The Montefiore Headache Center is dedicated to a comprehensive approach to diagnosing and treating patients with headache. To achieve optimal and long-term results, patients can benefit from treatments that include:
During your initial visit to our clinic, a licensed fellow will interview you and take a detailed and comprehensive medical history. People with severe headaches are often coping with unusual amounts of stress, depression and anxiety, so you will also have the opportunity to get a psychological evaluation and meet with a licensed psychologist associated with the Center. This evaluation is a key component to the proper diagnosis, treatment and management of headache.
You will then be seen by one of our physicians, who will use your interview, psychological evaluation and the physician's exam to develop a treatment and management plan specifically for you.
We use a team approach to treatment. Your treatment team includes your attending physician, the nurse coordinator, a neurology fellow, a psychologist, neurology house staff and the unit nurses. Other team members may include a physical therapist, dietitian and medical students. These professionals work together to ensure that you receive comprehensive treatment according to your care needs.
Research shows that when practiced correctly, techniques such as biofeedback, cognitive behavioral therapy, relaxation training and stress management can be as effective as medication in the treatment of headaches. They can also make medication work more effectively.
Patients learn how to manage stress by focusing on their heart rate, blood pressure, circulation, muscle tension and breathing to avoid headaches and reduce headache pain. Some approaches such as relaxation practice and stress management can be learned and practiced independently. Others, including biofeedback and cognitive behavioral therapy, require assistance from trained professionals—including doctors, physical therapists, occupational therapists, social workers or other experienced allied health professionals.
Biobehavioral treatments are especially important for patients who cannot take certain medications, like pregnant women or women who want to become pregnant.
Our trained clinicians provide botulinum toxin (Botox) injections, an approved therapy for the treatment of chronic migraine.
Occipital and other peripheral nerve blocks are injections that involve a local anesthetic and occasionally a steroid for patients that suffer from various types of headache disorders. These injections are performed in the clinic, and the patient, after a few minutes of observation, can return to his or her daily routine afterward.
A trigger point (a knot that forms when a muscle fails to relax) can often be felt under the skin. When trigger points are located in the neck, shoulders and upper back, these muscles contribute significantly to certain types of headache by trapping or irritating surrounding nerves and causing “referred” pain that is felt in another part of the body.
Trigger point injections treat extremely painful areas of muscle and alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatment. They are also helpful in treating headaches by relaxing the muscles that may contribute to pain.