Headache & Migraine Care

Migraine is a genetically influenced brain disorder in which the nervous system is more sensitive to change. Attacks are triggered when that sensitive system meets stressors such as irregular sleep, skipped meals, hormonal shifts, dehydration, alcohol, weather change or stress let-down. Understanding your own pattern matters more than any universal list of triggers.

Migraine headaches are typically moderate to severe, often one-sided or throbbing, made worse by activity, and accompanied by nausea or sensitivity to light and sound. Many people who believe they have “sinus” or “tension” headaches actually have migraine. A careful history is usually enough to tell the difference; imaging is rarely needed.

Sleep and migraine share brain circuitry. Both too little and too much sleep, and especially irregular timing, can trigger attacks. Untreated sleep apnea is a common contributor to morning headaches. Regularizing sleep is one of the most effective non-drug strategies we have.

Yes. Regular aerobic exercise has been shown in clinical trials to reduce migraine frequency, with effects comparable to some preventive medications. The key is gradual build-up, hydration and consistency, since sudden intense exertion can trigger attacks in some people.

Caffeine can help stop an attack, which is why it appears in some headache medications. But regular daily caffeine, and especially fluctuating intake, is a common cause of rebound and morning headaches. We review your intake honestly and plan any change carefully.

See a physician promptly for a headache that is sudden and severe (“worst ever”), new after age 50, progressively worsening, triggered by exertion or position change, accompanied by fever, weakness, confusion, vision loss or a seizure, or occurring in the setting of cancer, pregnancy or immune suppression. Those features warrant urgent, in-person evaluation, not a virtual visit.

Far more than a decade ago. Options include acute treatments (triptans, gepants, NSAIDs, anti-nausea medication), preventive medications (including CGRP monoclonal antibodies and oral gepants), onabotulinumtoxinA for chronic migraine, neuromodulation devices and structured lifestyle measures. Which is right for you depends on frequency, other conditions and your preferences.