PT
Paul Tortland, DORegenerative Orthopedics
Request Consultation
AboutAbout Dr. TortlandTeaching & SpeakingResearch & PublicationsTestimonialsAvoid SurgeryTreatmentsPRP TherapyCellular OrthobiologicsIntraosseous InjectionsNerve HydrodissectionProlotherapy & ProlozoneMSK Ultrasound DiagnosticsConditionsKneeShoulderHipBackNeckElbow, Wrist & HandAchilles, Foot & AnkleKnowledge HubContactRequest Consultation

Home / Conditions

Musculoskeletal Condition · Glastonbury, CT

Migraines & Chronic Headaches

Migraines and long-lasting headaches, including ones that start in the neck. See non-surgical options with Dr. Tortland in Glastonbury, CT.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What causes migraines and chronic headaches?

Some chronic headaches start in the neck and can look just like migraines, so an exam comes first. Migraines and long-lasting headaches have many causes, including how your nerves react, hormones, tight muscles, and problems in the upper neck. Doctors call headaches that start in the neck cervicogenic headaches.

A sudden severe headache, or one with fever, confusion, weakness or vision changes, needs urgent medical care. When your neck may be playing a part, Dr. Tortland checks your upper neck and the nerves at the base of your skull to see whether a targeted treatment makes sense.

Explore related conditions: Browse the Neck condition hub for related diagnoses and treatment options.

CARE OPTIONS

What are treatment options for migraines and headaches?

Dr. Tortland’s potential treatment options: Dr. Tortland first assesses whether neck or other musculoskeletal factors may be contributing; PRP or other orthopedic injections are not established general treatments for migraine. When symptoms suggest a primary headache disorder, he may recommend a neurologist or headache specialist rather than an orthopedic procedure.

Physical therapy and traditional care: Traditional migraine care may include a headache diary, identifying triggers, regular sleep and hydration, appropriate acute medication, and clinician-directed preventive treatment. Physical therapy may help a coexisting neck or movement-related component but does not replace migraine-specific care.

When other care may be needed: A sudden severe “worst headache,” new neurologic deficit, fever with stiff neck, or a new headache after injury needs urgent assessment. Persistent or changing headaches deserve clinical evaluation.

Common questions

Questions about migraines and chronic headaches

What causes migraines and chronic headaches?

Causes include sensitive nerves, hormone changes, tight muscles, poor sleep, stress, and problems in the upper neck. Because many conditions cause headaches, an exam comes first. It helps tell migraine, tension headache and headaches that start in the neck apart.

Can a headache come from the neck?

Yes. Headaches that start in the neck come from irritated joints, ligaments, muscles or nerves in the upper neck. They often begin at the back of the head, usually on one side, and can get worse with neck movement or posture. They can look like migraines, so the neck should be examined.

What are the non-surgical treatment options for migraines and chronic headaches?

Options include medicine, physical therapy, better posture, and nerve blocks, which are numbing shots near a nerve. A 2021 review found good evidence that blocks of the greater occipital nerve, at the back of the head, help several headache types, mostly for a short time. The right choice depends on your headache type.

What regenerative options may help chronic headaches?

If your neck is contributing, prolotherapy can help support loose ligaments in the upper neck, and ultrasound-guided hydrodissection can free stuck nerves at the base of the skull. Evidence is limited, and your doctor decides whether you are a candidate after an exam.

Not sure which treatment fits your condition?

Dr. Tortland can review your imaging and history to recommend the most appropriate non-surgical path forward.

Request a Consultation
Ask Dr. Tortland