About migraine
Migraine is a common neurologic condition that causes recurrent headaches, often on one side, along with sensitivity to light and sound, nausea, or visual changes called aura. Attacks can last hours to days and can make work, exercise, and family life difficult.
Chronic migraine means having headache on at least fifteen days a month for more than three months, with migraine features on many of those days. Seek emergency care for a sudden, severe headache that feels like the worst of your life, headache with fever and stiff neck, new weakness, confusion, trouble speaking, or a headache after a head injury.
Common symptoms
- Throbbing or pulsing head pain, often on one side
- Sensitivity to light, sound, or smells
- Nausea or vomiting
- Visual aura, such as flashing lights or zigzag lines, before the headache
- Pain that worsens with routine physical activity
- Fatigue or difficulty concentrating before or after an attack
Common causes and risk factors
- A genetic tendency, as migraine often runs in families
- Triggers such as poor sleep, skipped meals, dehydration, stress, and hormonal changes
- Frequent use of pain relievers, which can lead to medication-overuse headache
- Neck and shoulder muscle tension that can feed into headache
How we diagnose it
Dr. Chen takes a detailed headache history, including frequency, triggers, medication use, and warning signs, and performs a neurologic exam. A headache diary helps track patterns and response to treatment. Brain imaging is ordered when symptoms are unusual or change, and we coordinate with your neurologist or primary care physician as needed.
How Propel treats migraine
We start with the basics that make migraines less frequent: regular sleep, meals, hydration, managing medication use, and regular exercise, which many people with migraine tolerate and benefit from when it is built up gradually. We work alongside your other physicians on preventive and rescue medications.
For chronic migraine, Dr. Chen may recommend Botox injections, a series of small injections into the muscles of the head, neck, and shoulders repeated at regular intervals to reduce how often migraines occur. Occipital and sphenopalatine ganglion nerve blocks can help calm a stretch of frequent or prolonged headaches.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about migraine
- How does Botox help chronic migraine?
- Botox is thought to reduce the release of pain-signaling chemicals from nerve endings in the head and neck. It is approved as a preventive treatment for chronic migraine and is repeated about every three months. It is not intended to stop a migraine that has already started.
- What is an occipital nerve block?
- An occipital nerve block places numbing medicine, sometimes with a steroid, around the nerves at the back of the head. It can quiet an ongoing cycle of headaches, and relief can last beyond the numbing effect.
- Is it better to stop exercising with migraines?
- Usually not. Regular exercise can help reduce migraine frequency for many people, especially when intensity is built up gradually and hydration and meals are steady. We help you find a routine that works for you.