Migraine Pain Management

Migraines are no ordinary headache, and if you’ve ever had a migraine, you know only too well there’s no comparison between the two. Gazelle Aram, MD, is a pain management specialist at Expert Care Center in Delray Beach, Florida, providing various effective therapies to reduce migraine frequency and severity. For more information about Migraine Pain Management in Florida, call Expert Care Center or book an appointment online today.


What are migraines?

Migraines are headaches that are often debilitating as they don’t just cause extreme head pain but also other symptoms, including:

Sometimes, people who have migraines experience auras, which could appear as lights or spots in front of your eyes or affect your other senses. Auras originate from the nervous system and disrupt your normal senses.


Migraines are a condition that affects certain people and not others, so unlike headaches, which everyone gets now and then, only some people experience migraines. Most people who get migraines find it impossible to work through, and resting somewhere quiet and dark is the only answer.

What causes migraines?

While there’s no definitive answer to what causes migraines, there are specific triggers, and some groups of people are more likely to experience migraines. People who get migraines regularly can often tell when one is on the way as they learn to identify the signs from previous experience. Known triggers for migraine attacks include:

Changes in the weather

Intense physical activities

Poor quality of sleep

Powerful smells

Bright lights or glare from the sun


Alcohol and caffeinated drinks

Food additives

Eating irregularly and fasting

Eating processed foods

Chemical imbalances in the brain

Taking estrogen medications

To help determine what your triggers are, it’s helpful to start recording everything that happened prior to your migraine starting each time you have one. After several episodes, you can compare the notes you made and see if anything is the same each time.

Diagnosis and Medical Evaluation

Diagnosing and evaluating migraines is a crucial step in effective migraine pain management. It allows pain management specialist to understand the nature 
of your migraines, their triggers, and the most suitable treatment plan.

Recognizing when to seek medical attention for your migraines is essential. If you experience frequent migraines (more than a few times a month) or are particularly severe, it’s crucial to consult Dr. Gazelle Aram, pain management specialist 
at Expert Care Center. Chronic migraines, characterized by 15 or more headache 
days per month, often require specialized treatment.

Understanding the warning signs, frequency, and severity of your migraines is crucial for your pain management specialist to make an accurate diagnosis and tailor treatment to your specific needs. Some individuals experience warning signs or “auras” before a migraine attack, which can manifest as visual disturbances, tingling sensations, or difficulty speaking.

Reporting these auras is especially crucial if you have a specific type, like hemiplegic migraine, which involves temporary paralysis. Dr. Aram can differentiate between migraines and other primary headache disorders or secondary headaches by describing the intensity and characteristics of your migraine pain, which is often severe, throbbing, and one-sided—ensuring you a more accurate diagnosis and a treatment plan tailored to your specific needs.

Medical History and Physical Examination

During your consultation with headache specialist Dr. Gazelle Aram at Expert Care Center, you’ll undergo a comprehensive assessment that includes a detailed medical history and a thorough physical examination.

Dr. Aram will ask specific questions about your headache symptoms, such as frequency, duration, characteristics, and potential triggers like certain foods or stressors. Given the genetic component of migraines, she’ll also discuss your family’s medical history. Dr. Aram may inquire about any past head injuries or related diagnoses to fully understand your medical background.

The physical exam will focus on your head, neck, and neurological function, including reflexes, muscle strength, and coordination assessments, to rule out other causes of your symptoms.

Chronic Migraine Management Treatment at Expert Care Center

Migraine treatments tend to focus on using pain-relieving medications to stop you from having migraines so often or prevent your migraines from developing or worsening once they start. At Expert Care Center, we provide a range of prescription medications tailored to your specific needs.
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Nerve Blocks

By temporarily blocking the nerves responsible for transmitting pain signals from the elbow, nerve blocks can relieve pain, allowing patients to participate more comfortably in physical therapy and other rehabilitative activities.
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Trigger Point Injections

Pain is significantly diminished by administering a local anesthetic directly into these trigger points, and participation in physical therapy and rehabilitation exercises can be enhanced more effectively.
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Platelet-Rich Plasma (PRP) Injections

This involves injecting a concentration of the patient’s own platelets into the elbow to promote healing of the injured tendons. PRP therapy is gaining popularity for its potential to enhance tissue repair.
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Extracorporeal Shock Wave Therapy

This non-invasive technique stimulates tendon healing by using sound waves. ESWT is considered for cases that are resistant to more conventional therapies.
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Bracing or Orthotic Devices

Elbow braces or wrist splints rest the tendons and muscles, reducing strain and giving the affected area time to heal. Furthermore, these devices can prevent further injury during sports.
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Corticosteroid Injections

For more severe cases, corticosteroid injections directly into the affected area can provide significant relief from pain and inflammation. This method is typically considered when other non-invasive treatments have not provided adequate relief.
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Medication Management

Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. These medications may also improve blood flow 
to the area by reducing inflammation, though their primary benefit lies in symptom relief.


Active individuals or athletes who suffer from lower back pain due to overuse, improper technique, or injury during sports activities.

Aging Adults

Older adults experiencing degenerative changes in the spine, such as osteoarthritis, which can cause chronic pain and stiffness, which chiropractic care is not applicable.

Accident Victims

Individuals who have sustained back injuries from accidents or falls that continue to cause pain and limit function.

Lifestyle-Induced Back Issues

People suffering from back pain due to lifestyle factors such as long hours of sitting, improper lifting techniques, or inadequate physical conditioning.

Post-Surgical Patients

Patients who continue to face challenges with pain or limited mobility following back surgery and who may benefit from specialized rehabilitation.

Individuals with Chronic Pain

Those experiencing persistent low back pain that lasts for three months or more, which has not responded well to initial treatment efforts or chiropractic treatment.

Epidural steroid injections

For those suffering from severe back or neck pain, epidural steroid injections can be a game-changer. This technique entails administering a corticosteroid injection into the epidural area surrounding the spinal cord. The steroid helps reduce inflammation and pain, providing relief lasting for several weeks or even months. This medical treatment is often recommended for conditions like herniated discs or spinal stenosis that result from personal injuries.

Facet block injections

Spinal facet joints can be a significant source of pain, especially after injuries like whiplash or falls. Our facet block injections involve administering a local anesthetic and sometimes a corticosteroid directly into the facet joint. This procedure can provide immediate relief by numbing the area and reducing inflammation, allowing you to engage more comfortably in physical therapy and daily activities.

Regenerative injections

One of our cutting-edge pain management treatments is regenerative injections, which utilize substances like platelet-rich plasma (PRP) or stem cells to promote natural healing. These injections aim to regenerate damaged tissues, reducing inflammation and pain. They are particularly effective for soft tissue injuries, such as ligament sprains and muscle strains, and can accelerate the healing process while minimizing 
the need for more invasive treatments.

Medication Management

While over-the-counter medications like ibuprofen or acetaminophen may offer temporary relief, they are often insufficient for chronic migraine management. It’s essential to use these medications judiciously to avoid medication overuse headache, which can result from frequent use of acute treatments.

Nerve Blocks for migraine headaches

Another effective treatment option we offer is nerve blocks. This procedure involves injecting a local anesthetic near specific nerves to numb the area, providing immediate relief from intense migraine headache pain. Nerve blocks are beneficial for those who experience localized, severe migraines and are looking for quick relief.

Neurotoxin injections for migraine headaches

One of the innovative treatments we offer is neurotoxin injections. These injections work by blocking neurotransmitters that trigger pain, providing relief for an extended period. Many patients report a significant reduction in the frequency and severity of their migraines after undergoing this treatment.

Preventive Treatment of Migraine

The following medications can reduce the frequency and severity of migraine attacks:

Beta-blockers (B-Blockers)

Such as propranolol are effective in reducing the frequency of migraines.

Calcium Channel Blockers

Medications like verapamil can help prevent migraines by affecting muscle cells in arterial walls.

