Treatment Continuum

In health care, the standard of care typically involves utilizing the most conservative treatment for any health-related malady.

Step 1: Preventative and Prophylactic Behavior

Lifestyle changes are a critical part of migraine treatment. A severe headache can indicate a health problem such as dehydration, lack of sleep, stress, sensitivity to environmental factors, an allergy, or spine pain.

It is important for any migraine sufferer to keep a migraine diary to be able to identify if there is a pattern to the migraine occurrence, and how severe the migraines are.

You should also keep a list of migraine triggers and systematically try to remove such triggers from your environment, to see if the removal reduces your headache severity. Sign up for this migraine blog to get tips and reminders on managing your health and lifestyle – which will be an important part of treatment, no matter what other solutions you pursue.

Lifestyle management examples include: drinking 8 cups of water per day, wearing sunglasses in bright light, sleeping 7 hours or more per night, exercising and stretching regularly, practicing meditation and relaxation, eating healthy food, treating allergies and avoiding migraine triggers.

Triggers vary, and may include: chocolate, gluten, dairy foods, and strong smells. Download a full list of migraine triggers here.

When you take your migraine diary to your primary care physician to discuss your chronic headaches, he or she may identify a health concern that is creating migraines as a symptom, such as spine pain, that could be addressed with physical therapy. Treating the root cause of the pain is always preferable to masking the pain with pain medication.

Step 2: Aborting the Migraine Attack

If you continue to experience migraines even after lifestyle management, it may be time to use medication to control your symptoms. Pharmaceuticals include over-the-counter painkillers such as Aspirin, Naproxen, Acetaminophen and Ibuprophen.

Your physician may also prescribe medications such as muscle relaxants, anti-anxiety drugs, anti-depressants, prescription NSAID’s or strong pain medication.

Step 3: Pain Management

If lifestyle management and pharmaceuticals have not relieved your migraine pain, your primary care physician may refer you to an interventional pain management specialist, who can provide a multi-disciplinary approach to treat your migraine pain. Most patients referred to an interventional pain management specialist are experiencing chronic migraines, which are defined as severe headaches that occur more than 15 days per month (almost half of the month) and last more than 4 hours each (almost half of your waking day).

Patients experiencing chronic migraines typically have had their lives disrupted by their migraine pain, and may have become depressed because of the limitations the migraines have placed on them.

Migraine Treatment Centers of America was created to help chronic migraine sufferers find an interventional pain management specialist, and to direct them to the appropriate medical procedure for the chronic migraine pain.

Interventional pain management treatments may include

  • Narcotic injections such as Demoral or Toradol, which are injected intramuscularly to control the pain
  • Nerve blocks, which are injections such as Botox, Depomedrone or Sarapin, which paralyze the nerves that transmit pain
  • Surgery, such as a modified brow lift, to remove the nerves associated with migraine pain
  • Neurostimulation, which provides gentle stimulation to nerves to effectively mask the pain

Interventional pain management treatments for migraine pain are intended to last for long periods of time, from weeks or months (for injections), to years (for neurostimulation) or permanently (in the case of plastic surgery).Such treatments are reserved for patients who have a history of chronic migraine pain, and have tried more conservative treatments first.

Since the true cause of migraine remains a mystery, almost all migraine treatments focus on removing the migraine symptoms – in other words, the migraine still occurs, but your brain will not feel the pain. The best way to truly prevent a migraine is through lifestyle management and trigger prevention, which will be important in combination with any symptom-blocking treatment that you pursue.


The graphic below illustrates common treatments for most patients beginning with the most conservative treatments to more aggressive treatment methods.  Click the treatment continuum graphics below to enlarge.

Migraine Treatment Continuum

Spine/Neck Treatment Continnum

Please Note: The use and/or implantation of FDA-approved neurostimulation equipment to treat migraines or chronic headaches is not an FDA approved procedure.  The physician will determine whether this procedure is medically necessary, which is standard in the medical profession.