Can Botox really help my migraines?

Yes. For chronic migraine sufferers, Botox injections can prevent headaches before they start by blocking the release of chemicals involved in pain transmission.

Why do I get dizzy with my migraines?

This is known as an atypical or vestibular migraine. Nerve irritation affects the inner ear and balance centers, causing vertigo and dizziness even without severe head pain.

Does weather trigger migraines?

Yes. Barometric pressure shifts are a very common trigger that adds to your overall "set point" of nerve irritation.

Are my allergies causing my migraines?

They can be a contributing factor. Nasal congestion and inflammation add stress to the nervous system, which can push you closer to a migraine episode.

How do I know if it’s a migraine or TMJ?

They often overlap. TMJ disorder causes muscle tension that can trigger migraines. We evaluate your jaw, bite, and symptoms to treat both conditions simultaneously.

CONDITION GUIDE

Migraine: More Than a Headache

It’s not just a bad headache—it’s a neurological condition starting from nerve irritation. We help you identify your triggers and find targeted relief.

For years, you may have been told you just have a "bad headache" or even a sinus infection. But migraines are different. They start with nerve irritation that causes changes in blood flow, imitating neighboring nerves and creating a domino effect of pain, nausea, and sensitivity. At Exhale Sinus, TMJ, Headache and Sleep, we map out your unique "trigger set point" so you can finally break the cycle.

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Common vs. Atypical Migraines

Although the symptoms can look completely different, both "common" and "atypical" migraines respond to similar treatments because they share the same root cause: nerve irritation. Every person has a "set point." Individual triggers add up on each other until they hit that set point, and a migraine forms. Our goal is to identify and lower those triggers before the storm hits.

What causes migraines?

The short answer: a genetically sensitive nervous system meets a trigger.

Common triggers include:
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Sleep changes

Too little, too much, or shifted schedule

Hormonal shifts

Menstrual cycle, pregnancy, perimenopause

Skipped meals or dehydration

Low blood sugar and fluid loss are common, overlooked triggers

Certain foods

Aged cheese, cured meats, red wine, MSG (highly individual)

Caffeine

Both too much and withdrawal

Stress and stress let-down

(weekend migraines are real)

Weather changes

Barometric pressure especially

Bright, flickering, or fluorescent light

Screens and harsh lighting can spark or worsen an attack

Strong odors

Perfume, smoke, and chemical smells are frequent culprits

Neck tension and poor posture

Muscle tightness from desk work or poor ergonomics refers pain upward

Sinus disease and allergic rhinitis flares

Congestion and inflammation overlap heavily with migraine symptoms

TMJ disorder and jaw clenching

Jaw tension and grinding, often worse with stress or at night

Notice how many of those last few are ENT-adjacent. That's why an ENT-led evaluation matters for headache patients: we can identify and treat the sinus, jaw, and airway triggers that a neurologist may not screen for.

How is migraine treated?

Modern migraine care has two arms: acute (treating an attack in progress) and preventive (reducing how often attacks happen).

Acute treatment

Over-the-counter analgesics (ibuprofen, naproxen, aspirin, acetaminophen)

Triptans

A class of migraine-specific abortive medications (sumatriptan, rizatriptan, and others)

Gepants

Newer CGRP-blocking oral medications for acute treatment

Ditans

Another newer acute-treatment class

Anti-nausea medication as needed

A dark, quiet room and rest

Preventive treatment (typically considered when attacks occur 4 or more days per month, or whenacute meds aren't cutting it):
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Beta blockers, tricyclics, topiramate, and other daily oral medications

CGRP monoclonal antibodies

Monthly or quarterly injections that block the CGRP pathway

Botox for chronic migraine

FDA-approved since 2010 for chronic migraine (≥15 headache daysper month).

Magnesium, riboflavin (B2), and CoQ10 have modest preventive evidence

Behavioral therapy

CBT, biofeedback, mindfulness

Trigger management and sleep optimization

Treating coexisting sinus, TMJ, cervical, and airway issues

When should I see a doctor about my headaches?

See a provider for headaches that:

Occur 4 or more days per month

Interfere with work, school, or family life

Aren't responding to over-the-counter treatment

Wake you from sleep

Come with new neurological symptoms

Have changed in pattern or severity

Seek emergency care for a "thunderclap" headache that reaches peak intensity in seconds, headache with fever and stiff neck, headache after a head injury, or headache with weakness, confusion, or vision loss.

Migraine-Specific Quality of Life Questionnaire (MSQ)

Measure what migraines are taking from you.

The MSQ measures how much migraines interfere with your life rather than simply how often they occur. Seven questions cover time lost with family and friends, missed responsibilities at work or home, reduced output, low energy, needing help from others, and plans you've cancelled. Each scores 0 to 4, giving a total from 0 to 28 — higher means greater impact. Because frequency alone understates disability, this score helps your physician judge whether preventive treatment is warranted.

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Migraine FAQ

How is migraine different from a regular headache?

Migraine is a specific neurological disorder with defined criteria — recurring attacks of 4–72 hours with pulsating one-sided pain and features like nausea or light sensitivity. A "regular" tension headache is bilateral, band-like, and non-throbbing.

Can sinus problems really trigger migraines?

Yes. Chronic sinus inflammation and allergic rhinitis can lower migraine threshold. Treating the sinus disease often reduces migraine frequency, which is exactly why an ENT-led evaluation matters.

Does Exhale prescribe migraine medications?

We manage the ENT adjacent aspects of migraine — trigger identification, sinus/TMJ/cervical mimics, Botox for chronic migraine, and coordinate with neurology partners for complex preventive regimens.

Do I really need to keep a headache diary?

Yes. Pattern recognition drives treatment. A simple log — day, time, duration, severity, meds, and possible triggers — is one of the most useful things you can bring to your visit.

What if I've had migraines for years and nothing has worked?

You may have never been fully worked up for the ENT-adjacent triggers. You may be undertreated. You may be overtreating with rebound-inducing analgesics. All three are fixable.

Are migraines dangerous?

Migraine itself is not typically dangerous, but it is disabling and it modestly increases stroke risk in some subgroups. New, sudden, or changed migraine patterns should always be evaluated.

Is chronic migraine the same as regular migraine?

No. Chronic migraine is defined as 15 or more headache days per month for at least 3 months, with at least 8 of those days meeting migraine criteria. It's the diagnosis that opens the door to therapies like Botox.