Corewell Health Headache Center

As a first step into the program, you will attend a virtual group education class, which is held through mychart. This free, one hour class will provide an overview of what headache and migraine entail, discussion of lifestyle factors that can impact headache, explanation of specific treatments available within the program and ideas on how you can better prepare for your consult appointment.

Lifestyle modifications are changes patients can make independently at home, in the interim, while waiting for their consult appointment. Making lifestyle modifications can have an enormous impact on headache frequency and intensity. If patients can modify some or all of these factors before they reach the provider, it will also give the patient the optimum chance of responding to additional psychotherapy and medical treatments available.

All new patients are required to complete and pass a urine drug screen before they can schedule a consult appointment with the neurologist . This screen is in place to ensure no patient harm comes from any possible drug interaction between any illicit drugs (drugs not prescribed by a provider) or THC and medications used for treatment. New patients are also required to complete and pass a urine nicotine screen before they can schedule a consult appointment with the neurologist. Nicotine is a known trigger for headaches and it doubles the likelihood of developing them. In addition, nicotine in the body has a high likelihood of preventing medications available for treatment from having significant benefit. Nicotine cessation can decrease how often and how severely the patient experiences headaches, and it can also greatly improve the patient’s response to medications available.

• We want all patients to be successful in this area, as we know it can have a great impact on their success in managing headaches.
  For assistance with nicotine cessation:

  • Contact our nurse navigator at 616.447.1101 to discuss smoking cessation resources near you.

  • Contact the Corewell Health Lifestyle Medicine team which will give you access to a team of experts in smoking cessation and a variety of programs and services to help you be successful. To schedule an appointment or for more information:

  • Call: 616.486.0385

  • Email: lifestylemedicine@spectrumhealth.org

  • Website: Lifestyle Medicine

• These labs are to be completed at any Corewell Health laboratory at least four weeks before the consult appointment.

Evaluation of opportunities for psychological counseling and treatment is a vital step when developing a treatment plan for headache and migraine management. This is an important step that we take with every patient of the headache center. This is because we know that if we let stress or other psychological disorders, which are common among the headache and migraine population, such as depression, anxiety, panic disorder and bipolar disorder, go untreated, then the medications that are available for treatment will likely be ineffective. Our program has a dedicated pain psychologist who is available to all patients for their initial consult, and then for follow-up if deemed appropriate for the following services:

• Biofeedback (guided imagery)
• Cognitive behavioral training
• Development of coping skills
• Relaxation training
• Therapy sessions

Consistent re-evaluation for potential lifestyle optimization is vital to every patient of the headache center. Lifestyle optimization refers to making changes to the food, drink and substances we put into our bodies and the physical actions we perform with our bodies every day. The most common areas of opportunity that also have the most impact on the frequency and severity of headaches are sleep, diet, exercise, nicotine and drug avoidance, and medication overuse. By addressing one or more of these lifestyle modifications, you have the potential to decrease the frequency and severity of your headaches, and it can also increase your chance of success with the medications and therapies available for treatment.

A large part of lifestyle modification is about learning your specific triggers. Classic triggers include: increased stress, an external stimulus (e.g., weather change, bright lights, loud noises, etc.), various foods and drinks, medications, drug and nicotine use, etc. These can exacerbate a headache you already have or trigger a new headache altogether. Triggers do not affect everyone equally. A trigger for one person may have no effect on another person’s headaches. That is why it is very important to track these potential triggers to identify what has an effect on your specific headaches. If we can identify these triggers, you can implement trigger avoidance in your life, which can overall decrease the frequency or severity of your headaches and can also allow your medications or therapies to be more effective.

Please see the educational materials below for a more in-depth look into each of these classic lifestyle modifications:

There are two groups of medications that are highly important to discuss when developing a medication treatment plan. These are called preventive and acute medications.

A preventive medication is intended to reduce the frequency, severity and duration of the headache you experience over a long period of time. The average trial period for a preventive medication is three to six months to successfully determine the effectiveness of the medication. When preventive medications are successful, they also improve your body’s response to acute medications. This kind of medication is given in the absence of a headache and should be taken regularly as prescribed by your provider.

Acute medications are intended to be used if your headache has lasted for at least four hours or at the first sign you know it will be a migraine. It is to be taken on an as-needed basis and only as prescribed by your physician to avoid developing medication overuse headache.

There are additional rescue therapies that are potentially available within the Headache Center, if deemed appropriate by the provider. Rescue therapies are intended to be used as a last resort. It is important to focus on any opportunities for lifestyle modifications and psychological treatment first. If we have made the appropriate changes and completed the appropriate treatment, and our preventive and acute medications are still ineffective, then it might be time to discuss the possibility of rescue therapy. Rescue medications are intended to break up the acute pain cycle you are in to allow the preventive medications to be effective. Some rescue therapies include nerve blocks, trigger point injections, and outpatient infusions and planned hospital admissions.