Migraines typically cause severe, pulsating pain on one side of the head. A “chronic migraine” diagnosis is specific: amongst other symptoms, one must experience 15 or more headache days per month.

What Causes Chronic Migraines?

A “chronic migraine” diagnosis is dependent on the frequency of migraines, and not on the type of symptoms or headache triggers. As a result, the triggers for chronic migraine sufferers completely overlap with non-chronic migraine sufferers, including:

  • Specific types of food
  • Stress
  • Dehydration
  • Certain medications
  • Insufficient sleep or too much sleep
  • Environmental exposures
  • Exercise

Anatomically, there are four “triggers” – or nerve areas where the migraine can start (on one or both sides):

  • Forehead
  • Temples
  • Nose (usually felt behind the eye)
  • Neck

Importantly, migraine triggers vary patient-to-patient. For those who believe they are suffering from migraines, it is important to receive a proper diagnosis and treatment from a primary care doctor or neurologist.  

Migraine Triggers

Various factors can “trigger” migraine headaches. Fortunately, an individual who can identify his or her migraine triggers is better equipped than ever before to treat a migraine attack before it escalates.

Sometimes, an anatomical migraine trigger leads to a migraine attack. The four anatomical migraine triggers are:

  1. Forehead: Causes migraine pain above the eye or on the forehead.
  2. Temples: Causes migraine pain in the temples area.
  3. Nose: Causes migraine pain behind the eye and around one or both sides of the nose
  4. Neck: Causes migraine pain from the back of the neck, as well as on one or both sides of the neck.

Other migraine triggers include:

  • Food
  • Changes to a person’s daily or weekend routine
  • Insomnia or too much sleep
  • Caffeine
  • Environmental changes
  • Dehydration
  • Exercise
  • Drugs and/or medications
  • Muscle tension or other physical conditions

Meeting with a doctor offers a great first step to identify and treat migraine triggers. At this time, a doctor can also offer tips and recommendations to help an individual alleviate his or her migraine symptoms.

Chronic Migraine Symptoms

In addition to pain, chronic migraine sufferers can experience any of the classic or common migraine symptoms, including:

  • Nausea
  • Phonophobia (sensitivity to sound)
  • Photophobia (sensitivity to light)
  • Vomiting

Anyone experiencing one or more of these symptoms along with headache pain should meet with a doctor to see if a chronic migraine diagnosis is appropriate. At this point, a doctor should discuss lifestyle changes that can help decrease the frequency of migraines, and may prescribe any number of a selection of migraine medications, as well.

What Migraine Medications Are Available?

Common medications used to treat chronic migraines include:

  • Beta-Blockers
  • Calcium Channel Blockers
  • Antidepressants
  • Anticonvulsants

The overall effectiveness of migraine medications varies based on the individual, his or her migraine symptoms and other factors. If migraine medications cause intolerable side effects or fail to address an individual’s chronic migraine symptoms, a neurologist consultation is generally recommended.

Can Chronic Migraines Be Treated Without Medication?

In addition to taking migraine medications, there are several lifestyle changes that may limit the frequency of migraines, including:

  • Obtaining sufficient sleep
  • Decreasing caffeine intake
  • Eating regular meals
  • Avoiding migraine-triggering foods or environments
  • Reducing stress

Ultimately, taking a proactive approach to chronic migraines is key. If a person receives a chronic migraine diagnosis but finds that his or her current medications are ineffective or cause unwanted side effects, a consultation with Dr. Jonathan Cabin of The Migraine Institute may be ideal.

Migraine Treatment Options

Medications are commonly used to treat migraine pain. A doctor may prescribe “prophylactic” medications to prevent migraines, as well as “abortive” medications to treat migraines as they begin. Also, a doctor may prescribe “rescue” medications to treat migraine symptoms.

Although medications are among the most popular migraine treatments, they sometimes cause unwanted side effects. Or, medications may fail to deliver the desired results. If a person is dealing with chronic migraines and finds that his or her migraine medications are ineffective or cause intolerable side effects, this individual may qualify for Botox or minimally invasive migraine surgery.

