Headaches & Migraines

Migraines are a specific neurological condition with distinct features beyond pain. They typically cause moderate to severe throbbing pain (often one-sided), sensitivity to light and sound, nausea, and can last 4-72 hours. Many people experience warning signs (aura) like visual disturbances. Tension headaches are usually milder, feel like pressure or tightness, and lack the associated symptoms of migraine.

You should see a neurologist if you have headaches more than 15 days per month, headaches not controlled by over-the-counter medications, new or changed headache patterns (especially after age 50), headaches with neurological symptoms like weakness or vision changes, or sudden severe headaches. A neurologist can provide accurate diagnosis and access to advanced treatments.

Botox (botulinum toxin) is approved for chronic migraine (15+ headache days per month). It works by blocking pain signals and relaxing muscles. Treatment involves multiple small injections around the head and neck, performed in the clinic every 12 weeks. Most patients notice improvement after 2-3 treatment cycles. Medicare rebates may apply for eligible patients.

CGRP (calcitonin gene-related peptide) medications like Aimovig, Ajovy, and Emgality are newer preventive treatments specifically designed for migraine. They work by blocking CGRP, a molecule involved in migraine attacks. Given as monthly or quarterly injections, they can significantly reduce migraine frequency with minimal side effects. They're particularly helpful for people who haven't responded to other preventives.

Key lifestyle factors include maintaining regular sleep patterns, staying hydrated, eating regular meals, managing stress, and regular exercise. Identifying and avoiding personal triggers (such as certain foods, alcohol, or hormonal changes) is important. Keeping a headache diary can help identify patterns and triggers. These strategies work best alongside appropriate medical treatment.

Medication overuse headache occurs when pain relievers are used too frequently (typically 10-15+ days per month), causing the brain to become more sensitive to pain. This can transform occasional headaches into daily headaches. The solution involves gradually reducing pain medication under medical supervision while starting preventive treatment. This is one of the most treatable causes of frequent headaches.