Practices in Beverly Hills an also works at Cedar Sinai. Uses interventional methods (such as Botox/ surgery) to treat certain pain conditions such as migraines and TMJ.
Q: Difference between Migraines/ Headaches
A: Headaches are the umbrella term for anything that causes pain in the head. Migraines are a type of headaches with specific diagnostic criteria. Migraines require a number of criteria; last between 3 hrs. and 3 days, usually on 1 side of the head and throbbing, associated with nausea / vomiting, photophobia and phono phobia (sensitivity to light).
Q: What are treatment options do you offer for someone with Migraines?
A: My treatments now are mostly around Botox. I try to figure out where the migraine is originating from. The migraine is happening in the brain. What is up for debate is that for a lot of people there is a trigger, a cranial nerve or occipital nerve that is like a fuse. When that nerve is triggered it sets off the explosion for a migraine. I try to isolate where the “fuse” is to help to isolate and desensitize it to reduce the frequency, intensity and duration of migraines. For some it’s a reduction of symptoms and for some it’s curative.
Q: How does the Botox work for migraines?
A: It interferes with some signaling within the muscles and with muscle movement. So when you’re talking about treating migraines, and someone who has supraorbital or supratrochlear nerve issues, injecting Botox into that area relaxes the muscles that are associated with the nerve to reduce the pressure around the nerve and it bathes the nerve with Botox and dampens the nerves ability to send the pain signal.
Q: Now if a patient is getting relief with Botox, do you recommend them being proactive with seeking physical therapy? Craniosacral therapy? Is there a timeline?
A: Migraines are a multidisciplinary treatment. I encourage patients to work with neurologists on the medication side, physical therapists on the fascial side/ muscular side and acupuncturists. My goal is to reduce severity, frequency and duration of these headaches in conjunction with them taking some element of medication and still receiving acupuncture and physical therapy.