Frequently Asked Questions
Q What is a Migraine?
A migraine is a neurological condition that causes a severe headache, often characterized by throbbing or pulsating pain, usually on one side of the head. Unlike a simple headache, a migraine attack can last for hours or even days and is often accompanied by other debilitating symptoms. These can include nausea, vomiting, and extreme sensitivity to light, sound, and sometimes even smells. Some people experience auras—sensory disturbances like flashes of light or tingling in the face or hands—before or during the headache.A migraine is a neurological condition that causes a severe headache, often characterized by throbbing or pulsating pain, usually on one side of the head. Unlike a simple headache, a migraine attack can last for hours or even days and is often accompanied by other debilitating symptoms. These can include nausea, vomiting, and extreme sensitivity to light, sound, and sometimes even smells. Some people experience auras—sensory disturbances like flashes of light or tingling in the face or hands—before or during the headache.
Q What is a Migraine Aura?
As a migraine attack spreads across the brain, it causes temporary dysfunction in parts of the brain, leading to some neurologic symptoms. We call these symptoms aura and they are usually visual. Visual aura causes the patient to see things like flashing lights, zigzag lines, spots or dots. Other aura includes tingling, difficulty speaking, and weakness. This is scary to patients as they think they are having a stroke. A consultation with Dr. Saad Kanaan will help identify your neurologic symptoms and whether they are related to migraine or other neurologic conditions.
Q What Causes Migraines?
Migraine is a neurological condition with a genetic basis, meaning it tends to run in families. People with migraine have a brain that is more sensitive to certain changes and triggers. These triggers can include stress, hormonal fluctuations, certain foods or drinks, changes in sleep, and even environmental factors like light or weather. When exposed to these triggers, the brain’s pain pathways can become activated, leading to a migraine attack.
Q Can Migraines be Treated?
Yes. While there is no permanent cure for migraine, there are highly effective treatments that can significantly reduce how often attacks happen and how severe they are.
Q How are Migraines Treated?
- Preventive treatments to reduce the frequency and severity of attacks.
- Acute treatments to stop or ease the pain once a migraine begins.
Q What’s the Difference Between a Headache and a Migraine?
Migraines are typically more severe and immersive – with symptoms like throbbing pain, nausea, and light sensitivity – whereas common headaches are usually less intense and short-lived.
Q Do Migraines Get Worse With Age?
Most people start experiencing migraines in their teen years. They can get worse in their 20s-40s and often improve afterwards.
Q How Can I Tell if My Headache is Serious or Needs Urgent Attention?
Worst headache of your life; new, sudden, severe headache, new neurological symptoms (like weakness or vision changes); fever; or neck stiffness need prompt medical assessment for safety and peace of mind.
Q What is a Tension Headache?
A tension headache is the most common type of headache. It’s often described as a constant, dull, aching pain or a feeling of pressure, as if there’s a tight band wrapped around your head. This pain can affect both sides of the head and isn’t typically accompanied by other symptoms like nausea or light sensitivity. While not as severe as migraines, tension headaches can still significantly impact daily life. They are often triggered by stress, anxiety, lack of sleep, or poor posture.
Q What is a Cluster Headache?
A cluster headache is a rare but extremely painful type of primary headache. It’s characterized by severe, sharp, or piercing pain that’s typically located around or behind one eye or on one side of the head. The pain is so intense that it’s often described as a “suicide headache.” The headaches come in “clusters,” with attacks occurring frequently for a period of weeks or months, followed by long periods of remission. During an attack, a person may also experience other symptoms on the same side of the face, such as a drooping eyelid, a small pupil, a stuffy or runny nose, or a watery eye.
Q What Should I Expect During My Consultation With Dr. Saad Kanaan?
Your visit starts with a brief questionnaire to better understand your headaches, triggers, and overall health. You will then meet with Dr. Kanaan to discuss your symptoms, medical history, and any previous treatments you’ve tried. He will perform a focused neurological examination and provide a clear diagnosis. Together, you will review a personalized treatment plan that is practical, easy to follow, and targeted to your specific needs.
Q Is My Headache Caused by My Lifestyle?
Lifestyle factors can play a significant role in triggering or worsening headaches. Stress, poor sleep, dehydration, irregular meals, excessive screen time, and lack of physical activity can all contribute. While these factors may not be the sole cause, identifying and addressing them can make a noticeable difference. During your consultation, Dr. Kanaan will review your daily habits and help you create practical changes that support better headache control.
