In addition to medications and lifestyle changes, Dr. Cohen can discuss with you a variety of other treatment modalities which have been shown to have efficacy in controlling migraine. These include:
1) Stress management and Biofeedback: Stress is a major contributor to migraine and one of its most frequent triggers. Controlling stress and your
response to it may significantly impact the course of your condition. Stress may be managed in a variety of ways, including meditation, yoga, and
breathing exercises. One modality known as Biofeedback-assisted Relaxation Training has been found extremely helpful in a number of migraine
studies for reducing migraine frequency and severity. Biofeedback is a technique of trained relaxation and stress management utilizing physiologic
markers of stress such as pulse rate and blood pressure to enable the patient to determine when he or she is adequately managing the stress response.
The Headache Institute and Adolescent Headache Center offers in-house Biofeedback services.
2) Acupuncture: In recent years, some studies have demonstrated the benefit of acupuncture in the management of migraine. Dr. Cohen works with
an acupuncturist on staff at Roosevelt Hospital who has particular expertise in treating patients with migraine.
3) "Nutraceuticals": A number of studies have examined the role of various vitamins in the management of migraine. Of these, the agents found to be
most successful in controlling migraine were vitamin B2, also known as Riboflavin, and CoEnzyme Q10. Other studies have also showed benefit from
use of the mineral Magnesium, especially in menstrually-related migraine, and the herb Butterbur. Dr. Cohen utilizes these agents in his treatment plan,
either as adjunctive therapies, or as primary therapy in patients who may be able to obtain sufficient control on these vitamins without requiring medications.
4) Procedures: Dr. Cohen employs a variety of procedures in his practice to help control migraine. The most frequent procedure is BOTOX
(Botulinum Toxin Type A) Injection which is FDA approved for the management of chronic migraine defined as migraine headaches on 15 days a month
or more. For patients with significant muscle spasm in the neck, back, and shoulders contributing to migraine, Dr. Cohen may perform Trigger
Point Injections to reduce spasm and thereby decrease migraine frequency. Dr. Cohen also utilizes a variety of nerve blocks which may turn off a
constant headache or reduce the frequency of headaches caused by certain hyperactive nerves.