Most headaches are treated as an inconvenience to be medicated and endured. That works until it doesn't — and for people whose headaches have become frequent, the medication itself can become part of the problem. At Remix Medical in Houston, our board-certified pain physicians treat headache as a condition with a specific diagnosis and specific interventional options.
What Kind of Headache Is It?
The first task is separating primary headaches — disorders in their own right — from secondary headaches caused by something else. That distinction determines everything downstream.
Primary headaches include tension-type, migraine, and cluster headache. Secondary headaches arise from an underlying issue such as sinus infection, medication overuse, trauma, cervical spine disorder, or a systemic condition. Classification follows the International Classification of Headache Disorders criteria, which is what allows treatment to be matched accurately rather than by trial and error.
| Headache type | Typical feature |
|---|---|
| Tension-type | Band-like tightness on both sides of the head, without nausea or aura |
| Migraine | Throbbing, often one-sided, with nausea and light or sound sensitivity, sometimes preceded by aura |
| Cervicogenic | Starts in the neck and refers to one side of the head, provoked by neck movement |
| Cluster | Severe, centered around one eye, occurring in bouts with tearing and nasal congestion |
Why Headaches Become Chronic
1. Medication Overuse
Using acute pain relievers more than a couple of days per week can paradoxically generate more headaches. This is a common, reversible cause of chronic daily headache that is frequently missed.
2. Untreated Migraine
Frequent attacks left without preventive treatment tend to increase in frequency over time.
3. Cervical Spine Contribution
Upper neck joint dysfunction refers pain into the head and sustains it.
4. Sleep, Stress, and Trigger Load
Irregular sleep, skipped meals, dehydration, and stress lower the threshold for attacks.
5. Hormonal and Dietary Triggers
Hormonal fluctuation, alcohol, aged cheese, and processed meats are common precipitants in susceptible people.
How Remix Medical Can Help
Evaluation starts with a structured headache history — frequency, duration, quality, associated features, and what you have already taken and how often. Examination includes cranial nerve testing and assessment of the neck. Imaging is reserved for suspected secondary causes rather than ordered routinely.
Where standard medication has fallen short, interventional options change what is possible.
| Approach | What it involves |
|---|---|
| Trigger and lifestyle management | Sleep regularity, hydration, meal timing, and identifying your specific precipitants |
| Acute and preventive medication | Triptans and other acute agents, with preventives including beta-blockers, certain antidepressants, anticonvulsants, or CGRP-targeted drugs for migraine |
| Occipital and other nerve blocks | Anesthetic injection targeting the nerves carrying the pain — diagnostic and therapeutic |
| Trigger point injections | For the cervical and periscapular muscular contribution that accompanies many chronic headaches |
| OnabotulinumtoxinA (Botox) | For chronic migraine — a defined injection protocol for patients meeting frequency criteria |
| Withdrawal from overused analgesics | Structured, supervised reduction where medication overuse is driving the cycle |