A Physiatrist is a medical doctor specializing in Physical Medicine and Rehabilitation. For headache patients, this type of physician will often recommend a combination of therapies, including physical therapy, acupuncture, massage therapy, or chiropractic (more on these treatments below).
When conservative treatments have been exhausted, and headache symptoms continue, some patients are considered candidates for minimally invasive procedures such as Trigger Point Injections or Epidural Steroid Injections.
Trigger Point Injections may be used to treat headaches associated with myofascial trigger points (hypersensitive areas in the muscles that can lead to headache). Trigger Point Injections use a local anesthetic medication and/or cortisone.
In some cases, patients with neck pain also experience headaches. When neck pain is treated properly, headache pain may be alleviated. Physiatrists perform Epidural Steroid Injections to relieve pain and inflammation associated with neck pain and headaches. This treatment involves the injection of a long-lasting steroid (cortisone) into the epidural space—the area that surrounds the spinal sac and acts as cushioning for the nerves and spinal cord.