Acute and Chronic Headaches/Migraine

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Houston Methodist’s neurologist-led headache and migraine specialists offer expertise and advanced treatments to help you find relief from acute or recurring symptoms.

Headaches are complex conditions that can vary in intensity from occasional and minor aching to chronic, debilitating pain that interferes with your daily activities. When at-home remedies don’t keep the pain at bay — or when you also experience visual or other sensory symptoms — it’s time to see a specialist.

Houston Methodist’s board-certified team of neurologists combine unparalleled expertise with our leading-edge technology to effectively treat all types of headaches and migraines. We work together to identify the cause of your pain and develop a comprehensive treatment plan to improve your quality of life. 

Diagnosing & Treating Acute & Chronic Headache or Migraine

How are chronic headaches or migraines diagnosed?

Diagnosing headaches begins with a review of your medical history and a conversation about your symptoms. Headache symptoms vary depending on your diagnosis. In some cases, patients have visual changes or more severe symptoms caused by light, sound or certain foods. Learn more

Next, we conduct a physical exam to determine the type of headaches you are experiencing and how to treat them. There are two major types of headaches:


  • Primary headaches include cluster headaches, migraines and tension headaches. These are caused by triggers such as stress, diet or allergies. In the case of migraine headaches, there can be a genetic link.  
  • Secondary headaches are a symptom of an underlying medical condition, such as sinusitis or more serious conditions such as stroke, aneurysm, a sudden blood pressure spike, blood sugar issues or a brain tumor.  


Your doctor may order a variety of tests to better understand your symptoms and eliminate underlying causes of headaches. Testing can include: 


  • CT or MRI 
  • Lumbar puncture (spinal tap) 
  • Blood tests  
  • Neurological tests


Always seek emergency care if you have a severe headache that gets worse over a few days, or if pain occurs in combination with other serious symptoms, such as: 


  • A sudden, very severe burst of pain with no known cause (thunderclap headache) 
  • Difficulty speaking, seeing or moving  
  • Fever, nausea or vomiting, neck stiffness, confusion, seizures, fainting spells, numbness  
  • Head injury 


The specialists at Houston Methodist offer a wide range of treatments for headaches and migraines, customized to your unique symptoms.

What treatments are available?

When it comes to headaches and migraines, what works for one person may not work for another. Our board-certified neurologists and pain-management specialists can help you decide what treatment combinations might work best for you. 

Lifestyle and Dietary Counseling – Our headache experts work with you to identify and eliminate specific triggers that can lead to headaches or migraines. General recommendations include eating a nourishing diet, getting moderate exercise and drinking plenty of water.  

Stress Management – Stress is the lifestyle factor most linked to headaches and migraines. While it’s impossible to eliminate stress completely, we can recommend simple techniques, such as: 


  • Avoiding stressful situations when possible 
  • Calming physical practices, such as yoga or tai chi 
  • Deep breathing and meditation 
  • Making time for hobbies or leisure activities 
  • Massage therapy


Medication – Some over-the-counter medications like aspirin, naproxen, ibuprofen or acetaminophen can treat mild to moderate symptoms. For severe migraines, certain prescription medications can provide relief, including:


  • Ergots, such as dihydroergotamine (Migranal), which constrict blood vessels and block pain pathways in the brain 
  • Narcotics, such as codeine, can help reduce pain and improve sleep 
  • Triptans, such as sumatriptan (Imitrex), which also control blood flow and pain pathways in the brain


Infusion Therapy – Powerful medications given through an IV can reduce severe headache or migraine pain. Infusion therapy is administered on an outpatient basis, usually involving several hours of infusion over three to four days. 

Botulinum Toxin (Botox®) Injections – For people suffering from chronic migraines, Botox® (botulinum toxin or onabotulinum toxin A) therapy can relax the contraction of muscles by blocking nerve impulses. It is injected using a fine needle to minimize discomfort and maximize accuracy. The procedure can be performed in a doctor’s office, does not require anesthesia and typically takes only a few minutes. 

For severe cases that do not respond to other therapies, we offer advanced surgical treatment options including:


  • Brain surgery for underlying conditions  
  • Neurostimulation devices and procedures  
  • Patent foramen ovale (PFO) assessment  
  • Personalized medication combinations

What if I need advanced care or a second opinion?

Receiving a precise diagnosis is key to preventing and treating severe headache and migraine symptoms. Our world-class team of specialists diagnose and treat the most complex headache conditions, even when other centers seem to be out of options. Let our experienced team design a personalized treatment plan to help you find relief.

Understanding Migraines

Scientific 3 dimensional image of head with inflamed brain
Houston Methodist neurologist Dr. Julia Jones discusses the causes of migraine headaches.

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