Gallery

Contact

Call

Menu

Close
Instagram Facebook-f Yelp Comment
Headaches & Migraines

Villanueva Institute of Pain and Spine

Headaches and Migraines Treatment in Burbank, CA

Headaches and migraines can take over more of your life than people realize. It is one thing to have an occasional headache after a stressful day. It is very different to live with head pain that keeps coming back, disrupts sleep, interrupts work, makes light or sound unbearable, or forces you to cancel plans because you are not sure when the next attack will happen.

I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). When I evaluate headaches and migraines, I look at the full picture: where the pain starts, how often it happens, what it feels like, what symptoms come with it, what you have already tried, and how much the condition is affecting your life.

At VIPS, headache care starts with careful listening; I will help you understand your headache pattern, whether your neck or nerves may be contributing, and which treatment options make sense for your symptoms.

If you are looking for headache and migraine treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

Request a Consultation

Quick Links

What Are Headaches and Migraines?

A headache is pain felt in the head, scalp, face, temples, behind the eyes, or upper neck. Some headaches are mild and short-lived, while others are severe, frequent, or tied to nerve, muscle, spine, or neurological patterns that need closer evaluation.

Migraine is a neurological condition that can cause intense head pain along with symptoms such as nausea, light sensitivity, sound sensitivity, visual changes, dizziness, fatigue, brain fog, or sensitivity to movement. Some people have migraine with aura, which may include temporary visual, sensory, or speech-related symptoms before or during an attack.

Many patients use the word “headache” as an umbrella term for everything because that is the easiest way to describe the pain. Our job is to determine what kind of headache pattern is happening, what is driving it, and how we can best treat it.

Headache vs. Migraine

A migraine is more than a bad headache, as migraine attacks often come with neurological symptoms and can make normal activity difficult or impossible until the episode passes.

A typical migraine may involve throbbing or pulsing pain, often on one side of the head, along with nausea, light sensitivity, sound sensitivity, or worsening with movement. Some patients need to lie down in a dark room. Others feel wiped out even after the head pain improves.

Other headaches may feel more like pressure, tightness, aching, burning, stabbing, or pain that starts in the neck and travels upward. These differences are important because they help guide treatment.

Common Headache Patterns I Evaluate

Headaches can come from several different sources. Some are primarily neurological, some are nerve-related, some are connected to the neck, and some involve more than one pattern at the same time.

Migraine

Migraine can cause moderate to severe head pain, nausea, light sensitivity, sound sensitivity, visual changes, dizziness, and sensitivity to movement. Some patients have a clear aura before the migraine begins. Others do not.

Migraine can be episodic or chronic. Chronic migraine is usually considered when headaches occur on many days each month, with migraine features on at least some of those days. Patients with chronic migraine may feel like they are rarely fully out of a headache cycle.

A cervicogenic headache begins from a problem in the neck. Pain may start at the base of the skull, upper neck, or one side of the head and travel toward the forehead, temple, or behind the eye.

Patients with cervicogenic headaches often notice neck stiffness, limited range of motion, pain with certain positions, or headaches that flare after driving, computer work, sleeping awkwardly, or holding the head in one position too long.

Occipital neuralgia involves irritation of the occipital nerves at the back of the head. The pain may feel sharp, shooting, burning, electric, or stabbing. It can begin near the base of the skull and travel into the scalp, behind the ear, toward the temple, or over the top of the head.

Some patients also have scalp tenderness. Brushing the hair, lying on a pillow, wearing a hat, or touching the back of the head can become uncomfortable.

Tension-type headaches often feel like pressure, tightness, or a band-like sensation around the head. Muscle tightness in the neck, shoulders, jaw, or upper back can also contribute to head pain.

This does not mean the pain is “just stress.” Muscle tension can be part of a real pain pattern, especially when posture, neck mechanics, sleep, work position, or chronic guarding keeps the muscles irritated.

Cluster headaches and certain facial pain patterns can cause severe pain around one eye, temple, forehead, or side of the face. Some patients also notice tearing, nasal congestion, eyelid changes, sweating, or restlessness during attacks.

These patterns deserve careful evaluation because the treatment approach can be very different from migraine, occipital neuralgia, or neck-related headache pain.

Headaches can begin or worsen after an injury, concussion, whiplash, fall, car accident, or sports-related trauma. The pain may involve migraine features, neck pain, dizziness, light sensitivity, concentration problems, or nerve irritation.

Post-traumatic headaches often require a broad evaluation because several systems may be involved at once.

Symptoms That Matter During a Headache Evaluation

The details of your symptoms help narrow the diagnosis. I want to know more than where it hurts, and I want to understand the rhythm of the problem. Tracking headache days, migraine days, severity, triggers, and medication use can also be helpful. Patterns are easier to treat when we can see them clearly.

During your visit, I may ask about:

  • How often headaches occur
  • How long they last
  • Where the pain starts and where it spreads
  • Whether the pain feels throbbing, pressure-like, burning, stabbing, electric, or sharp
  • Light sensitivity, sound sensitivity, nausea, vomiting, aura, dizziness, or visual changes
  • Neck pain, jaw pain, scalp tenderness, numbness, tingling, or weakness
  • Tearing, nasal congestion, eye redness, or facial sweating
  • Sleep patterns, stress, posture, work position, diet, hydration, and triggers
  • Medications used, including how often rescue medications are taken
  • Prior imaging, neurology visits, injections, procedures, or emergency visits
  • How headaches affect work, driving, exercise, family life, social plans, and sleep

When Headaches Need Urgent Medical Attention

Most headaches are not emergencies, but certain symptoms should be taken seriously. Seek urgent medical care if you have a sudden severe headache, the worst headache of your life, headache after head injury, fever with neck stiffness, seizure, confusion, fainting, new weakness, trouble speaking, vision loss, or a headache that feels very different from your usual pattern.

New headaches in patients with cancer, immune suppression, pregnancy, recent infection, or significant neurological symptoms should also be evaluated promptly.

For ongoing headaches or migraines that are not an emergency but are disrupting your life, a pain management evaluation can help clarify the diagnosis and treatment options.

How Headaches and Migraines Are Diagnosed

I examine the location of pain, frequency, duration, triggers, associated symptoms, neck involvement, nerve sensitivity, prior response to treatment, and the impact on daily function. A neurological and musculoskeletal exam can help identify whether the neck, occipital nerves, muscles, or spine may be contributing.

Imaging is not needed for every headache. When symptoms are unusual, changing, severe, associated with neurological findings, or not fitting a typical pattern, MRI, CT, or referral to another specialist may be appropriate.

If the pattern suggests nerve-related pain, neck-related headache, or overlapping spine issues, additional evaluation may include imaging review, physical exam testing, medication review, or targeted diagnostic injections.

Treatment Options for Headaches and Migraines

Treatment depends on the headache type, frequency, severity, and source. A patient with chronic migraine may need a different plan than someone with occipital neuralgia, cervicogenic headache, or headache pain driven by neck mechanics.

Botox for Chronic Migraine

Botox may be used as a preventive treatment for chronic migraine. It is placed in specific areas around the head, neck, and shoulders using a medical migraine injection pattern.

Botox for migraine is different from cosmetic Botox. The purpose is to reduce headache frequency and severity over time. It is usually repeated at regular intervals when it is helping, and some patients need more than one treatment cycle before the full benefit is clear.

Occipital nerve blocks target nerves at the back of the head. They can be helpful when pain starts near the base of the skull and travels into the scalp, behind the ear, toward the temple, or over the top of the head.

The block may reduce pain and help clarify whether the occipital nerves are part of the headache pattern.

Learn More

An SPG block targets the sphenopalatine ganglion, a nerve bundle located deep behind the nasal cavity. This area can be involved in certain migraine, cluster headache, facial pain, and autonomic headache patterns.

SPG blocks are often performed through the nose using numbing medication. For the right patient, they can be part of a targeted headache treatment plan.

When headaches start in the neck or worsen with neck movement, posture, driving, computer work, or certain sleeping positions, the cervical spine may be part of the problem.

