As part of our evaluation process, we will try to ensure that any serious causes of your headache disorder have been ruled out. Some of these secondary causes include conditions such as aneurysms, tumors, infection and inflammation. Fortunately, most headaches are primary, such as migraine or cluster headaches, and once we have established that there are no worrisome causes for headache, our goal is to ensure that we diagnose the underlying headache disorder correctly. In the majority of the patients this means we are dealing with migraine. Once we have established the correct diagnosis, the next step is to develop a management plan for your specific headache disorder. This will include education about what we know about the causes of your headache disorder, the potential triggers that may be worsening the headache problem, and discussion about the variety of treatment options.
One of the main goals of our treatment is to develop a preventative approach for your headache disorder. This may require daily medications to reduce the headache frequency and severity. Importantly, painkillers, particularly opiates, but even over-the-counter medications such as Tylenol, may aggravate the underlying headache disorder and could interfere with preventative treatments. As a result efforts will be made to wean you off of these medications and establish a preventative approach that can allow you to become headache-free. In some instances it may not be feasible to wean off of painkilling medications. In this situation we may refer you to a pain specialist.
In addition to preventative treatments, we have a strong focus on managing headaches acutely. This will require developing an acute treatment plan that will focus on quickly stopping the headache when it begins. If this approach fails, patients have the option of coming into the clinic on an urgent walk-in basis for acute care. Treatments include intramuscular injections of anti-inflammatories, anti-nausea medication, and nerve blocks. The latter involve injections around nerve endings that supply the head and scalp.
Sphenopalatine Ganglion Nerve Block Injection (TX360)
The Sphenopalatine Ganglion (SPG) is a group of nerve cells that is linked to the trigeminal nerve, the main nerve involved in headache. The SPG, located behind the nose, carries information about sensation, including pain, and also plays a role in autonomic functions, such as tearing and nasal congestion.
How often can I have this procedure done?
Tx360® device use reports reduced frequency and severity of chronic migraine pain over a six month period if the procedure was done twice a week for six weeks (a total of 12 procedures).
Will insurance cover this procedure?
Most insurance carries cover SPG block for a variety of headache disorders, but you should speak with your insurance representative to ensure it is covered if your provider performs it.
Occipital Nerve Block Injection for Acute Headache
Injections of local anesthetic in the greater or lesser occipital regions may lead to complete resolution of a severe headache.
Botox for Chronic Migraine
Please download the Headache Questionnaire (click on the pdf icon) and bring it to your visit. This will ensure that our Physicians will provide the most comprehensive care and offer you the right choice of treatment for your headache.