Headache and migraine treatment

Headache and migraine disorders can be difficult to pinpoint, which is why our care team is loaded with expertise, including a full-time, board-certified, fellowship-trained neurologist whose practice is focused on diagnosing and managing headache and migraine and who maintains relationships with American Academy of Neurology and the American Headache Society. This additional specialty training and network enable an extra layer of expert care to tackle the toughest cases.

Our expert, interdisciplinary headache and migraine team includes:

• RN nurse navigator: Our nurse navigator understands your condition and can help coordinate your care, give you care tips, and answer your headache and migraine questions.
• Nutrition services: Get advice about dietary triggers or manage symptoms with a specialized diet.
• Rehabilitative therapy: Directed therapies, including stretching, strengthening and trigger-point release can reduce muscle spasms in the neck and head, helping address symptoms.
• Social worker: Our team can connect you to resources you may need to get treatment or receive appropriate accommodation for your diagnosis.
• Specialty pharmacy: Our specialty pharmacy handles the intricate ins and outs of complex neurologic prescriptions all day, every day. Our specialty pharmacy is accredited by the Utilization Review Accreditation Commission (URAC), which means we meet the highest quality standards for care, quality and safety among specialty pharmacies. The specialty pharmacy can also assist you with insurance questions and explain out-of-pocket costs.

Our headache and migraine team’s goals include:

• providing the full spectrum of options for treatment through medications, supplements, devices and procedures
• helping interpret scientific data and knowledge
• supporting and advocating directly to — and on behalf of — patients in a way that allows them to live their lives most fully and according to their own values and priorities

No headache or migraine is quite the same. We work with you to accurately diagnose and treat your specific symptoms and kinds of headache or migraine disorders.

Our experts help treat these main headache disorders:

Tension type headache: These are the most common headaches, marked by a pressure-sensation wrapping around the head, rather than a pulsating one. They can be touched off by stress, muscle tension, fatigue, allergies or environmental factors, among other things. They can last from a half hour to several days, and do not usually come with nausea or other symptoms of migraine.

Cluster headache and other related headache disorders: This type of headache disorder is rare, but extraordinarily painful, and often described as having an ice pick stabbed through one eye. They are more common in men than women and can be chronic or episodic. The pain centered around the eye may be accompanied by a tearing eye or drooping eyelid, pupil constriction, nasal congestion, sweating and more. They can strike and disappear quickly but reappear multiple times per day.

Migraine: This category can include migraine with or without neurological symptoms commonly referred to as an aura. Some types of migraine may cause unusual symptoms — with or without head pain — such as abdominal migraine, hemiplegic migraine, isolated visual aura (often called ocular migraine) and vestibular migraine.

Other rare primary headache disorders: This category can include headaches such as hypnic headache (occurs during sleep), nummular headache (persistent, coin-shaped area of pain on the scalp), primary cough headache (occurring exclusively when coughing) and many others.

Secondary headache: These headaches appear as a symptom of something else, such as a brain tumor or aneurysm. We will help determine if there are any red flags that suggest your headache may warrant more diagnostic testing.

Additionally, there is some overlap between headache disorders and disorders of neck and facial pain. They include occipital neuralgia (back of the head) and trigeminal neuralgia (bursts of facial pain), which we also diagnose and treat.

You deserve a personalized plan to tackle your toughest headache and migraine symptoms. Together, we can develop the treatments that work best for you. They may include: 

• Injections: Our team offers a variety of injections to help control headache and migraine disorders, including Botox, trigger point injections, sphenopalatine ganglion (SPG) block and nerve block injections, including ultrasound-guided nerve block injections.
• Integrative and behavioral therapies: We partner with the Penny George Institute for Health and Healing to provide integrative therapies, including acupuncture, that may help reduce or eliminate your symptoms. Behavioral treatments can include Cognitive Behavioral Therapy (CBT) or biofeedback to address your pain and its impact on your life.
• IV infusions: We partner with the Allina Health Cancer Institute to deliver IV infusion therapy at multiple convenient locations. These medications are delivered directly to the bloodstream for faster, more effective pain relief.
• Lifestyle modifications: We are here to help you sort through what is scientifically supported when it comes to identifying and addressing headache triggers.
• Neuromodulation devices: These noninvasive devices can help prevent, reduce or stop migraine and cluster headaches with magnetic or electrical stimulation. These are especially good for those experiencing breakthrough, drug overuse or refractory headaches that are not fully relieved by medications. 
• Nutrition services: Nutritionists can help analyze your diet for trigger ingredients or foods, plus recommend balanced meal plans that support neurological and physical health and wellbeing.
• Oral medications: This can include medications taken on a regular basis to prevent migraine attacks and others to reduce symptoms or stop an ongoing attack in its tracks.
• Rehabilitation therapy: Occupational and physical therapy through our 50-plus, conveniently located Courage Kenny Rehabilitation Institute (CKRI) locations can help improve underlying blood flow, musculoskeletal issues, tension, posture and more, leading to pain relief. These therapies can also help with pain tolerance and learning how to manage symptoms when they happen.

If you’ve been struggling with headache or migraines for a while, it helps to come prepared to discuss your history.

Some things to think about, write down and bring to your appointment:

• Detailed descriptions of headache or migraine symptoms or patterns, including how many days in the last three months you missed work, household tasks or social events, as well as when you were able to be present but not functioning at your best due to headache.
• Any known headache or migraine triggers.
• The location, intensity and duration of your pain and other associated symptoms.
• Medications — past and present, over-the-counter and prescription. It also helps to know how often, or for how long, you’ve used them.

We spend a lot of time identifying your experiences, symptoms and concerns so that we can arrive at an accurate diagnosis and treatment plan that is right for you.

Your initial intake may take up to an hour. We’ll review your medications, including what has worked and what hasn’t. We may send you home with homework, such as a migraine diary, to track symptoms and help give us additional insight into your condition. We may also recommend lab tests or an MRI as a follow-up for further information.

Appointments come by referral from your general practitioner.

Insurance coverage may vary based on your policy — call the number on your insurance card to check your specific coverage and financial responsibility.