Treatment may include physical therapy, posture and movement work, trigger point injections, cervical medial branch blocks, facet joint evaluation, radiofrequency ablation, or other targeted care depending on the exam and imaging.

Trigger point injections may help when tight, painful bands of muscle in the neck, shoulders, or upper back are contributing to headaches. These injections can reduce muscle irritation and make stretching, posture work, or therapy more tolerable.

Learn More

Lifestyle changes do not replace medical treatment when headaches are severe, but they can make the overall plan stronger. Sleep consistency, hydration, meal timing, stress management, posture, screen habits, caffeine patterns, and headache tracking can all matter.

The point is not to blame you for your headaches. The point is to identify patterns that can reduce the number or severity of flares.

Medication may be used to treat acute headaches, reduce migraine frequency, calm nerve pain, improve sleep, or support a broader care plan. Medication choices depend on your diagnosis, medical history, current prescriptions, prior response, and safety concerns.

I also review how often rescue medications are being used, since frequent use can sometimes make headache patterns harder to control.

Good Candidates for Headache and Migraine Treatment

You may benefit from a headache evaluation if head pain is interfering with your life or if your current plan is not giving enough relief. You do not need to know which type of headache you have before coming in, since the consultation is where we sort through the pattern and decide what makes sense.

Patients often come in with:

  • Frequent headaches or migraines
  • Headaches that interfere with work, sleep, exercise, driving, or family life
  • Migraine symptoms such as nausea, light sensitivity, sound sensitivity, aura, or dizziness
  • Head pain that starts in the neck or base of the skull
  • Scalp tenderness, burning pain, or shooting pain in the back of the head
  • Headaches after injury, whiplash, concussion, or surgery
  • Facial pain, eye pain, tearing, congestion, or cluster-like symptoms
  • Headaches that have not improved enough with medication
  • A need to understand whether Botox, nerve blocks, SPG blocks, or neck-related treatment may help

How I Evaluate You Before Recommending Treatment

Before recommending treatment, I want to understand how headaches are affecting your actual life. A headache that happens once every few months needs a different plan than pain that appears several days a week or never fully goes away.

During your consultation, I review your symptoms, medical history, prior treatments, medications, imaging when available, and exam findings. I look at the neck, nerves, muscles, posture, range of motion, tenderness, and neurological signs.

I also ask what improvement would matter most, because above all, I want you to be able to enjoy the things that you specifically care about. Fewer migraine days? Less pain behind the eye? Fewer missed workdays? Better sleep? More confidence driving? Less need for rescue medication? Setting these clear and specific goals helps me adjust your plan to match your lifestyle.

Why Choose VIPS for Headache and Migraine Treatment?

Headache care works best when the treatment matches the pattern. At VIPS, I look at migraine pathways, neck mechanics, occipital nerves, muscle tension, facial pain pathways, and the daily burden of living with recurring head pain.

When you choose VIPS, you can expect:

I am double board-certified in PM&R and interventional pain management. My PM&R training helps me evaluate movement, posture, neck function, rehabilitation, and daily limitations. My interventional training allows me to perform targeted headache injections and nerve blocks when appropriate. As a double board-certified physician and Certified Life Care Planner, I bring additional specialized training in evaluating the long-term needs of individuals with complex injuries and disabilities. This includes assessing future medical care, rehabilitation, and other ongoing needs that may be relevant in a medical-legal setting.

I review the headache pattern, associated symptoms, neck involvement, prior treatment response, imaging when needed, and functional impact before recommending care.

Care may include medication management, Botox for chronic migraine, occipital nerve blocks, SPG blocks, trigger point injections, cervical spine treatment, rehabilitation planning, or coordination with another specialist.

I want to know whether headaches are limiting work, parenting, school, sleep, exercise, driving, social plans, or your ability to trust your schedule.

I will explain which treatment options fit your symptoms and why. If imaging, neurology, physical therapy, medication adjustment, or another specialist should be part of the plan, we will talk through that directly.

Many headache patients have been told to “just manage stress” or keep trying medication without a clear explanation. I want you to feel heard, informed, and more confident about the plan.

Learn More

What Happens During Headache Treatment?

