Dr. Nitish Mandal
Migraine and headaches
Migraine and tension headaches are treated here when rescue tablets are no longer enough. Dr. Nitish Mandal maps the pattern first: migraine, tension-type, or pain referred from the neck. Nerve blocks and Botox protocols are discussed after that assessment at Koramangala and J.P. Nagar.
When should I see a pain physician for headache?
Migraine and tension headaches are treated here when tablets are no longer enough, or when you want a plan that is not only another painkiller.
Approaches discussed are Botox protocols and nerve blocks. Those pairings are confirmed in clinic.
How do these headaches feel?
- Throbbing or pressing pain that takes you off work or out of a room.
- Sensitivity to light, sound, or screens.
- A tight band around the head or neck that never fully switches off.
Do I need a brain scan?
The visit maps the pattern: migraine, tension-type, or pain referred from the neck. Examination comes before a procedure is chosen.
Bring any scans and prescriptions you already have. A normal scan does not mean the headaches are minor.
What have you already tried?
- Rescue tablets that you now take too often.
- Avoiding travel, gym, or late work because a headache may follow.
- Normal scans, with no explanation that matches how bad the days feel.
What is a headache nerve block or Botox?
Alongside clinic care
- Notice and avoid the days that reliably trigger a headache, without putting life on hold.
- Neck and shoulder knots can feed headache. Those are examined when they are part of the story.
When tablets are not enough
- Nerve blocks aimed at the pain source.
- Botox protocols for selected migraine and tension headache patterns.
What happens at the headache visit?
- History of triggers, frequency, and tablets already tried.
- Examination of the head, neck, and related muscle knots.
- A nerve block or Botox plan only if the pattern fits after that assessment.
Frequently asked questions
- Do I need a brain scan first?
- Bring any scans and prescriptions you already have. The visit still starts with conversation and examination. A normal scan does not mean the headaches are minor.
- What treatments are used?
- Botox protocols and nerve blocks for migraine and tension headaches, at Koramangala and J.P. Nagar.
- Is this the same as seeing a neurologist?
- A pain physician focuses on interventional options when tablets have not been enough. You can still keep your neurologist in the loop.
- Will Botox stop every headache?
- No. It is for selected patterns after the visit. You can keep your neurologist in the loop.
- Can neck pain cause headache?
- Yes. Neck and shoulder knots can feed headache. Those are examined when they are part of the story.
Not every headache needs Botox or a nerve block. The first visit is to understand the pattern, then choose care that fits. Procedure details are confirmed in clinic.
Reviewed by Dr. Nitish Mandal, MBBS, MD, FIPM, TIPM (Nashville). Clinics: Koramangala and J.P. Nagar.
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Tablets are not enough for my headaches. What else is listed?
Nerve blocks and Botox protocols for migraine and tension headaches, after the pattern is mapped in clinic.
My brain scan was normal. Does that mean it is nothing?
No. A normal scan does not mean the headaches are minor. Bring the reports anyway.