Atypical Antidepressants

Amitriptyline is commonly used to avoid migraines by affecting serotonin levels.

Antiseizure Medications

Topiramate is another preventive option that also provides symptom relief.

Other alternative for acute migraine treatments:

These migraine medications are used for immediate relief or for treating accompanying symptoms:

Abortive Medications

Triptans, available in various forms, including nasal spray and Ergotamine, constrict blood vessels and block pain pathways to provide immediate relief from migraine symptoms.

Anti-Nausea Medicine

Medications like metoclopramide can be used 
to manage nausea and vomiting often associated with migraines.

It is also important to make sure that the headaches are indeed migraines and not other types of headaches such as cervicogenic headaches, cluster headaches, tension-type headache, etc.


Book an appointment online or call Expert Care Center today to learn more about headache treatments.

Migraine Headache Relief

Migraine headache relief generally refers to strategies for alleviating the headache pain and discomfort associated with acute or chronic migraines.

Simple changes to your daily habits can significantly influence your experience with migraines. Maintaining a consistent sleep schedule, staying well-hydrated, and employing stress-reduction techniques like meditation or deep breathing can go a long way in preventing migraine triggers and reducing their severity.

In addition to lifestyle adjustments, several non-medical approaches can offer immediate relief during a migraine attack. Applying cold packs to the forehead or neck can numb the area and reduce pain. Deep breathing exercises can help relax the nervous system while finding a dark, quiet room to rest in can significantly alleviate the sensory overload often associated with migraines.

The Importance of a Pain Management Specialist for Migraine Pain Management

When dealing with chronic migraines, the specialized expertise of a Pain Management Specialist like Gazelle Aram, MD, at Expert Care Center can make 
a significant difference.

One of the critical advantages of consulting with Dr. Aram is the personalized treatment plan tailored to your specific needs. Dr. Aram aims to optimize your migraine pain management using treatment options such as neurotoxin, nerve blocks, and medication management.

By seeking the expertise of Dr. Aram, you’re taking a proactive step in improving your quality of life. Her comprehensive approach aims to reduce the impact of migraines on your daily activities and provide a deeper understanding of your condition.

Frequently Asked Questions (FAQ)

Early signs of a migraine can vary from person to person but commonly include mood changes, food cravings, and increased sensitivity to light and sound. Some people also experience neck stiffness or tingling sensations in the limbs. These early signs are often referred to as the “prodrome” phase of a migraine.
The duration of a migraine can vary widely but generally lasts between 4 to 72 hours if untreated. Some people experience what’s known as “postdrome” symptoms, like fatigue and mood changes, that can last for an additional 24 hours after the headache subsides.
As of now, there is no definitive cure for migraines. However, various treatments, such as neurotoxin, nerve blocks, medication management, and lifestyle changes, can effectively manage symptoms and reduce the frequency of attacks. Ongoing research aims to find more permanent solutions.
Yes, migraines have a genetic component and are more common in individuals with a family history of the condition. Research has identified several genes associated with increased migraine susceptibility, although the exact mechanism is not fully understood.
Migraines are typically characterized by intense, throbbing pain on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. The severity and combination of these symptoms can help differentiate a migraine from other types of headaches.
If you experience a sudden, severe headache, symptoms resembling a stroke such as vision loss or limb weakness, or if your migraine lasts more than 72 hours, seek immediate medical attention. These could be signs of a more serious medical issue.
Yes, hormonal fluctuations, particularly in women, can significantly impact migraines. Many women report increased migraine activity around their menstrual cycles, during pregnancy, or around menopause.
Acute treatment of migraine is designed to alleviate symptoms during an active migraine attack and is not formulated to prevent future episodes. Preventive medications and lifestyle changes are more effective for long-term management.
Not all acute treatments are suitable for every type of migraine. Factors like the severity of the attack, accompanying symptoms, and individual medical history should be considered. Consult a healthcare provider for a treatment plan tailored to your specific type of migraine.

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