Your treatment visit depends on the plan.

For Botox for chronic migraine, small injections are placed in specific areas around the head, neck, and shoulders. For an occipital nerve block, medication is placed near the occipital nerves at the back of the head. For an SPG block, numbing medication is delivered through the nose toward the SPG region. For trigger point injections, medication is placed into painful muscle bands in the neck, shoulders, or upper back.

If the headache pattern appears connected to the cervical spine, treatment may involve a separate spine evaluation and procedures such as medial branch blocks, facet joint injections, or radiofrequency ablation when appropriate.

Before any procedure, I explain what we are treating, what the treatment is intended to do, what you may feel afterward, and how we will judge the response.

What Should You Expect After Treatment?

Occipital nerve blocks, SPG blocks, and trigger point injections may provide relief sooner because they often involve local anesthetic. Botox for chronic migraine usually works more gradually and may take more than one treatment cycle before the benefit is clear.

After treatment, I believe that it is crucial to track changes that matter in your day-to-day life. For example, I will ask: Are you having fewer headache days? Are flares shorter? Are migraines less severe? Are you using rescue medication less often? Are you sleeping better, working more consistently, or making plans with less fear of canceling?

That response helps decide whether to continue, adjust, or try a different approach to your headache relief plan.

Headaches and Migraines Treatment in Burbank, CA

VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.

This is a place where your story has time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.

We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

Burbank Headache and Migraine FAQs

To schedule a headache and migraine consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right care may help you spend less time bracing for the next headache and more time living with comfort, confidence, and peace of mind.

A headache is head pain. A migraine is a neurological condition that can cause head pain along with symptoms such as nausea, light sensitivity, sound sensitivity, aura, dizziness, fatigue, or worsening with movement.

Consider an evaluation if headaches are frequent, severe, changing, interfering with daily life, or not improving enough with medication. You should also seek care if headaches are affecting sleep, work, driving, exercise, or your ability to make plans.

Chronic migraine is usually diagnosed when headaches occur on many days each month, with migraine features on a significant number of those days. Patients with chronic migraine often feel like they spend much of the month in a headache or recovering from one.

Botox can help some patients with chronic migraine. It is used as a preventive treatment and is injected in specific areas around the head, neck, and shoulders. It is not the same as cosmetic Botox treatment.

An occipital nerve block is an injection near the occipital nerves at the back of the head. It may help when pain starts at the base of the skull and travels into the scalp, behind the ear, toward the temple, or over the top of the head.

An SPG block targets the sphenopalatine ganglion, a nerve bundle behind the nasal cavity. It may be used for certain migraine, cluster headache, facial pain, or autonomic headache patterns.

Yes. Neck problems can cause cervicogenic headaches or contribute to migraine and other headache patterns. Pain may start in the neck or base of the skull and travel toward the head, temple, forehead, or behind the eye.

Occipital neuralgia often causes sharp, shooting, burning, electric, or stabbing pain that starts at the back of the head or upper neck and travels into the scalp. Some patients also have tenderness when touching the scalp.

Yes. Muscles in the neck, shoulders, jaw, or upper back that have become tight or irritated can be major contributors to headache pain. Treatment for this may include things like physical therapy, posture work, medication review, trigger point injections, or other targeted care.

Seek urgent medical care for a sudden severe headache, the worst headache of your life, headache after head injury, fever with neck stiffness, seizure, confusion, fainting, new weakness, trouble speaking, vision loss, or a headache that feels very different from your usual pattern.

Yes. Pain management may help when migraines or headaches have not improved enough with medication alone, especially when Botox, occipital nerve blocks, SPG blocks, trigger point injections, or neck-related treatment may be appropriate.

The duration of headache injections often depends on the specific treatment that has been administered. For example, Botox is usually repeated at regular intervals when it is helping. Occipital nerve blocks, SPG blocks, and trigger point injections vary by diagnosis, medication used, and your response.

The cost of headache and migraine treatment in Burbank can vary depending on the evaluation, imaging, medication plan, Botox, nerve blocks, SPG blocks, trigger point injections, or other treatments recommended. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.

Request a Consultation