Botox temporarily blocks faulty nerve signals in the brain that cause migraine attacks. Comparatively, migraine surgery permanently removes faulty nerve signals that trigger migraine pain. A chronic migraine patient may qualify Botox, migraine surgery or both. To determine if he or she is a good candidate for Botox and/or migraine surgery, it is important to meet with Dr. Cabin. That way, Dr. Cabin can perform a patient evaluation and determine the best course of action to treat an individual’s migraine pain.

Dr. Cabin’s Approach to Chronic Migraines

Dr. Cabin is a board-certified head and neck surgeon with dual subspecialty training in facial plastic and reconstructive surgery. This expertise allows Dr. Cabin to take a holistic approach to chronic migraines and help patients achieve long-term migraine pain relief.

To treat chronic migraines, Dr. Cabin performs a detailed patient consultation, including reviewing medical history. If indicated, Dr. Cabin will recommend specific testing. Using this patient data Dr. Cabin can offer a personalized treatment recommendation.

In some instances, Dr. Cabin recommends minimally invasive migraine surgery to treat chronic migraines. Or, in other cases, Dr. Cabin recommends Botox for chronic migraines. Dr. Cabin will review how chronic migraine treatment works and works to incorporate specific patient concerns and questions.

Minimally invasive migraine surgery is an outpatient procedure that eliminates nerve irritation associated with chronic migraine triggers. The surgery is tailored to a patient and has been shown to reduce migraine pain, intensity and duration. Also, approximately half of all migraine surgery patients have reported no migraines after surgery.

Botox for chronic migraines reduces or eliminates migraine symptoms. It involves Botox injections into one or more areas of the face. Botox treatments are temporary, and they are usually performed every two to four months.

Dr. Cabin requests a patient consultation before he treats chronic migraines with minimally invasive migraine surgery or Botox. In most instances, chronic migraine patients who receive Botox injections are also good candidates for minimally invasive migraine surgery.

Chronic Migraines FAQ?

Are chronic migraines common?

Migraines represent one of the world’s most prevalent diseases. Research indicates roughly 15 percent of the global population – or one out of every seven people – is currently dealing with migraines. Among these individuals, 2 percent suffer from chronic migraines.

How does a migraine differ from a chronic migraine?

A migraine causes severe throbbing or pulsating pain on one side of the head. It typically lasts between two hours and three days, resulting in vomiting, nausea and other physical symptoms. Additionally, a migraine is generally diagnosed and treated by a primary care doctor or neurologist.

A chronic migraine refers to a migraine headache that occurs for at least 15 days per month for more than three months. If an individual is dealing with chronic migraines and finds that his or her migraine medications are ineffective or cause unwanted side effects, Dr. Cabin can help.

Can chronic migraines be treated with over-the-counter (OTC) medications?

OTC medications like Motrin and Tylenol are commonly used to address mild headache pain. These medications sometimes provide temporary migraine pain relief. But for people dealing with chronic migraines, a long-term treatment may be required.

What are the stages of a chronic migraine?

There are four potential migraine stages:

  • Prodrome: Prodrome is the warning stage of a migraine attack and causes food cravings, muscle stiffness and other physical symptoms.
  • Aura: Aura usually causes visual disturbances and other changes in one or more of the senses.
  • Migraine Attack: A migraine attack causes pain on one or both sides of the head.
  • Postdrome: Postdrome, the final stage of a migraine attack, causes a hangover-like feeling that typically lasts 24 to 48 hours.

A person may experience one or more of the aforementioned migraine stages.

How is a chronic migraine diagnosed?

Dr. Cabin uses nerve block injections, a Doppler ultrasound and other tests to provide an accurate chronic migraine diagnosis. He also evaluates a patient and learns about his or her migraine history and migraine trigger points. With this information in hand, Dr. Cabin can offer a personalized chronic migraine treatment recommendation.

What is the best treatment for chronic migraines?

Chronic migraine symptoms vary in terms of duration and severity, and there is no one-size-fits-all treatment for chronic migraines. Instead, an evaluation is necessary to identify a patient’s chronic migraine triggers.

During a patient evaluation, Dr. Cabin conducts a series of specialized tests. Dr. Cabin also examines a patient’s medical history and conducts a physical exam. He then offers a personalized chronic migraine treatment designed to deliver long-lasting migraine pain relief.

Schedule a Chronic Migraine Treatment Consultation with Dr. Cabin Today

To set up a chronic migraine treatment consultation with Dr. Cabin, please call us today at 310.461.0303.