less migraines
more life
Treatments
Botox Injections
Botox® is a well-established treatment for chronic migraine. It is administered as 31 small injections into specific areas of the head, neck, and shoulders using the internationally recognised PREEMPT injection protocol.
Although its exact effect on migraine is not fully understood, it is thought to work by blocking the release of pain-signalling neurotransmitters, helping to reduce the transmission of migraine pain.
Treatment is initially given every 12 weeks, with ongoing treatment tailored according to your response and headache diary.
The procedure takes around 15–20 minutes. Most people experience a brief stinging sensation during the injections, but this is usually mild and settles quickly.
Key Benefit
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30–50% Reduction in Migraine Days – Many patients experience a significant reduction in the frequency of migraine attacks.
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Reduced Attack Severity – Migraine attacks that do occur are often less severe, shorter in duration, and more manageable.
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Reduced Reliance on Acute Medication – Fewer migraine attacks may reduce the need for rescue medication, helping to lower the risk of medication overuse headache.
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No Known Long-Term Side Effects – Botox® has an established safety profile with no known long-term side effects when administered appropriately for chronic migraine.
Greater Occipital Nerve Block Injection
The nerve block is an injection around the greater occipital nerve. The injection is a combination of steroid and local anaesthetic which interrupts the nerve signals, reduces inflammation and anaesthetises the nerve.
It lasts for 3 months but long term can only be administered every six months due to the long term risks of bone and hair thinning.
It is two injections one each side of the head only with a slight discomfort at time of injection.
Key Benefit
A Greater Occipital Nerve Block may:
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Provide effective relief from migraines cluster headaches and chronic headaches.
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Reduce the frequency and severity of headache episodes.
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Relieve pain originating from the back of the head and upper neck.
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Reduce reliance on pain medication.
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Improve quality of life and daily functioning.
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Be performed quickly in the clinic with minimal discomfort and little to no recovery time.
Multiple cranial nerve block
Multiple cranial nerve block injections involve administering a small amount of local anaesthetic around targeted nerves on both sides of the head. The anaesthetic temporarily numbs the area and reduces nerve sensitivity, which may help alleviate migraine or headache symptoms.
The procedure is performed using a series of small injections and is usually completed within a few minutes. Although some discomfort may be experienced during the injections, many patients find that the treatment provides relief for several weeks to several months.
Key benefits
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Rapid Pain Relief – Many patients experience relief within 15–30 minutes following treatment.
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Temporary Relief from Migraine or Cluster Headache – Can provide relief from headache pain for several weeks to
months in suitable patients.
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Interrupts Pain Signalling – Helps to temporarily reduce pain by interrupting overactive nerve pathways involved in headache disorders.
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Reduces Nerve Sensitivity – May help desensitise the trigeminocervical pain pathway, reducing the cycle of recurring headache pain.
CRGP Monoclonal Antibodies
Calcitonin Gene-Related Peptide (CGRP) is a protein involved in the transmission of pain signals and plays a key role in the development of migraine. CGRP monoclonal antibodies are targeted treatments that work by blocking the activity of CGRP or its receptor, helping to prevent migraine attacks before they begin.
The treatments currently available include:
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Fremanezumab (Ajovy®)
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Erenumab (Aimovig®)
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Galcanezumab (Emgality®)
These medications are administered as a once-monthly injection. Following appropriate assessment and training, most patients can self-administer their treatment at home. Alternatively, injections can be administered at the clinic if preferred.
Key Benefit
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35% or Greater Reduction in Migraine Days – Many patients experience a significant reduction in the frequency and severity of migraine attacks.
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Migraine-Specific Treatment – Developed specifically to target the CGRP pathway, a key mechanism involved in migraine, rather than using medications originally designed for other conditions.
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Well Tolerated – Most patients experience few side effects, which are typically mild and may include temporary injection-site discomfort.
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Reduced Reliance on Acute Medication – Fewer migraine attacks can reduce the need for rescue medication and help lower the risk of medication overuse headache.
Gepants
Gepants are a newer class of migraine medication that block the action of Calcitonin Gene-Related Peptide (CGRP), a protein involved in the development of migraine. Depending on the medication prescribed, they can be used to prevent migraine attacks or to treat an attack when it occurs.
The currently available gepants include:
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Rimegepant (Vydura®) – licensed for both the acute treatment and prevention of migraine.
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Atogepant (Aquipta®) – licensed for the prevention of migraine.
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These medications are taken orally and may be an appropriate option for patients who are unable to tolerate or have not responded to other migraine treatments.
Key Benefit
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Reduces Migraine Frequency and Severity – Regular treatment can help decrease both the number of migraine attacks and their intensity.
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Suitable for Patients with Cardiovascular conditions – Unlike triptans, gepants do not cause blood vessel constriction THEREFORE appropriate for patients with stroke history
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Convenient Oral Treatment – Taken as a tablet, either as a preventative treatment or for the treatment of an acute migraine attack.
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Ongoing GP Prescribing – Treatment is initiated by a headache specialist and can often be continued by your GP under a shared care agreement, where appropriate.
Comprehensive Migraine Assessment & Treatment Plan
A specialist consultation to assess your migraine history, current symptoms, previous treatments, and their impact on your daily life. Following your assessment, you'll receive a personalised treatment plan and a detailed letter for your GP with clear recommendations for medications, preventative treatments, and ongoing management. By working alongside your GP, we aim to ensure you receive the most effective, evidence-based migraine care and a clear pathway to better symptom control.
Start Your Migraine relief journey
Book an initial assessment to define your clinical needs and find the right treatment for you.
Your initial consultation is a comprehensive, one-to-one appointment designed to gain a thorough understanding of your migraines. We will discuss your symptoms in detail, including the frequency, duration, triggers, and impact on your daily life, alongside your medical history, current medications, and any previous investigations or treatments.
Following a detailed assessment, we will explain your diagnosis, answer any questions you may have, and work with you to develop a personalised treatment plan tailored to your individual needs and goals. This may include lifestyle advice, preventative medications, migraine attack medication and treatment for chronic migraines.
Our aim is to provide clear, evidence-based recommendations and ongoing support, helping you to achieve better control of your migraines and improve your quality of life.