Migraine and Tension Headache Relief: Severe Headache and Migraine Treatments You Might Have Overlooked
Our New Jersey Headache and Migraine Clinics provide a broader, more detailed and step by step approach for people with severe migraine or tension headaches. We help treat patients with severe headaches by spending extra time with them. Our typical new patient visit includes 1.5 hours with the physician plus additional time with our nurse educator. We also integrate holistic and alternative medicine approaches with the most useful headache medicines. We find that our patients gain the most migraine or tension headache relief when we take the extra time to best understand each individual's headache and all lifestyle factors that may contribute to their headache. Better understanding means better headache treatment.
Is your headache diagnosis correct? Many people with severe headaches have more than one kind of headache. At our New Jersey Headache and Migraine Clinics we carefully evaluate each of your several headaches. We pay special attention to identifying triggering factors, including metabolic, nutritional and environmental headache triggers. We ask you to complete a 25 page headache history questionnaire. We read this carefully before your first visit. A more correct diagnosis means better migraine treatment.
In our Summit and Somerset, New Jersey (NJ) Headache and Migraine Clinics we find that most headache patients have additional or “comorbid” conditions. These additional conditions are often overlooked; but their effect on your headache can be important.
We can often identify correctable problems such as: Sub-optimal diet, Food Allergies/Sensitivities, Non-restorative sleep, Low blood sugar (hypoglycemia), Awkward posture, Thyroid or Sex-hormone imbalances, Unsuspected medicine side-effects and/or psychological stress. Helping these problems often increases migraine and tension headache relief.
Medicines for tension or migraine relief or prevention can be terrific. But too often medicine side-effects are also a problem. Good scientific studies show that adding natural or “alternative” migraine headache relief treatments often makes a difference. For example:
- Detect and eliminate food allergies or sensitivities e.g. wheat gluten, sugar, yeast.
- Recognize food additives that are common migraine triggers e.g. MSG, Nutrasweet™, Nitrates and others.
- Add herbal or nutritional treatments that reduce headache risk such as coenzyme Q10, the herb Butterbur, the vitamin Riboflavin, and/or the mineral Magnesium.
- Identify and reverse low blood sugar vulnerability.
- Review the role of caffeine. Caffeine can help treat headache; but caffeine “addiction” is an important and unsuspected headache trigger.
Standard Physical Therapy tension or migraine treatments can often help even severe tension or migraine headache. But, more specialized techniques are often needed. Part of our initial history and physical exam evaluates whether your particular headache is likely to benefit from such specialized care.
Please see our listing of recommended specialized physical therapists in New Jersey (NJ), New York (NY), and Pennsylvania (PA). These physical therapists have special interest and experience focusing on tension and migraine relief. Please contact our office if you know of physical therapists who might be added to our list.
Temperomandibular Joint Dysfunction (TMJ)—Stresses and strains in and around the jaw are common but often overlooked triggers of severe headaches. Please refer to our listing of recommended dental specialists in New Jersey (NJ), New York (NY), and Pennsylvania (PA).
We also evaluate each patient carefully for fibromyalgia—a common comorbid headache trigger. Treating fibromyalgia often improves both migraine and tension headache relief. More information on headaches and fibromyalgia is on our Fibromyalgia page.
Headache doctors typically use the following tension or migraine relief medicines to prevent migraine and/or tension headache. These include: Beta blockers (e.g. Inderal); Tricyclic antidepressants (Elavil), Anti–seizure medicines (Topamax, Depakote, Neurontin, Lyrica, Lamictal); Calcium channel blockers (Verapamil).
These medicines often provide excellent tension or migraine headache relief—IF common side effects don’t get in the way. But other medicines, less recognized for migraine or tension headache relief can also help—and perhaps be better tolerated. Effective migraine or tension headache relief treatments include the following:
- Muscle relaxants for migraine or tension headache relief
- Local anesthetics (Lidocaine patches, nasal sprays or injections)
- Antihistamines for migraine relief (Periactin)
- ACE inhibitor blood pressure medicines for migraine relief (Lisinopril, Atacand)
The same medicines are also useful in cluster headache treatments.
For very severe migraine or tension headache we might consider promising but still semi-experimental techniques such as Botox, Lidocaine injections around the occipital nerve in the back of the head, or Lidocaine on a tiny cue tip to reduce pain transmission at an important nerve juncture high up at the back of the nose. For selected patients, tension or migraine headache relief can be major.
“Rebound” or Medication Overuse Headache (MOH) is more common and important than we used to think. Some, but not all persons with severe headaches who take acute headache relief medicines 10 to 15 days or more each month—these severe headache patients can fall into a vicious cycle called MOH—Medicine Overuse (or Medicine Withdrawal) Headache.
Think how drinking 4 or 5 cups of coffee a day makes some people “caffeine dependent”. If their coffee is stopped, headache results. The same kind of rebound or withdrawal headache can sometimes be caused by regular use of migraine relief medicines. We are especially concerned about MOH caused by barbiturates (e.g. Fiorinal), Triptans (e.g. Imitrex) or opiate drugs (e.g. Percocet).
Treatments for Medication Overuse Headache have to be individualized for each patient’s special needs.
We find that we accomplish the most for migraine or tension headache relief when we take extra time with each patient to understand the complexities of each individual pattern of headaches. That’s why we ask you to fill out a very detailed Headache and Migraine Health History Questionnaire. We review this before your visit. That’s also why we schedule 1.5 hours with the physician at our first visit, as well as time with our nurse educator.
(Please note: Because we take this “extra” time we cannot accept commercial health insurance as full payment. Nor do we take Medicare as either full or partial payment.)
To consult with Dr. Podell at our New Jersey Headache and Migraine Clinics, please review our New Patient information and download our Headache and Migraine Health History Questionnaire. If you are unable to download or have questions, please speak to our staff at our New Jersey Headache and Migraine Clinics in Summit NJ (main office) and Somerset NJ. They can mail you the appropriate Questionnaire(s).
Is your headache an emergency and you don‘t think you can wait for an appointment? Find out the signs of a severe headache emergency and what you can do about it.
To Learn More About Dr. Podell’s Holistic Approach to Health Treatment: Merging Traditional Medical Practice With Alternative Therapies, review our Home page.
Learn More About Severe Headaches, Migraine Relief and Tension Headache Treatments
Headache Diagnosis and Headache Treatment Summary by the National Institutes of Health (NIH) – This is a brief summary about headache diagnosis and tension and migraine treatments.
For more on severe headaches, review information provided by the National Headache Foundation.
Alternative Migraine Treatment - Abstracts of scientific papers for promising alternative migraine treatments.
Severe Headache Relief from David Burns, M.D., author of Feeling Good: The New Mood Therapy – A very practical work that helps you “reframe situations” to see the glass half full instead of half empty—a guide to cognitive behavioral therapy. Many of our New Jersey, New York, and Pennsylvania headache and migraine patients have found Dr. Burn’s book to be very helpful.
Migraine Relief: Learn about Medication Overuse Headache (M.O.H.) – MOH or Medicine Overuse Headache is an important but often unrecognized cause of severe headache.
The Jefferson University Hospital Headache Center is one of the most advanced tension and migraine treatment headache clinics in the United States as is The Mayo Clinic Migraine Headache Treatment Clinic in Scottsdale Arizona. Their websites are worth reviewing.
Dr. Podell is grateful for having had the opportunity to spend time working with Dr. Dodick and his associates at the Mayo Clinic Migraine Clinic in Arizona and with Dr. Silberstein and his associates at the Jefferson Headache Center in Philadelphia.