Hi, my name is Dr. Graham McRary. I am a board-certified physical medicine rehabilitation physician, specializing in interventional pain management at EmergeOrtho. The exact cause of migraines is actually not entirely known. There is currently a lot of ongoing research to try and figure out the ideology behind migraines. It is thought to be a combination of nerve and vascular phenomena, sometimes acting peripherally, meaning from the outside of the brain, and sometimes with neurotransmitters and peptides and the transmission of pain inside the brain.
Headaches can occur in different classifications, such as tension headaches and cluster headaches, that differ from a true migraine phenomenon. Migraines typically follow a classic pattern: they last longer, are a little bit harder to treat, and respond only to certain types of treatments. Migraines can last anywhere from seconds and minutes to numerous hours. Some people even have intractable migraines, which can last for days.
The best treatment for migraines is actually preventative. Start with a headache diary to see if there are any common triggers, including things as simple as cheeses, wines, alcohol, dehydration, stress, and menstrual cycles in women. Figuring out why you are having migraines and acting to prevent them will be the best treatment. If they continue, there are a number of different oral medicines that can be taken as needed or even daily to prevent migraines. There are also newer injectable medicines that can be helpful in reducing the frequency and intensity of migraines. If your migraines don’t respond well to these medicines, there are options such as Botox injections. Botox essentially acts to relax skeletal muscle in the area around the face, scalp and upper neck to try and reduce or prevent some of the peripheral sources of migraines.
You can see a pain management specialist at any time for a migraine, not only for treatment and prevention. Family medicine providers and your primary care providers are typically very knowledgeable on the topic of migraines, as well. If it exceeds their expertise, a neurologist or a pain management physician may be helpful for continuing your treatment.
If you suffer from migraines and have not found relief, schedule an appointment with the pain management specialists at EmergeOrtho. We are here to help you emerge stronger, healthier, and better.
