How are migraines different from cervicogenic headaches?

Cervicogenic headache originates from the cervical spine — typically the upper cervical facets or muscles — and refers into the head. Migraine is a primary neurologic condition. They can coexist, and treating both is sometimes the key.

What is occipital neuralgia?

Occipital neuralgia is sharp, shooting pain in the back of the head and scalp from irritation of the greater or lesser occipital nerve. It often responds well to a targeted occipital nerve block.

What is a sphenopalatine ganglion block?

An office-based, intranasal procedure that delivers local anesthetic to the sphenopalatine ganglion — a nerve cluster involved in migraine and cluster headache. It can provide rapid relief in select patients.

Will I still need to see my neurologist?

For most patients, yes. We coordinate with neurology rather than replace it. Migraine prevention is best when interventional and pharmacologic approaches work in parallel.

Can RFA help with my headaches?

When headache is driven by upper cervical facet pathology, cervical medial branch RFA can provide durable relief. We confirm with a diagnostic block first.

How quickly will I see improvement?

Some interventional procedures (occipital block, SPG block) provide rapid relief within hours. Others (RFA) build over the following weeks, reaching full benefit at about the 6-week mark. We track headache-day frequency over the first 1–3 months.

What about Botox for migraines?

Botox is a well-established preventive for chronic migraine and is typically administered by neurology. We coordinate with your neurologist on combined approaches when appropriate.

Pain Center

Migraines & Chronic Headache

Beyond medication management — interventional options when headaches don't respond.

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A woman in a white shirt with her eyes closed presses her hand against her temple and forehead in soft natural light.

Overview

Understanding migraines & chronic headache.

Migraine and chronic headache are among the most disabling conditions in medicine — and among the most under-treated. Most patients with chronic headache have been on rotating medications for years, often without much benefit, and have not been offered the interventional options that can dramatically change their trajectory.

We do not replace neurology — we work alongside it. For patients with cervicogenic headache, occipital neuralgia, or migraine that has not responded to standard preventives, interventional pain medicine has a real toolkit: occipital nerve blocks, sphenopalatine ganglion procedures, cervical medial branch blocks and RFA when the upper cervical facets are involved, and selective targeting of other cranial nerves.

Our goal is simple: fewer headache days, less disability, and less reliance on rescue medications.

Common Symptoms

Headaches occurring 8+ days per month
Throbbing pain often one-sided
Sensitivity to light, sound, or smells
Headaches limiting work, sleep, or relationships

Common Causes

Migraine with or without aura
Cervicogenic headache (originating from cervical spine)
Occipital neuralgia
Medication-overuse headache

Treatments at HTx Pain

How we approach migraines & chronic headache.

Occipital Nerve Blocks

Targeted relief for occipital neuralgia and cervicogenic headache.

Learn more

Sphenopalatine Ganglion Block

Office-based option for migraine and cluster headache.

Cervical Medial Branch RFA

When upper cervical facets drive headache symptoms.

Learn more

Diagnosis & workup

Detailed headache history — pattern, frequency, triggers, prior treatments.
Focused neurologic exam and cranial nerve testing.
Cervical spine assessment, including range of motion and palpation.
Coordination with neurology when migraine pathology dominates the picture.
Diagnostic occipital or sphenopalatine block to test interventional candidacy.

When to see a specialist

Headache 8 or more days per month despite preventive medication.
Failed multiple migraine preventives at adequate trial doses.
Suspected cervicogenic headache or occipital neuralgia.
Reliance on triptans or rescue medications more than twice per week.
Chronic daily headache without clear diagnostic clarity.

Recovery & outlook

What to expect over time.

Recovery from headache treatment is measured in headache-day reduction, not cure. A successful interventional plan often reduces headache frequency by 50% or more within the first few months. Cervical RFA when indicated can provide 6–18 months of substantial relief. We work iteratively — refining the plan based on your headache diary and response.

Common Questions

Direct answers — no jargon.

If your question isn’t here, ask us at your consultation.

Cervicogenic headache originates from the cervical spine — typically the upper cervical facets or muscles — and refers into the head. Migraine is a primary neurologic condition. They can coexist, and treating both is sometimes the key.

Why HTx Pain Institute

How we treat migraines & chronic headache, differently.

Most pain practices do not focus on headache. Most neurology practices do not have an interventional toolkit. We bring both in one place — coordinated with your neurologist when appropriate — and bring the same diagnostic discipline to headache that we bring to every other pain syndrome.

Other conditions we treat.

See all conditions

Reviewed by Edward Baumgartner Jr., MD · Last reviewed September 10, 2026. Information on this page is not medical advice. Always consult your physician.

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