nuts peanut butter wineCheese
aspartame caffeine chocolateavocoda


Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population — prevalence study. J Clin Epidemiol 1991;44:1147-1157