Chronic Migraine Treatment in Houston Heights

If you live with headache on more days than not, you are not alone—and you may have chronic migraine, a distinct condition that often needs more than a standard prescription refilled every few months.

What is chronic migraine?

Chronic migraine means headache is a frequent part of your life. In clinical terms, many adults meet criteria when they have headache on 15 or more days per month, with at least 8 of those days involving migraine features (such as throbbing pain, sensitivity to light or sound, nausea, or pain that limits activity). The exact definition your neurologist uses follows international headache classification guidelines; what matters in daily life is that the burden is high and the pattern is persistent.

People with chronic migraine often cycle through medications, urgent care visits, and imaging studies—yet still do not understand why the pain keeps returning. At headacheMD^® Houston, we treat chronic migraine as a problem that deserves a structured evaluation of all contributors, not only a new abortive or preventive drug.

Why standard treatment sometimes falls short

Many patients receive appropriate acute and preventive medications and still struggle. One reason is that migraine can be driven or worsened by factors that pills alone do not fix—muscle tension in the neck, occipital nerve irritation, sleep disruption, medication overuse, or stress carried in the body. Another reason is that “migraine” and “tension headache” labels are sometimes applied when the pain generator is actually peripheral nerve compression or neck-related (cervicogenic) pain.

How Dr. Blake’s evaluation differs

Pamela Blake, MD, FAHS, is a board-certified neurologist and headache medicine specialist. Her protocol begins with a detailed history—not only how often you hurt, but how headaches evolve through the day, what you have already tried, and how symptoms involve your neck and shoulders. The visit includes an emotional health screen when relevant, because stress and trauma can amplify pain. The physical examination includes careful assessment of the occipital region and related structures, looking for patterns that suggest occipital nerve involvement.

Research co-authored by Dr. Blake and Harvard’s Rami Burstein helped clarify how occipital nerve compression can fuel neurogenic inflammation and pain that patients experience as migraine-like attacks. That science informs when we pursue targeted procedures, medication adjustments, or referral for nerve decompression surgery after a clear diagnosis.

Treatment options we coordinate

Your plan is individualized. It may include optimized preventive and acute medications, lifestyle and sleep strategies, coordination of physical therapy when appropriate, occipital nerve blocks or other procedures when indicated, and referral within the headacheMD^® surgical network when surgery is the right next step. For patients who benefit from addressing emotions held in the body, heal Houston offers EAET (Emotional Awareness and Expression Therapy) at the same Houston Heights address.

Insurance, follow-up, and what success looks like

The headacheMD^® network encourages broad insurance participation; participation can vary by plan and network, so our team confirms benefits when you schedule. Chronic migraine care is rarely “one and done.” Follow-up visits adjust medications, track triggers, and revisit whether occipital or neck findings have changed. Success is not always zero pain—it is fewer severe days, clearer understanding of your condition, and a plan you can sustain.