Migraine Treatment
Migraines are more than bad headaches; they can disrupt work, family and daily life. We build a personalized, evidence-based plan to reduce how often attacks happen and how severe they are.
Become a Patient
Understanding Migraines
A migraine is a neurological condition that causes recurring episodes of moderate to severe head pain, often accompanied by nausea, sensitivity to light and sound, and sometimes visual or sensory changes called aura. Attacks can last from four hours to several days. Migraine is very common, and it is more frequent in women than in men. Beyond the pain itself, migraines can cause missed work, canceled plans, and worry about when the next attack will strike.
The exact cause is not fully understood, but migraines involve changes in brain activity, nerve signaling and blood vessel behavior, along with chemical messengers such as serotonin and CGRP. Genetics play a strong role, and many people have a close relative with migraine. Common triggers include hormonal fluctuations, stress, irregular sleep, skipped meals, dehydration, alcohol, certain foods, strong sensory input and weather changes. Other conditions, such as anxiety, depression, sleep disorders and high blood pressure, can make migraines more frequent or harder to control.
Professional treatment matters because migraines are often under-recognized and self-treated with over-the-counter pain relievers, which can lead to medication-overuse headache when taken too often. A clinical evaluation confirms the diagnosis, rules out other causes of headache, and identifies the right mix of acute treatment, prevention and lifestyle strategies. With a structured plan and regular follow-up, most people can meaningfully reduce the burden of migraine on their lives.
Signs & Symptoms of Migraines
- Throbbing head pain. Pain is often pulsing or pounding and commonly affects one side of the head, though it can occur on both.
- Sensitivity to light. Normal lighting can feel painful, leading many people to seek a dark room.
- Sensitivity to sound. Everyday noise may feel overwhelming during an attack.
- Nausea or vomiting. Stomach upset often accompanies the pain and can make oral medication harder to take.
- Aura. Some people see flashing lights, zigzag lines or blind spots, or feel tingling, before or during the headache.
- Worsening with activity. Walking, climbing stairs or bending over can intensify the pain.
- Early warning changes. Mood shifts, yawning, food cravings or neck stiffness may appear a day or two before an attack.
- Exhaustion afterward. A "migraine hangover" with fatigue and fogginess can linger after the pain fades.
What to Expect
- A detailed telehealth review of your headache history and triggers
- Personalized plan combining acute treatment, prevention and lifestyle strategies
- Headache diary to guide adjustments
- Regular follow-up to refine doses and medications
- Goal of fewer, milder attacks rather than instant elimination
How We Treat Migraines
Assessment
We review your headache history, attack patterns, triggers, medications and family history. Your history is usually the key to confirming migraine. When a hands-on neurological exam or imaging is needed to rule out other causes, we will help you arrange it. We also look at sleep, stress and other health conditions that may contribute.
Treatment Plan
Together we choose a plan matched to your attack frequency, severity and preferences. It may include a medication to stop attacks, preventive options, and trigger and lifestyle strategies. You come away knowing what to take, when to take it, and when to contact us.
Ongoing Care
We follow up to see how the plan is working, using your headache diary to guide changes. Doses and medications are adjusted as needed. Over time we aim to reduce attacks, limit medication overuse and keep you functioning well.
Benefits
A Personalized Care Plan
Your triggers, schedule and goals shape your plan, rather than a one-size-fits-all protocol.
Time for Your Questions
We want you to understand your diagnosis and options, so your questions are always welcome.
Coordinated Follow-Up
Regular check-ins keep your plan on track and adjusted as your needs change.
Your Treatment Journey
First Evaluation (Week 1)
At a telehealth visit we take a detailed history and discuss your goals. You may be asked to begin a headache diary right away.
Treatment Begins (Weeks 2 to 4)
You start your acute and, if needed, preventive plan. Expect some trial and error; preventive medicines often take weeks to work.
Progress Review (Months 2 to 3)
We review your diary, assess changes in frequency and severity, and adjust doses or medications. Meaningful improvement is the realistic goal, not instant elimination of attacks.
Long-term Management
Migraine can change over time, so we continue periodic check-ins, refine prevention and revisit the plan as life circumstances shift.
Warning Signs That Need Prompt Care
Sudden, severe "thunderclap" headache. A headache that peaks within seconds is an emergency. Call 911 or go to the nearest emergency room.
Headache with fever and stiff neck. This combination can signal infection and should be evaluated right away.
New weakness or numbness. Weakness on one side, facial drooping or trouble speaking requires emergency attention. Call 911 or go to the nearest emergency room.
Confusion or trouble with vision. Sudden double vision, vision loss or disorientation should not be ignored.
Headache after a head injury. New or worsening pain following a blow to the head needs prompt assessment.
A change in your usual pattern. Headaches that become more frequent, more severe or different in character deserve evaluation.
First migraine after age 50. New headache patterns later in life warrant a careful workup.
Medication overuse. Needing pain relievers on most days can cause rebound headaches and calls for a new plan.
If you recognize these signs, help is available. Early treatment leads to better outcomes.
Evidence-Based Migraine Care
Evidence-based migraine care typically combines acute and preventive approaches. Acute treatments include NSAIDs, triptans, and newer options such as gepants, often paired with anti-nausea medication. Preventive options may include beta-blockers, certain antidepressants or anti-seizure medications, and CGRP-targeted therapies when appropriate. Non-drug measures such as consistent sleep, regular meals, hydration, exercise, stress management and trigger avoidance are important parts of every plan. Medication choice depends on your health history, other medicines and, where relevant, pregnancy plans.
Common Questions About Migraines
How long does migraine treatment take?
It varies. Some people notice improvement within a few weeks of starting an acute or preventive plan, while preventive medications often need six to twelve weeks to show their full effect. Migraine is a long-term condition, so the goal is fewer, milder attacks and quicker recovery over time.
Is medication required?
Not always. Some people do well with trigger management, sleep and stress changes, and consistent routines. Others need acute medication to stop attacks or preventive medication to reduce frequency. We discuss the options and decide together.
Does insurance cover migraine treatment?
Sagebrooke Family Medicine is an insurance-based practice, and we are in the process of joining insurance plans. Your cost depends on your plan, including any copay, deductible or coinsurance. Contact the practice to check whether your plan is accepted, and check with your insurer about coverage for migraine medications, labs and imaging.
What if the first treatment does not work?
This is common and not a failure. Finding the right approach often takes adjustments to the medication, dose, timing or prevention strategy. Tracking your attacks helps us refine the plan at follow-up.
What triggers migraines?
Common triggers include missed meals, irregular sleep, stress, hormonal changes, certain foods, alcohol, dehydration, bright light and weather changes. Triggers vary widely, and a headache diary helps identify yours.
When should I seek emergency care?
Call 911 or go to the nearest emergency room for a sudden severe headache, headache with weakness, trouble speaking, confusion, fever with stiff neck, or after a head injury. When in doubt, get urgent help.
Get Help for Migraines
Fewer, milder migraines are a realistic goal. Request a telehealth visit and we will build a plan with you.
Become a Patient