Underutilization of behavioral and other alternative therapies by headache specialists

June 24, 2012

Behavioral therapies, such as biofeedback, progressive relaxation, cognitive therapy, and other alternative therapies are routinely recommended only by a quarter of headache specialists, according to research presented at the 54th Annual Scientific Meeting of the American Headache Society in Los Angeles by Robert Nichols of St. Louis. This despite the fact that these therapies are considered proven (so called, Grade A evidence) to relieve migraine and other headaches. Physicians are more likely to prescribe medications, even if they are less proven to work and carry a risk of serious side effects, which are absent with behavioral therapies. Cost of biofeedback and cognitive therapy can be one of the obstacle for some patients, but many techniques such as relaxation training or meditation are inexpensive and are easily learned without the help of a mental health professional. Other studies have shown that combining a behavioral technique with a preventive migraine medication results in better outcomes than with either therapy alone. So, if you take a medication it does not mean that you could not find additional relief from behavioral approaches, as well as aerobic exercise, magnesium, and other alternative therapies.

Written by
Alexander Mauskop, MD
Continue reading
May 21, 2026
Research
Your Brain Has Many Pathways, And TMS Can Now Use Them
A groundbreaking University of Iowa study shows that personalized fMRI-guided TMS can now reach and modulate the deep hippocampus — the brain’s command center for memory, emotion, and migraine — without surgery or heavy medications. By mapping each patient’s unique neural pathways, TMS delivers precise stimulation to surface “control points” that influence deep brain structures. Generic approaches barely work, but individualized targeting produces clear, measurable changes. At our headache clinic, we combine TMS and fMRI to offer this advanced, personalized treatment for migraines, depression, PTSD, anxiety, and more.
Read article
May 10, 2026
Research
Elismetrep: A Promising New Experimental Migraine Treatment
Elismetrep is a promising experimental migraine medication that targets the TRPM8 pathway rather than serotonin or CGRP. Early clinical trials suggest it may offer a new option for patients who do not respond well to current treatments.
Read article
May 6, 2026
Alternative Therapies
New Research on Brain Excitability and TMS Treatment for Migraine
New research shows how the brain dynamically regulates excitability in real time—and why this matters for transcranial magnetic stimulation (TMS) as a treatment for migraine.
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe