Migraine & Headache

Headache Clinic

About our Headache Clinic

Headaches that are new, persistent, chronic and incapacitating can hinder an individual’s quality of life and often require prompt medical intervention.


Headaches and migraine are major causes of disability in the community. We find that headaches can be overcome through a well-coordinated team approach.


Our multidisciplinary team are dedicated to the diagnosis and treatment of headaches and facial pain and is contactable throughout your headache treatment plan to help manage your treatment and discuss your progress.


Types of Headaches

Some of the conditions we treat include:

Episodic Migraines

Episodic Migraine is headaches that develop up to 7 times per month and settle with or without treatment. 

Cluster Headaches

Cluster Headaches are episodes of frequent severe headaches which involve the area of the forehead and eye. They are usually one-sided.

Trigeminal Neuralgia

Facial pain that is often episodic, with sharp shooting pain in the face and can be severe and constant.

Whiplash Headaches

Pain at the back of the neck after a neck injury caused by a strain, sprain, or tear in the soft tissues. It is often worse with movement and frequently peaks one or two days after the injury

Cervicogenic Headaches

It can result from spinal problems in the neck, such as disc degeneration or prolapse or facet joint arthritis. Cervicogenic headaches are quite common and under-recognised.

Chronic Migraines

Chronic Migraine is head pain and migrainous ‘flares’ that occur more than 14 days per month.

Headache Symptoms

Episodic Migraines

A migraine attack is not just a severe headache. It is a definite neurological phenomenon when one can suffer other symptoms of nausea, visual disturbance, and sensitivity to light and sound.


 It is a very common condition affecting 1 in 8 women and 1 in 12 men. Most migraine sufferers are not greatly impaired, suffering only a handful of attacks a year but can get on with their lives.


Migraines may also be confused with cervicogenic headaches. An opinion from a neurologist is frequently sought to be more confident of the diagnosis.


Chronic Migraines

A small minority of Migraine Headache sufferers have what is called chronic migraine. This is a more established form of the disorder, where the attacks are more frequent and sometimes longer lasting with almost continuous daily headaches.


Chronic migraine is the most severe form because of the persistence and long-term pain.

  • Is it occurring more than 14 days per month?
  • Do you require frequent pain relief?
  • Have you used migraine preventers?


If you have >14 days a month of headaches, and at least 8 of these are migraine-like, then you may have chronic migraine.


Cluster Headaches

Occur suddenly where the pain is typically in or around one eye or temple and may spread to other regions on the same side of the head. They often involve eye-watering (lacrimation), nasal congestion or runny nose, a ‘bloodshot’ eye (‘scleral injection’), swelling around the eye, a droopy eye, constricted (small) pupil, and facial sweating. Occurring over several days or weeks and then disappearing for a variable period. Each attack usually lasts 45-90 minutes. Attacks may occur once every couple of days, up to eight times daily.


They usually occur at the same time of the day, and patients frequently say they could ‘set their clock’ by the onset of the headache. It is common for a cluster to last 1-3 months once every year or two and to occur at about the same time.


Cluster headaches most frequently affect men in early to mid-adulthood. We do not know exactly what causes cluster headaches, but evidence suggests genetic factors, where some people find that certain activities or environmental factors like Alcohol, Hot temperatures or strong smelling substances such as perfumes, petrol, etc.


Cluster Headaches diagnosis is based on the typical symptoms with diagnostic tests used to rule out other causes.


Whiplash Headaches

The symptoms of whiplash may include neck stiffness or reduced range of movement, neck pain, headaches, and back of the head and arm pain.


Approximately 20% of people involved in rear-end motor vehicle accidents experience neck symptoms later. It is common to find that these symptoms worsen a day after the injury. Although most recover quickly, some develop chronic severe pain that may result in significant disability.


Cervicogenic Headaches

Cervicogenic headaches may resemble occipital neuralgia, which is a condition that causes localised pain and neurological abnormalities in the distribution of the occipital nerves at the back of the head.


Pain at the back of the head. This pain may spread to the top of the skull and sometimes to the forehead or temple. It may also be associated with pain or discomfort behind the eye. Sometimes associated with neck pain or discomfort, and sometimes the neck pain and headaches become more or less severe simultaneously.


Nausea, poor concentration and irritability are frequent symptoms.


Headache & Migraine Diagnosis

The diagnosis and treatment of headaches and facial pain have evolved rapidly in recent years. Our clinic can assess your headaches to see if you suffer from headaches, migraines or chronic migraine.


Initial Consultation

Headaches are often a primary diagnosis rather than a symptom of another systemic disease. Our doctors can help diagnose your headache condition and discuss management options. By gathering a detailed history (as well as completing some investigations),

Initially, you will be reviewed by Dr Baumann to determine whether this treatment is appropriate for you.


To ensure the best possible outcome, your condition may be discussed formally and confidentially with our other specialists. This usually occurs in a multidisciplinary meeting in which best practice treatment plan strategies are devised.


Headache Treatments

After your initial meeting with a Headache Clinic specialist, you will receive a highly specialised and evidence-based treatment plan.

Your treatment can be multifaceted, and you may qualify for the injectable medication free of charge (PBS) if you have tried several headache preventers.


