Our neurology team offers expert diagnosis and coordinated care for all types of headache. Our team specializes in treating refractory migraine headaches that do not respond to conventional therapies, offering the latest treatment options to restore optimal daily functioning and quality of life.
The Headache Center is led by Regina Krel, M.D., the only neurologist in NJ to be a Fellow of the American Headache Society, fellowship trained in headache medicine and board certified in headache medicine.
Conditions We Treat
- Cervicogenic headache
- Chronic daily headaches
- Cluster headaches
- Concussion-related headaches
- Facial pain
- Migraine headaches
- New daily persistent headaches
- Tension headaches
- Trigeminal autonomic cephalalgias
To diagnose your condition, we will first evaluate your symptoms, physical health, and medical and headache history. We typically also perform a neurological exam and, if indicated, order diagnostic tests, including:
- Neuroimaging. We offer a full range of neuroimaging tests that can identify the cause of headaches, including X-rays and magnetic resonance imaging (MRI) and computed tomography (CT) scans.
- Lumbar puncture (spinal tap). A spinal tap is a procedure that involves taking a small sample of cerebrospinal fluid so it can be examined for abnormalities.
- Sleep evaluation. If we suspect that your headaches are related to sleep issues, we may recommend a sleep study.
- Blood or urine tests. Blood and urine tests look for a variety of medical conditions that could cause headaches.
After determining the cause of your headaches, our team will work closely with you to develop a comprehensive treatment plan. Treatment may include:
- Lifestyle changes. Exercise, eating a balanced diet, drinking plenty of fluids, reducing stress, and regulating sleep routines and sleep quality may help some people manage headaches. Our team may also recommend keeping a headache diary to track headache frequency and severity over time, which can help determine how well your treatment plan is working.
- Rehabilitation. If your headaches are related to a concussion or traumatic brain injury (TBI), our neurologists will partner with rehabilitation professionals to provide you with expert care.
- Psychological counseling. Patients who have headaches that are related to or triggered by stress, depression or anxiety may benefit from psychological counseling. Psychological counseling may also be used to help patients deal with the emotional impact of recurrent and chronic pain.
- Medications. Pain-relieving medications stop headache symptoms after they start. Preventive medications are taken regularly to reduce the severity and frequency of headaches. Our neurologists will work closely with you to determine which medications are most effective in helping you achieve long-term headache control.
- We have started treating patients with the first FDA-approved intravenous treatment to help prevent migraine pain before it even starts. Patients receive a 30-minute IV treatment four times a year, with patients seeing improvements as early as the first infusion.
- Pain management techniques. Depending on the cause of your headaches, our team may recommend trigger point injections, nerve block injections or Botoxâ injections to provide temporary pain relief.
- Physical therapy. Physical therapy techniques such as massage, heat/ice therapy, transcutaneous electrical nerve stimulation, stretching and exercises may help relieve headache pain in some patients.
- Neuromodulation. Neuromodulation uses noninvasive devices that create painless electrical or magnetic currents to alter pain pathways, which prevents, reduces or eliminates headaches — often with no side effects.
Our neurologists routinely participate in headache and migraine research and provide our patients with access to the latest evidence-based therapies and the most promising clinical trials.
Mental Health Support for People with Chronic Headaches
People with chronic headache, such as migraine, frequently have depression and anxiety. There is a strong connection between chronic headache and mood. Having bad headaches may make you feel sad or worried. And feeling sad or anxious can contribute to a headache.
The counseling psychologists at Hackensack University Medical Center can help you learn how to cope with your headaches and take control of your life. With your psychologist, you can improve the way that you:
- Adhere to medications, which is very important in the treatment of headache
- Participate in pleasurable activities, with the goal of preventing headaches from controlling your life
- Strive to improve your sleep patterns, your diet, and other aspects of healthy living
Using an integrative approach, your headache physician and psychologist will work together to treat your headaches both physically and psychologically. Often you can see your headache physician and psychologist on the same day, avoiding multiple appointments in different locations.
The Alfred N. Sanzari Medical Arts Building
360 Essex Street, Suite 303,