This study underscores the pioneering work on migraines by Dr Elliot Shevel of The Headache Clinic in South Africa, who has long maintained that the pain of migraine headache does not come from the blood vessels in the brain. Even though many sufferers feel as though the pain is coming from inside the skull, the pain of migraine and headache originates from those parts of the head, face and neck that lie outside the skull. This is good news for sufferers as these structures are accessible, and can be successfully treated and often cured without the need for medication. For more details please click on migraine surgery.

For a list of Dr Shevel's publications please click on publications.

To determine the correct treatment for any of the primary headaches, including migraine headaches, tension headache, sinus headache, and cluster headache, the first step is to accurately diagnose where the pain is coming from. Exactly what structure or structures are actually generating the pain signals must be very accurately identified. For this reason it is necessary to have what is called a “multidisciplinary assessment”. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a maxillo-facial specialist will examine the facial structures, a dentist the occlusion, an ENT the sinuses etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single comprehensive body of knowledge.

It is absolutely essential that this assessment includes a thorough examination of those structures most commonly involved in the pain, namely:

• The head and neck muscles to determine the presence of abnormal tension.
• The external carotid vasculature to determine whether there is an arterial element to the pain.
• The nerves of the scalp, which are often involved in the pain process.

Migraine treatment based on migraine symptoms alone does not take into account the origin of the pain or the headache causes, which vary from patient to patient. At The Headache Clinic, headache treatment is based on the actual cause and origin of the pain, and in the majority of patients, after treatment migraine is drastically reduced or completely eliminated. Even more severe headache such as cluster  can often be successfully treated.

Individual treatment programs are therefore developed based on the patient's own specific history and diagnosis. Most patients can be successfully treated without the use of drugs, using the techniques developed at The Headache Clinic.