Headache/ Migraine

Headache is a symptom of head and neck pain. Dr. Din believes the most important step in appropriate management of headache is recognizing, what type of headache patient is suffering with, and making accurate diagnosis. Because every patient has unique symptoms and circumstances we treat every patient individually and personally. Remember for accurate diagnosis you need a qualified physician.  Dr. Din treats all different types of headaches 

Migraines are not your typical headaches, they may cause debilitating symptoms and cause sensitivity of light and sound, dizziness, nausea or vomiting. Duration can vary from hours to days. 

Migraine with aura, various sensations before the actual headache starts, which includes visual disturbance, abdominal symptoms, smell and taste changes, etc., these symptoms are called warning signs.

Migraine without aura, This type of migraine is more common and starts without any warning signs.

Tension Headaches 

Tension-type headache is the most common type of headache. Characterized as a constant dull ache on both sides of head with pain going down to neck and shoulders. 

Cluster headaches 

Mostly common  in males, attacks in cycles, usually  lasts anywhere between 15 minutes to 2-3 hours, and happens in clusters. 

Other common type are Hemiplegic Migraine, Menstrual Migraine, Abdominal Migraines, Hemicrania Continua, Paroxysmal Hemicrania, Medication Overuse Headache, Chronic Daily Intractable Headache, Idiopathic Intracranial Hypertension, Low pressure Headache.

Dr. Din believes that 50%  to 75% of our teenagers suffer from headaches. Which can affect their quality of life and can have bad impact on their future. Its very important to make the accurate diagnosis and treat them appropriately. 

Half of adult male and female suffer with some kind of headache and have variety of symptoms. Sometime these symptoms are very debilitating and can affect their day to day life. 

Peripheral Nerve Blocks are a type of regional anesthesia, injected near a specific nerve or bundle of nerves to block sensations of pain from a specific area of the body. Nerve blocks usually last longer than local anesthesia.

Dr. Din recommends Peripheral Nerve Blocks for 

1. Acute migraine attack or status migrainosus

2. Cluster headache

3. Medication overuse headaches

4. Chronic daily headache 

Injection site 

1. Greater occipital nerve 

2. Lesser occipital nerve 

3. Supratrochlear  & supraorbital nerves

4. Auriculotemporal  nerves.

Agents 

Local anesthetics lidocaine and bupivacaine with or without steroid. 

Results

Based on patients and Dr. Din's assessment nerve block offer better headache control then oral medications and other treatment. 

Dr. Din uses Sphenopalatine Ganglion Block for acute migraine attack, status migrainosus and chronic intractable headache. Quick procedure and usually take less than 15 minutes in clinic. Consider if your headache is not responding to multiple medications and conventional treatment.

Botox is most commonly thought of as a cosmetic treatment that can smooth fine facial wrinkles. However, the medicine received FDA approval for the treatment of chronic migraine in October 2010. 

Dr. Din recommends Botox for chronic migraine, tension headache and clusted headaches. Consider personal evaluation if you have headache 15 or more days in each month and lasts four or more hours per day. Dr. Din will do complete assessment including your complete medical history, previous health conditions and treatments for headache. 

Frequently asked Questions. 

What is Botox ?

It’s a neurotoxin, called botulinum toxin. And treatment involves careful injection of dilute Botox.

How Botox works ?

Doctors are not sure the exact way how Botox works in Migraines, Botox blocks the release of neuropeptide calcitonin gene related polypeptides (neurotransmitter) and causes relaxation of muscles. 

Sites of Botox

Dr. Din injects into seven key area of forehead, head and neck. Dr. Din uses very small needles and sometime may have temporary soreness or swelling, Dr. Din says don’t focus on discomfort from injections, may be you will feel minor pinpricks or pinching sensations but no serious pain.  Quick and easy to perform in clinic.

How frequently Botox are injected?

Every three months

How long is the process?

It takes roughly 10-15 minutes and Dr. Din perform is his office. 

Dr. Din after thorough assessment recommend trigger point injections. 

Dr. Din describes as feeling of knots or tight muscle fibers, these knots can cause pain all over the body including head.

Dr. Din injects local anesthetic with or without steroids, into a specific area of muscles. When effective, this injection can relieve pain not only in the targeted area but also in area with referred pain.