Q Why Have My Headaches Suddenly Gotten Worse?
A sudden change in headache pattern or severity can be caused by many factors, including stress, poor sleep, dehydration, changes in medication, or other medical conditions. While most causes are not life-threatening, it is important to have any new or worsening headache evaluated promptly. A detailed assessment — and sometimes additional tests — will help identify the cause and ensure nothing serious is overlooked.
Q Do All Headache Patients Need a Brain MRI or CT Scan?
No. The majority of headaches are primary headaches, such as migraine or tension-type headaches, which do not require brain imaging. MRI or CT scans are only recommended if there are red flag symptoms, changes in your headache pattern, or signs that suggest another underlying condition. Dr. Kanaan bases this decision on your history and physical examination.
Q What is the Role of Botox Injections in Treating Migraine?
Botox is an FDA-approved treatment for chronic migraine, which is defined as 15 or more headache days per month, with at least 8 being migraine days. Botox works by blocking the release of certain pain-related chemicals in the brain. It is generally recommended for patients who have not responded well to other preventive medications or who cannot tolerate them. Many patients experience a significant reduction in migraine frequency and severity with this treatment.
Q How Long Does it Take for Migraine Treatments to Work?
Acute treatments are designed to stop a migraine once it begins and can bring relief within minutes to a few hours, depending on the medication and how quickly it’s taken after symptoms start. Preventive treatments, on the other hand, aim to reduce how often migraines occur and how severe they are, but they may take several weeks, sometimes up to several months to reach their full effect.
Q When Should I Consider Botox for Migraines?
Botox is recommended for chronic migraine, defined as 15 or more headache days per month, especially if other preventive medications have failed or caused side effects. A consultation with Dr. Saad Kanaan is the best way to determine if Botox is the right option for you, as he will review your headache history, assess your previous treatments, and create a personalized plan based on your needs.
Q Is Botox Covered by Insurance?
Yes. Most insurance providers cover Botox injections for chronic migraine when the patient meets the medical criteria. Our clinic team can assist you in checking your coverage and handling any necessary approvals.
Q What Other Procedures Do You Offer?
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Nerve blocks:
A targeted injection of numbing medication around specific nerves in the scalp to interrupt pain signals and reduce headache intensity. -
Trigger point injections:
These injections target tight or tender "knots" in the neck and shoulder muscles that can contribute to headaches, neck pain, and shoulder pain. They help relax the muscle, reduce inflammation, and ease discomfort.
Q Are Nerve Blocks Painful?
You may feel a brief sting or pressure during the injection, similar to having blood drawn, but the procedure is quick and generally well-tolerated. Most patients describe it as mildly uncomfortable rather than painful, and any discomfort usually fades within minutes.
Q Do Trigger Point Injections Work Immediately?
Some patients notice relief within minutes, especially if muscle tension is a major trigger. For others, it may take a day or two for the full effect as the muscle relaxes and inflammation subsides. The results can last from several days to weeks, depending on the individual.
Q How Often Will I Need Treatment for My Headaches?
The frequency depends on your diagnosis, symptoms, and how you respond to treatment. Botox for chronic migraine is typically repeated every 12 weeks to maintain results. Nerve blocks may be needed every few weeks or months, while other treatments are scheduled based on your progress and overall care plan discussed with Dr. Kanaan.
Q Will My Headache Pain Ever Go Away Completely?
Every patient’s experience with headaches is different. Some find long-term relief with the right treatment plan, while others manage their symptoms to greatly reduce their impact. The only way to know what’s possible for you is through a thorough evaluation. A consultation with Dr. Saad Kanaan will help identify the underlying cause of your headaches and explore the most effective options for your situation.
Q What is a Caffeine or Alcohol-Related Headache?
A caffeine or alcohol-related headache is a headache caused by the consumption or withdrawal of caffeine or alcohol. A caffeine withdrawal headache often feels like a throbbing pain in the temples and can occur if you suddenly stop consuming coffee or other caffeinated drinks. An alcohol-related headache, commonly known as a hangover headache, is a widespread, throbbing pain that is a result of dehydration and the effects of alcohol on the body.
Q What is Medication-Overuse Headache?
