Interventional Headache Center

Headache Treatment and Management

With locations in Burlington and Peabody, the Lahey Interventional Headache Center treats a wide variety of primary and secondary headache disorders as well as conditions affecting the head/neck/face area. The Center’s staff includes three double board-certified physicians and utilizes the full spectrum of pharmacological and interventional treatment options. Interventional treatments include trigger point injections, nerve blocks, Botox injections, trigeminal nerve blocks, fluoroscopy-guided injections and nerve ablations, blood patches and nerve stimulator implants.

For patient referrals, providers can use the Epic code “HEADACHE” to customize the reason for their submission.

Headache Conditions

Common conditions treated at the Lahey Headache Center include:

  • Migraine headache – Severe head pain on one or both sides of the head often accompanied by nausea, vomiting, sensitivity to light or sound, and sometimes heralded by neurological symptoms such as disturbed vision or a tingling sensation in your body
  • Cervicogenic headache – Headaches triggered by neck pain or degenerative disease of the cervical spine
  • Whiplash injury – Chronic headaches and neck pain caused by sudden neck strain, often the result of a car accident
  • Occipital and other neuralgias – Sharp pain often shooting up from the neck, around your head and sometimes behind the eye, caused by irritation of the scalp nerves
  • Cluster headache – Intense, piercing pain on one side of the head associated with eye tearing/swelling or a stuffy nose
  • Tension-type headache – Like a rubber band or vise-grip around your head often associated with muscle tension and stress
  • Trigeminal neuralgia – Severe pain attacks on one side of the face caused by irritation or compression of the trigeminal nerve
  • Spinal fluid (CSF) leak – this can happen after a lumbar puncture, and accident or spontaneously and causes severe headaches typically in the sitting or standing position

Headache Treatments

Headache, neck and facial pain belong to the most common and most disabling diseases worldwide, and successful treatment has many challenges. Healthy lifestyle changes and identifying pain triggers are an important first step. Oral medications can often be successful to prevent or acutely treat headaches, however medication side-effects, overuse or the notion of “being sick of taking all these pills” leave many patients suffering from untreated pain.

At the Interventional Headache Center, we focus on interventional treatments, which can often be a successful addition to your current treatment regimen. In some cases, targeted nerve blocks also help us understand where your pain is coming from and this might offer new treatment options. Interventional treatments offered at the Lahey Interventional Headache Center include these cutting-edge procedures:

  • Botulinum toxin (Botox) – An FDA-approved prevention treatment for chronic migraines. Injections of small amounts of botulinum toxin around the head and neck every 3 months can results in significant reduction of headache frequency and intensity
  • Nerve blocks – Injections of local anesthetic and small amount of steroid medication can block the nerve causing or contributing to your pain
  • Trigger point injections – A procedure in which a local anesthetic is injected into tight muscles to break up muscle spasms and provide pain relief
  • X-ray guided neck injections/cervical facet blocks – The use of x-ray imaging in an OR setting helps us to precisely guide an injection to nerves and joints in your cervical spine. This helps us understand where exactly your pain is coming from, but also helps treat some types of headache and neck pain.
  • Radiofrequency Ablation – Once we have identified a specific pain source in your neck using targeted nerve blocks, we can “heat shock” these nerves under X-ray guidance to provide longer-lasting pain relief
  • Trigeminal nerve block – X-ray guided Injections of the trigeminal nerve to help treat trigeminal neuralgia and other facial pain
  • Sphenopalatine Ganglion Block (SPG) – Injection of a nerve structure (ganglion) which can contribute to some headache types, using either a catheter through your nose or an X-ray guided injection
  • Blood patch – Xray -guided injection in the lower back to stop spinal fluid (CSF) leakage, which can cause severe positional headaches
  • Occipital nerve stimulation (ONS), peripheral nerve stimulation (PNS) – An outpatient procedure for the most refractory cases, where a small programmable, electric lead is inserted over the affected nerve to disrupt or modify pain signals

Make an Appointment

For an appointment, please contact the Lahey Department of Neurology at 781-744-1270. You will need a referral from your healthcare provider prior to your appointment.

Headache Center Team

The Lahey Interventional Headache Center is led by Daniel Vardeh, MD, a board-certified neurologist and fellowship-trained and board-certified pain specialist. Dr. Vardeh is joined by fellow neurologists and interventional pain medicine specialists to offer you exceptional multispecialty patient care.

Daniel D. Vardeh, MD
Daniel D. Vardeh, MD Anesthesiology Neurology Pain Management
Azmin Kahriman, MD
Azmin Kahriman, MD Neurology Sleep Medicine