Department of Migraine and Chronic Headache Treatment

Migraine and chronic headache are conditions defined by headaches occurring more than 15 days per month for at least 3 consecutive months. These conditions significantly affect quality of life, daily functioning, and work performance.
When medication alone does not provide adequate relief, interventional pain management procedures offer an effective and evidence-based treatment option.

 

Diagnosis and Clinical Evaluation

Diagnostic Criteria

According to the International Classification of Headache Disorders (ICHD), chronic migraine is diagnosed when:

• Headache occurs more than 15 days per month, and

• At least 8 days per month have migraine features, such as:

  • Unilateral or localized headache

  • Moderate to severe intensity

  • Associated symptoms including nausea, vomiting, or sensitivity to light and sound

Identifying the Underlying Cause

• Imaging studies such as CT scan or MRI may be used to rule out structural brain abnormalities, although they are not required in all cases.

Severity Assessment

• Pain severity and impact on daily life are assessed using standardized tools such as:

  • Numeric Rating Scale (NRS)

  • Visual Analog Scale (VAS)

 

Interventional Pain Management Options

1. Nerve Blocks

Occipital Nerve Block
Injection around the occipital nerves to relieve migraine and tension-type headaches.

Supraorbital Nerve Block
Blocks the nerve above the eye socket to reduce migraine pain or facial pain related to the trigeminal nerve.

Greater Occipital Nerve Block
Targets higher-level occipital nerves and is effective for chronic headache syndromes.

 

2. Trigger Point Injections

Myofascial Trigger Point Injection
Local anesthetic injection into tight muscle knots to relieve muscle-related head and neck pain.

Botulinum Toxin Injection (Botox)
Botox injections help relax overactive muscles and are an established treatment for chronic migraine, reducing headache frequency and severity.

 

3. Radiofrequency Ablation (RFA)

This technique uses high-frequency electrical energy to selectively deactivate nerve fibers responsible for transmitting pain signals to the brain.
RFA provides longer-lasting pain relief and is suitable for patients who do not respond adequately to medication or injections.

 

4. Neuromodulation

Neuromodulation uses electrical or magnetic stimulation to modulate pain pathways in the nervous system.

• Small implantable devices are placed under the skin to deliver controlled electrical signals, such as:

  • Greater Occipital Nerve Stimulation

  • Cervical Spinal Cord Stimulation

These techniques help regulate abnormal nerve activity and significantly reduce chronic headache and migraine symptoms.

 

Benefits and Risks

Benefits

• Effective and sustained pain relief

• Improved quality of life and daily functioning

• Reduced long-term dependence on medication

Risks

• Possible complications include infection, allergic reactions, or nerve injury

• Treatment decisions should carefully balance benefits and risks

• Patients should always consult a medical specialist before undergoing any procedure

 

Conclusion

Interventional pain management is a highly effective option for patients suffering from chronic migraine and chronic headache, especially when conventional medication is insufficient.
A thorough evaluation by a specialist physician is essential to determine the most appropriate and personalized treatment plan.

 

Our Services

We provide comprehensive care for chronic headache and migraine conditions, including treatment for:

- Migraine headaches

- Tension-type headaches caused by neck and muscle tightness

- Neuropathic (nerve-related) headaches

- Headache related to cervical spine abnormalities

Our goal is to help patients regain comfort, functionality, and a better quality of life through safe, modern, and targeted pain management approaches.

Our healthcare service offers interventional pain management for chronic migraine and headache, including nerve blocks, trigger point injections, radiofrequency ablation, and neuromodulation. These methods aim to provide effective pain relief, enhance quality of life, and reduce medication dependence.