Medication overuse headache, also called rebound headache, is a chronic headache that is caused by long, frequent use of painkillers. The typical scenario is a migraine patient who has frequent headaches that they treat with painkillers only. Over time, the headache becomes more frequent, usually daily, causing them severe disability. It is a very important condition to recognize as it is both preventable and treatable. If you suffer from daily headaches and take painkillers frequently, a consultation with Dr. Saad Kanaan will help you reduce your headache frequency and get you off the painkillers.
Q How do I know if my migraines are caused by hormones?
Female hormones have a strong relationship to migraines. Here are some clues that hormones are influencing your migraines:
- Migraines get worse just before the menstrual cycle starts
- Migraines get better during pregnancy
- Migraines get worse after delivery
- Migraines get worse before menopause (premenopause)
- Migraines get better after menopause
If you have any of these features, a consultation with Dr. Saad Kanaan will help you understand the relationship between your migraines and hormones, leading to better control of your headaches.
Q What is a Hypertension Headache?
A hypertension headache can be a serious symptom of severely high blood pressure. This type of headache is often described as a throbbing or pulsating pain that affects both sides of the head, and it’s a signal that your blood pressure has reached a dangerously high level. Unlike a common tension headache, this one does not respond to over-the-counter pain relievers and requires immediate medical attention.
Q What is an Ice Pick Headache?
An ice pick headache is a primary headache disorder characterized by sudden, sharp, and very brief stabbing pains in the head. The pain is so quick and intense that it feels like a jab with an “ice pick.” The pain typically lasts for only a few seconds and can occur in a single spot or move to different locations on the head. While these stabs of pain can be quite frightening, they are generally harmless and not a sign of a more serious underlying condition.
Q What is a Thunderclap Headache?
A thunderclap headache is an extremely severe headache that comes on very suddenly, reaching its maximum intensity in less than a minute. This type of headache is a medical emergency and should be evaluated immediately by a doctor. While it can be caused by a number of conditions, it is often a key symptom of a life-threatening problem such as a brain hemorrhage from a ruptured aneurysm.
Q What is a Hypnic Headache?
A hypnic headache is a rare type of headache that only occurs during sleep, waking the person up at night. Because of its predictable timing, it’s also known as “alarm clock headache.” The pain is typically a dull ache and can be mild to moderate in intensity. It usually lasts for 15 to 60 minutes and often occurs at the same time each night.
Q What is an Allergy or Sinus Headache?
An allergy or sinus headache is a headache that is a direct result of a sinus infection or an allergic reaction. The pain is typically felt in the face, forehead, or around the eyes and is often accompanied by other symptoms like a stuffy nose, facial pressure, and congestion. The pressure and pain are caused by the inflammation of the sinus passages. Treating the underlying sinus infection or allergy can often relieve the headache.
Q What is a Post-Traumatic Headache?
A post-traumatic headache is a type of headache that develops after an injury to the head, such as a concussion. The pain can feel like a tension headache or a migraine and may last for weeks, months, or even years after the initial injury. It can be a chronic condition that significantly impacts a person’s quality of life. The symptoms can vary widely and may include light and noise sensitivity, dizziness, and difficulty concentrating.
Q What is a Hormone Headache?
A hormone headache, often referred to as a menstrual migraine, is a type of headache related to fluctuations in hormones, specifically estrogen. This type of headache is particularly common in women and can occur around their menstrual period, during pregnancy, or with hormone replacement therapy. The drop in estrogen levels just before a period is a common trigger.
Q What is an Exertion Headache?
An exertion headache is a headache triggered by strenuous physical activity, such as running, weightlifting, or sexual activity. The pain is usually throbbing and can last from a few minutes to several hours. The exact cause is not fully understood, but it is believed to be related to the increased blood flow and pressure in the head that occur during intense physical activity.
Q What is Hemicrania Continua?
Hemicrania continua is a rare, one-sided headache that is continuous and lasts for at least three months. The pain is usually a moderate, dull ache, but it can have periods of severe intensity that feel like a migraine. A unique and key characteristic of this headache is that it responds completely and quickly to a specific medication called indomethacin.
Q What is a Spinal Headache?
A spinal headache is a headache that occurs after a spinal tap (lumbar puncture) or epidural injection. It is caused by a leak of cerebrospinal fluid from the site of the needle puncture, which reduces the pressure around the brain and spinal cord. The key symptom is that the pain is often much worse when you sit or stand up and dramatically improves when you lie down.