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Headache & Migraine · Chronic Migraines

More than a headache. A lot more.

Chronic migraines — defined as 15 or more headache days a month — are a neurological condition, not just bad luck with headaches. The throbbing, the light sensitivity, the nausea: there are real mechanisms driving them, and real treatments that interrupt that cycle without resorting to daily medication alone.

Your doctor may call this chronic migraine disorder or transformed migraine.

Often seen within a few days — sometimes as soon as tomorrow

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What's actually happening

What chronic migraines really is.

A migraine is not simply a severe headache. It's a neurological event involving the trigeminovascular system — a network of nerves and blood vessels in the brain and scalp. During an attack, this system becomes activated, releasing inflammatory molecules that cause the vessels to dilate and pain signals to amplify. That's what produces the throbbing, one-sided pain that gets worse with movement.

When attacks happen 15 or more days per month for three months or longer, the condition is classified as chronic migraine. At that frequency, migraines aren't just painful — they interfere with work, sleep, and relationships in ways that add up fast. Overusing short-acting pain relievers can actually make the pattern worse, a phenomenon called medication overuse headache.

The good news

Chronic migraines are treatable. With the right combination of preventive therapy and acute treatment — and by identifying personal triggers — most patients substantially reduce their headache days. Interventional options like nerve blocks give physicians an additional tool that works independently of daily medication.

The clinical picture

Episodic vs. chronic migraine

The International Headache Society defines chronic migraine as headache on 15+ days per month, with at least eight of those days meeting migraine criteria, for more than three months. The distinction matters clinically because it changes the treatment goal — from managing individual attacks to reducing overall frequency — and opens the door to preventive therapies, including interventional options, that aren't typically used for episodic cases.

How it feels

Common signs we treat.

Throbbing, one-sided pain

A pulsating pain that typically affects one side of the head, worsens with physical activity, and can last 4 to 72 hours without treatment.

Sensitivity to light and sound

Bright light and loud noise become genuinely painful during an attack — most people need a dark, quiet room to get through the worst of it.

Nausea with the headache

Nausea, and sometimes vomiting, is so common during migraines that it's part of the diagnostic criteria — and it can make oral medications harder to keep down.

How we treat chronic migraines

From hurting to healed.

We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.

Step 1

Diagnose the cause

A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.

Step 2

Calm it down

Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.

Step 3

Image-guided injections

If pain persists, a precisely targeted injection delivered to the source under imaging.

Step 4

Advanced options

For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.

Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.

Common questions

Still have questions?

A migraine is a neurological event, not just a bad headache. It typically involves throbbing pain (often one-sided), nausea, and heightened sensitivity to light and sound — and it can last hours to days. About a third of people also experience an aura: visual disturbances, numbness, or speech changes that precede the pain. Tension headaches, by contrast, tend to feel like a steady pressure on both sides and don't come with nausea or light sensitivity.

Triggers vary by person, but common ones include hormonal changes, disrupted sleep, skipped meals, dehydration, certain foods or drinks (aged cheese, alcohol, caffeine withdrawal), strong smells, bright or flickering light, and stress. Keeping a headache diary for a few weeks is one of the most useful things you can do before your first visit — it helps identify patterns that may not be obvious otherwise.

Treatment typically combines two tracks: preventive therapy (taken regularly to reduce how often migraines occur) and acute treatment (taken at the start of an attack to stop it). Preventive options range from daily medications to CGRP-blocking therapies to interventional procedures like nerve blocks. Acute options include triptans, newer CGRP receptor antagonists, and anti-nausea medication. Most patients do best with a plan that addresses both.

A nerve block for migraine typically targets the occipital nerves at the back of the skull, or in some cases the sphenopalatine ganglion — a nerve cluster behind the nasal cavity. A small amount of local anesthetic is injected to calm the nerve pathway that drives migraine pain. The procedure takes only a few minutes, often brings rapid relief, and can reduce attack frequency for weeks to months. It's a good option for patients who haven't responded well to medications alone.

Stop living with the migraine cycle.

Book with a board-certified pain physician near you — most patients are seen within days.

Book an appointment → Or call (855) 862-7767