Headaches & Migraines

Chronic headaches and migraines are far more than inconveniences — they are debilitating neurological events that can strip away your ability to work, care for your family, and enjoy daily life. At Global Pain Management, we offer specialized, evidence-based treatment for patients across Maryland who suffer from frequent or severe headaches that have not responded adequately to primary care management.

What is headaches & migraines?

Headaches are broadly categorized as primary (arising without an underlying structural cause) or secondary (caused by another condition). The most common primary headache disorders are migraine, tension-type headache, and cluster headache. Migraines affect roughly one in seven adults and are characterized by moderate to severe throbbing head pain — often unilateral — that is worsened by physical activity and associated with nausea, light sensitivity, and sound sensitivity. Up to one-third of migraine sufferers experience an aura, which may include visual disturbances, tingling, or temporary speech difficulty. Cervicogenic headaches, a commonly overlooked secondary type, originate from structures in the cervical spine — particularly the upper facet joints and occipital nerves — and can mimic migraines closely. Tension-type headaches produce a bilateral, pressure-like sensation and are frequently driven by myofascial trigger points in the neck, scalp, and shoulder musculature. Chronic daily headache, defined as headache occurring fifteen or more days per month, often involves a combination of headache types and may include medication-overuse headache as a complicating factor.

Common symptoms

• Moderate to severe throbbing or pulsating head pain
• Headache on one or both sides of the head
• Nausea or vomiting during a headache episode
• Sensitivity to light, sound, or smell
• Visual aura or other neurological symptoms before headache onset
• Headaches triggered by stress, hormonal changes, or certain foods
• Neck pain or stiffness associated with headache

How we treat headaches & migraines

Our approach integrates interventional procedures with carefully tailored medication management. Greater occipital nerve blocks and trigger point injections targeting the neck, scalp, and temporalis muscles can interrupt the pain cycle and provide both diagnostic and therapeutic benefit. For cervicogenic headaches, cervical medial branch blocks and radiofrequency ablation address the underlying facet joint source. Sphenopalatine ganglion blocks offer rapid relief for cluster headaches and certain migraines. Preventive medication protocols — including anticonvulsants, beta-blockers, and CGRP-pathway therapies — are prescribed when headache frequency warrants prophylaxis. We also counsel patients on trigger identification and lifestyle modifications that can meaningfully reduce headache burden.

Treatment options we may use