About 28 million Americans experience migraines, typically beginning in their 20s. Prevalence is higher in women, with 70% of those with migraines are women.

The causes for migraines and headaches is not well known. Research suggests that the pain is due to inflammation, the trigeminal nerve, blood vessels surrounding the brain, and Serotonin levels.

It is important to record your migraine experience. For example, what did you eat before the migraine started, what was the weather that day, etc. This will help you learn the warning signals that trigger your migraine.

The most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression, anxiety, lock of sleep, missed meals or use of alcohol. Other common types of headaches include migraines, cluster headaches and sinus headaches.

Most people can feel much better by making lifestyle changes, learning ways to relax and taking pain relievers. A migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

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Medications Used for Headaches


  • High blood pressure medications
  • Anti-depressants
  • Anti-seizures


  • Triptans
  • Anti-inflammatories
  • Over-the-counter pain medications

What Are My Treatment Options?

  • Acupuncture 
  • Massage Therapy 
  • Biofeedback 
  • Cognitive Behavioral Therapy 
  • Trigger Point Injections 
  • Occipital Nerve Block/ Radiofrequency Ablation 
  • Botox 
  • Pericranial Bupivacaine Injections 
  • Prolotherapy of Trigeminal Nerve
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Types of Headaches

  • Sinus: Pain is usually behind the forehead and/or cheekbones
  • Cluster: Pain is in and around one eye 
  • Tension: Pain is like a hand squeezing the head. Usually in the forehead region. 
  • Migraine: Pain, nausea, and visual changes are typical, and pain is usually restricted to one side of the head, but can affect both sides.

Common Causes of Headaches

  • Temporomandibular Joint Pain (TMJ) 
  • Lifestyle factors: food, stress, poor posture, menstrual cycle
  • Pseudotumor cerebri
  • Trigeminal Neuralgia
  • Referred pain (i.e., neck pain)
  • Inflammation of sinuses
  • Low pressure in spinal column
  • Hypertension

Headaches and Migraine

Tension-type headache   This is the most common type of headache with the clinical features as:    Constant pain spreading all over the skull   Pain radiating forward from the occipital region  Feeling ‘dull’, ‘tight’ or like pressure.  Sometimes, continuous pain for weeks without interruption  The severity of pain varies individually.  There is no photophobia.  No complaint of vomiting  Pain increases as the day goes on.    Diagnosis Diagnosis of tension headache is mainly clinical.  Your doctor can diagnose your headache from a description of your pain. Therefore, never forget to include all the details,  such as pain characteristics, pain intensity, pain site, etc. In most cases, your physician will diagnose tension headache based upon the above clinical feature. However, he may run some imaging tests in certain cases to rule out an underlying serious problem. Following are the most important imaging tests in this regards:    MRI (Magnetic Resonance Imaging) Brain  CT (Computed Tomography) Scan Brain    Management   Management of this type of pain is mainly based on discussion with patients about the causes of this type of disease and the explanation that this is not a serious disease. Many medications both OTC and prescription, are available to reduce the cluster headache, including:   Pain relievers: Simple over-the-counter (OTC)  pain relievers are the first line of treatment for tension headache. These OTC medications include aspirin, naproxen, and ibuprofen.  Prescribed drugs for tension headaches include naproxen, ketorolac and indomethacin.    Combination drugs: Aspirin or acetaminophen or both can be combined with caffeine or a sedative drug to form a single medication. These drugs can be more effective. Some of these combinations are available over the counter.     Triptans can be used in persons suffering from both migraines and episodic tension headaches because they are effective against the pain of both headaches.    Preventive medications: Your doctor may advise you on some medications to minimize the frequency and intensity of tension headache. This is especially important when you suffer from frequent or chronic headaches that aren't easy to go away. Preventive medicines include:     Tricyclic antidepressants such as amitriptyline and protriptyline, [...]

Pain Types and Treatments

At Carolinas Pain Center we serve patients dealing with all types of pain. Read about some of the most common types of pain that we treat.

Chronic Pain

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