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Migraine and Headache Care

woman with migraine image

More than 90 percent of all headaches do not have any obvious cause and are not associated with any recognizable, serious condition.

But this does not mean you should ignore the pain of chronic headaches. Untreated headaches such as migraines can affect your quality of life and ultimately lead to disability.

Untreated headaches, particularly migraines, may worsen over time and become harder to treat.

Our neurologists have advanced training in headaches, facial pain and pain management. This level of specialized expertise helps us treat headaches and screen patients for conditions such as brain tumors, stroke or neck problems that may be the root cause of headaches.

Conditions We Treat

We treat all types of headaches, including:
  • Tension headaches
  • Migraines
  • Cluster headaches (headaches that always occur on the same side of the head)
  • Chronic daily headaches
  • Medication overuse headaches
  • “Sinus pain,” a misnomer for headaches that are usually migraines

When to See a Doctor

Most headache specialists generally agree that a person who has headaches more than once a week for three consecutive months or longer should get medical help. You should get immediate medical attention if you are experiencing headaches accompanied by any of the following:

  • Stiff neck or fever
  • Dizziness, unsteadiness, slurred speech, weakness, numbness, tingling
  • Confusion or drowsiness

Other red flags that warrant immediate medical attention include headaches that:

  • Always occur on the same side of the head
  • Worsen when lying down
  • Started while on steroids, chemotherapy, HIV medications or any other immunosuppressant medication
  • Started after the age of 50 for the first time or are “the worst headache of my life”

What You Can Do Before Your First Visit

You can greatly help your physician tailor an effective treatment to your condition by keeping a detailed headache diary. Items to note and record include:

  • The location where your headache starts (front of head, back of eyes, back of head, neck or temple area)
  • The duration of your headache (with and without taking medication)
  • Any symptoms co-occurring with headaches
  • Possible headache triggers, such as a particular food, smell or stress
  • Number of days per week you take medications for headaches
  • A list of all medications taken currently or previously, their doses and durations

Treatment for Headaches

Strategies we  offer at UC San Diego Health include:

Medication Management

After proper diagnosis, medication management is usually the first step in treating headaches. This is true even for patients who have already tried different medications without relief. We will work with individuals to identify the correct medication, dose and duration of treatment.

Lifestyle Modifications

Regular exercise and stress management can help alleviate headaches and improve long-term health more generally. Yoga, tai-chi and other mind-body practices are particularly beneficial and are recommended for our patients.

Avoiding certain food and weather triggers can also be helpful. Artificial sweeteners, nitrates, MSG, alcohol and atmospheric pressure changes are among the more common migraine triggers.

Multiple studies show that migraines often become chronic among overweight individuals. For this reason, attaining or maintaining a healthy, normal weight is a key component of each person’s treatment plan. Drinking plenty of fluids, avoiding stress and getting adequate sleep are also all important and addressed.

Physical Therapy and Biofeedback

Physical therapy in conjunction with biofeedback can be extremely helpful for some patients, particularly those with chronic tension-type headaches.


Acupuncture can help alleviate headaches in some people and is offered at UC San Diego Health’s Center for Pain Medicine

Injections and Other Interventions

For those with severe intractable pain, nerve blocks, trigger point injections and Botox injections are available.

Multidisciplinary Approaches

Our physicians work with patients who do not respond to a single approach by combining multiple treatment options. Healthy lifestyle choices and good mental health are always core components of our treatment plans.

Online Second Opinions

If you've received a diagnosis that requires neurosurgery and would like one of our neurosurgeons to review your X-rays and other imaging studies, UC San Diego Health offers online imaging reviews. It's an easy and affordable way to help you make an informed decision before neurosurgery. For more information, see Online Second Opinions.