Published January 12, 2019 By Adam Lowenstein

It seems there is often much misunderstanding surrounding the terminology pertaining to headaches.  While “migraine headache” is indeed a specific diagnosis, there are many subtypes of migraines with terminology that can get confusing.  Additionally,  many headache sufferers have not yet seen a neurologist to get a migraine diagnosis, and others have diagnoses such as “chronic tension headaches” that seem to take them out of the migraine grouping such that migraine treatments that might help are not offered to them.

The interesting fact is that for many, though the end diagnosis of their pain is different, the root cause is the same nerve irritation or neuralgia.  For example, the diagnosis of occipital neuralgia refers to inflammation of the occipital nerves in the back of the head.  Patients with occipital neuralgia often carry diagnoses of migraine headache, chronic tension headache, or even cervical spinal stenosis.  The pain associated with ALL of these diagnoses comes from compression of the occipital nerves in the back of the neck and base of the skull, and ALL of these diagnoses are treatable with migraine surgery.

What is migraine surgery?

We use the term “Migraine Surgery” to describe microvascular decompression of peripheral nerves in the head and neck outside of the skull (this is NOT brain surgery).  By decompressing these nerves, we can reduce the inflammation in these nerves that cause the pain associated with migraine disorders.  And neuralgia disorders.  And tension headaches.  And eye strain headaches.  And chronic headaches.  Calling the surgery “Migraine Surgery” is a lot easier than calling it “Nerve decompression surgery that treats many different kinds of headaches including stress headaches, migraine headaches, etc…”

There are certainly headaches and pain syndromes that are not treated by nerve decompression migraine surgery.  And migraine surgery is not always successful- 7% of patients don’t respond to the operation.  And that means that 93% of patients do respond to migraine surgery.  A nerve block comprises the screening process to see if one of the easily accessible nerves that we treat with migraine surgery is the cause of your pain.  Using nerve blocks to map out the problematic nerves causing the pain is very straight forward, and anyone with any diagnosis who has headaches can undergo this easy screening process to see if migraine surgery can reduce your pain.

Nerve decompression surgery for headache takes one to three hours and is done in an outpatient setting.   Because there are few surgeons that specialize in this type of surgery, finding a center such as the Migraine Surgery Specialty Centers in Denver and Santa Barbara can be the biggest hurdle.  And because there are so few surgeons like Dr. Lowenstein who routinely practice nerve decompression for headache pain, we commonly see patients from around the country at our facilities.  If you have a question about your pain, a call or email to our center is an easy first step to potential headache pain relief.

So, no matter the name of your head and neck pain, from whiplash to tension headache to migraine, an evaluation by a migraine surgeon may open the door to long term pain reduction.

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