A long day at the office, lack of sleep, or a loud noise can all be headache triggers. Headache pain can interfere with your life and make it difficult to go about your day. But if you suffer from regular headaches or migraines, treatment can help.


Whatever the cause of your headaches, you are not alone. It is estimated that migraine sufferers in the United States number 28 million, with women more likely than men to have experienced migraine or severe headache. The prevalence of migraines causes approximately $13 billion a year in lost productivity.

Differentiating Between Headache Types

There are two classifications of headaches.


Primary Headaches


Primary headaches occur when no other cause of pain exists elsewhere in the body, or when the headache itself is the main medical problem. It can be associated with non-medical causes like dehydration, changing hormones, and medications.


Examples of primary headaches include:

  • Tension headache
  • Migraine
  • Cluster


Secondary Headaches


Secondary headaches occur when a person has trauma or a problem in another part of the body.

Examples include:

  • Sinus headaches
  • Influenza (flu)
  • Concussion
  • Hangover
  • Headaches that are a result of bleeding in the brain, a brain injury or a brain tumor, such as an aneurysm or blood clot


Headache and migraine symptoms are different for each individual. If you have concerns about your headaches, you should monitor how often the headache occurs and the intensity of the headache.


If severe symptoms occur, it is recommended that a physician be consulted. Serious symptoms may include:

  • Nausea, vomiting, dizziness, confusion, loss of consciousness or blurry vision
  • Age 50 or older with chronic headaches or new type of headache
  • Two or more headaches in a week
  • Weakness in arms or legs
  • Seizures or epilepsy

Our Approach to Diagnosis and Treatment

A comprehensive exam including your medical history, family history and physical exam will be used to evaluate your condition. Several diagnostic tests to help determine the type of headache may also be ordered:

We offer evaluation and treatment of headaches in patients ages 17 and above. When you arrive at your appointment, you will be asked to give the specifics of your headaches, and our physicians will complete a medical history and physical exam.


Each type of headache has different treatment methods that can be effective in treating headache pain. However, treatment for headache pain is as much an art as it is a science. Two patients that describe their headache pain the same way will not necessarily find relief from the same headache treatment. We often need a process of trial and error to find effective treatment options.


Those with chronic or episodic headaches may benefit from a change in medication or a weaning of certain medications. Other treatments may include lifestyle modifications, including:

  • Stress Reduction
  • Regular Sleep
  • Exercise
  • Dietary counseling
  • Caffeine adjustment

Most headaches are treated with prescription or over-the-counter medicines. Patients have also experienced relief using stress management techniques, massage therapy and alternative medicine. For those with chronic migraines, Sinai Hospital’s Headache Program provides FDA-approved Botox injections for migraine prevention.


Botox Injections for Chronic Migraines


Botox is a prescription medicine that is injected to prevent headache flares in adults with chronic migraines who have 15 or more headache days a month. Botox injections also may help reduce headache frequency.