Comprehensive Migraine Care at Stanford: Treating the Whole Person
Learn what migraines are, who gets them, our care approach, and the most current treatments available
Migraines are more than just bad headaches. They can affect your ability to think, work, and enjoy life. Many people also experience neck pain, back pain, or fatigue alongside their migraines. At Stanford, our care team takes a whole-person approach—treating not just the pain, but every factor that contributes to it.
What Is a Migraine?
A migraine is a brain network disorder, meaning that parts of the brain and nerves that control pain, sensation, and emotion become overly sensitive and reactive. This can create a cycle of overactivity that keeps the pain going for hours — sometimes days.
People often experience four phases of migraine:
- Prodrome – hours or days before the headache: changes in mood, light sensitivity, yawning, food cravings, or neck pain.
- Aura – visual changes, numbness, tingling, or trouble speaking (in about 30% of people).
- Headache phase – throbbing pain, often with nausea and sensitivity to light and sound.
- Postdrome – fatigue, brain fog, and weakness that can last for days.
Because migraine involves the brain’s pain and sensory networks, symptoms can also include dizziness, numbness, or body pain — not just head pain.
Who Gets Migraines?
Migraines affect 1 in 7 people worldwide — more than diabetes or heart disease. They are especially common in women, often starting in the 20s or 30s, when many are balancing careers, families, and other responsibilities. Children and men also experience migraines, but women are three times more likely to have them.
Children are more likely to get migraines if a parent has them—studies show the risk is two to three times higher.
Looking Beyond the Headache
Migraines don’t just cause pain—they can affect mood, sleep, and daily functioning. During the first visit, patients complete a comprehensive assessment that examines how headaches influence:
- Mental health, including depression or anxiety
- Sleep patterns and fatigue
- Physical function and activity levels
- Social engagement and isolation
This broader view of migraine care allows the team to address both the physical and emotional effects of chronic pain. Improving sleep, mood, and overall well-being is seen as essential to reducing the burden of migraine.
Building Better Habits for Migraine Prevention
While medical treatments are important, lifestyle changes can make a meaningful difference. Clinicians often emphasize one key word: schedule.
The brain functions best on a steady routine. To support migraine prevention, patients are encouraged to:
- Go to bed and wake up at the same times each day
- Eat three balanced meals that include protein
- Limit caffeine and alcohol
- Exercise regularly
- Avoid skipped meals or irregular sleep patterns
These consistent habits help regulate the body’s natural rhythms and can reduce the frequency and severity of migraine attacks.
Common Migraine Triggers
The “migraine brain” tends to be sensitive to change. Keeping a regular routine helps stabilize it. Common triggers include:
- Skipping meals or not drinking enough water
- Lack of sleep or inconsistent sleep patterns
- Bright lights, loud noises, or strong smells
- Weather changes or stress
- Hormonal fluctuations
- Certain foods (such as red wine or processed meats)
Experts often encourage patients to track patterns and maintain consistency in daily habits, such as sleep, exercise, and meal times.
Stanford’s Comprehensive Migraine Treatment: What to Expect
Stanford offers one of the most comprehensive migraine care programs in the country. Our multidisciplinary team—comprising physicians, psychologists, and physical therapists—works together to create individualized care plans for every patient. Because each migraine journey is unique, the team takes extra time to listen and understand each person’s story. New patients receive a full hour for their first visit and 30 minutes for follow-ups, giving the team time to fine-tune treatment as needed.
Rather than relying on a one-size-fits-all approach, the team collaborates with each patient to find the most effective combination of therapies.
- Medications
Medication remains an important part of migraine management. Stanford clinicians tailor treatments to each person’s needs, combining:- Preventive medications that reduce how often migraines occur (including CGRP-targeting drugs, beta-blockers, or anti-seizure medications).
- Rescue or acute medications taken during a migraine to shorten or stop the attack.
- Hormonal management for patients whose migraines are linked to menstrual cycles.Medication plans are adjusted over time to balance relief with minimal side effects.
- Botox Injections
For people with chronic migraine (15 or more headache days per month), Botox injections can significantly reduce headache frequency. The treatment involves tiny injections into key areas of the head and neck that help calm overactive pain pathways. Patients usually receive Botox every 12 weeks, and many notice improvement after a few sessions. - Nerve Blocks and Procedures
Stanford offers a range of targeted nerve blocks that can reduce migraine pain by numbing or quieting irritated nerves. These quick, in-office procedures include:- Occipital nerve blocks, which target nerves at the base of the skull.
- Sphenopalatine ganglion (SPG) blocks, which calm nerve clusters deep in the face. Some studies also explore longer-lasting nerve blocks using slow-release medications for extended relief.
- Neuromodulation Therapies
Neuromodulation is a gentle electrical or magnetic stimulation to calm the nervous system without drugs. Devices can be worn on the forehead, neck, or arm to interrupt migraine signals and prevent attacks. - Pain Psychology and Empowered Relief
Pain psychologists help patients understand how the brain and body interact in chronic pain. Through Stanford’s Empowered Relief program, patients learn science-based tools to manage pain, reduce stress, and calm the body’s “fight-or-flight” response. This can improve pain levels, mood, and sleep. - Physical Therapy and Acupuncture
Neck, jaw, and shoulder tension can trigger or worsen migraines. Stanford’s physical therapists use stretching, posture correction, and gentle strength exercises to reduce strain. Acupuncture may also help balance nerve activity and relieve tension in the muscles that affect headache patterns
The center’s ability to provide so many services in one place helps patients avoid delays in care and keeps all treatment under one coordinated team.
From Lab to Clinic: Research in Migraine Therapy
Stanford Pain Management Center is home to innovative migraine research that aims to expand treatment options for patients with difficult-to-treat migraine. One study explores peripheral nerve stimulation, a technique that uses tiny implanted devices near the occipital nerve to reduce chronic headache pain.
The team is also partnering with Stanford’s Ear, Nose, and Throat specialists to study longer-lasting nerve blocks designed to provide sustained relief. These projects reflect Stanford’s mission to bring scientifically grounded, forward-looking treatments to people living with chronic migraine.
Patient Story: Conquering Migraines
One patient came to Stanford’s Pain Management Center after struggling with severe daily headaches that hadn’t improved with other treatments. With a personalized plan that combined medication, therapy, and a specialized procedure called a sphenopalatine ganglion (SPG) block, the patient began to experience meaningful relief.
Although the pain didn’t vanish completely, it became manageable, allowing the patient to regain confidence and take back control of daily life. He described the changes as “life-changing,” saying it finally felt possible to think clearly and return to normal routines. Today, with ongoing support and self-management strategies, he continues to live with renewed hope, confidence, and a better quality of life.
How to Get Care at Stanford
Most patients begin by getting a referral from their primary care provider to the Stanford Pain Management Center. This ensures ongoing communication between care teams and supports long-term follow-up once a treatment plan is in place.
Our migraine program is built on cutting-edge science, compassion, and interdisciplinary collaboration. Whether through advanced procedures, behavioral strategies, or patient education, the goal is simple: to help you find lasting relief and a better quality of life.