Migraine Treatment Options

Depending on the headache or migraine type there are many treatments can be used to optimise your outcome, your specialist may recommend one or more of the following treatment strategies:

  • Education and explanation of your symptoms
  • Facet joint or nerve blocks
  • Individually tailored pain medications
  • Injection Therapy (botox)
  • Occipital nerve blocks
  • Occipital or peripheral nerve stimulation (neuromodulation)
  • Radiofrequency denervations
  • Specialised physiotherapy, acupuncture, or myotherapy
  • A structured pain management program or rehabilitation program
  • Biofeedback therapy
  • Cognitive behavioural therapy


Migraine Treatment

A migraine headache management plan may be required to treat painful and severe headaches, but common migraine headache treatments can include:

  • Trigger avoidance
  • Lifestyle changes, relaxation and cognitive behavioural therapy
  • Physical therapies
  • Regular medications (preventers)
  • Botox injections around the head and neck
  • Occipital nerve stimulation
  • Natural treatments


Chronic pain and impairment may have been present for many years. It is most important to carefully consider medication use with an expert, avoid triggers and look at physical therapies.


Chronic Migraine Headache Treatment

Chronic Migraine Treatment can be complex, but injectable treatments have been shown to help many patients, even when other therapies have failed. You may qualify for the injectable medication free of charge (PBS) if you have tried several headache preventers.

Dr Baumann also offers botulinum toxin injections for the therapeutic management of migraine and headaches, particularly if conventional medications and treatments fail to alleviate symptoms.


Botox injections (now on the PBS for migraine) - injectable therapies (anti-wrinkle muscle relaxants with ultra-fine needles) to treat chronic migraine.


Many treatments are available, including a well-known, recently PBS-approved and clinically proven injectable muscle relaxant drug. This treatment can also be used for excessive teeth/jaw clenching (bruxism), which can occur on its own or in combination with migraine/headache. If you think that you may be suffering from chronic migraine, we may be able to help you.


An appointment will then be made for you on our allocated Botox Clinic Day, which is held once a month.


Whiplash Headache Treatments

Like sprains in other body parts, neck sprains usually heal gradually, with time and appropriate treatment.


Collars - A soft cervical collar may be worn for comfort. In cases where there is a severe disc and ligamentous disruption, a hard collar (such as an Aspen Collar) may be prescribed.


Medication - Analgesics and anti-inflammatory medications are often used to reduce pain and swelling. Muscle relaxants can be used to help ease muscle spasms. An ice pack may be applied for 15-30 minutes, several times a day for the first two or three days after the injury. Heat can help relax cramped muscles but should not be applied for the first few days. Other treatment options include massaging the tender area, ultrasound, and physiotherapy.


Modify Activities - Early return to work is encouraged, usually with modifications in your workplace activities, which can be eased with time and recovery. Aerobic activities, such as walking or swimming, should be started early.


Whilst most symptoms resolve in one or two months, and severe injuries may take several months to heal completely. Symptoms of arm weakness, numbness, or shooting pains should be investigated further.


Surgery - Neck sprains or strains rarely require surgery. Indications for surgery include spinal cord compression, prolonged arm pain and weakness, and severe persistent headaches. Surgery may be recommended if other conditions such as a vertebral fracture or disc herniation are present.


Trigeminal Neuralgia Treatments

  • Medication - Is treated with medication. Nerve membrane-stabilising agents such as carbamazepine (Tegretol) improve pain and provide long-term relief.
  • Needle Therapy - When trigeminal neuralgia does not respond to pain medications, more invasive treatments may be considered. Percutaneous targeting of the trigeminal ganglion (through a needle in the cheek) and microvascular decompression (through an operation behind the ear) are the most frequently used surgical approaches.
  • Percutaneous techniques involve the insertion of a needle into Meckel’s cave through the cheek. Meckel’s cave is a small cavern at the base of the skull which contains part of the trigeminal nerve called the trigeminal ganglion. Patients suitable include:
  • Multiple sclerosis-related trigeminal neuralgias
  • Patients unfit for major brain surgery
  • Patients who do not wish to undergo major brain surgery


Cervicogenic Headache Treatments

It is important to try to determine exactly which structures in the neck are causing the headaches. Once this has been done, appropriate treatment may be prescribed. Initially, cervicogenic headaches are treated with

  • Pain medications and
  • Physiotherapy.
  • Avoidance of aggravating activities is important.


Depending on the diagnosis, other treatments can include:

  • Percutaneous radiofrequency denervation
  • Microsurgical discectomy and fusion.
  • Peripheral nerve stimulation


Cluster Headache Treatment & Prevention

Standard painkillers do not work. Even if they do, they usually take so long to work that the headache may have gone before the pain relief takes effect.


Most cases can be controlled by a coordinated treatment and prevention plan, including

  • Anti-migraine agents (Sumatriptan)
  • Lithium,
  • Breathing pure (100%) oxygen.


When cluster headaches do not respond to these medical therapies and are severe enough to cause a significant reduction in the person’s quality of life, surgical intervention may be considered. These treatments include

  • Occipital and frontal peripheral nerve stimulation.
  • Deep brain stimulation
  • Percutaneous interference with the trigeminal or sphenopalatine ganglion by balloon compression, heating, or glycerol injection


Booking a Headache Appointment

If headaches are disturbing your enjoyment of life or interfering with your work and leisure, you will need a referral from your GP requesting an assessment and migraine solution appointment.


Contact

Call reception to make an appointment

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