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
July 3, 2026
Alternative Therapies
Essential Oils Can Change Your Brain
The science of essential oils and the brain is still young, but the findings so far are more compelling than many people realize. Brain imaging studies show that common scents like rose, lavender, peppermint, and lemon produce measurable changes in brain structure, brain activity, and pain processing. These studies are small and preliminary, and essential oils are not a substitute for medical treatment. But the evidence suggests that what we smell can influence the brain in real, physical ways
Read article
June 30, 2026
Alternative Therapies
Why I Ask You to Breathe Out When I Inject Botox
Incorporating slow, prolonged exhalation into procedures such as Botox injections offers a practical, evidence‑informed way to reduce discomfort and anxiety. By aligning the injection with the out‑breath, we engage parasympathetic and attentional mechanisms that help the brain process pain signals less intensely. This simple breathing cue does not replace careful technique or other comfort measures, but it complements them and gives patients an active role in their own pain control. As research on breathing and pain continues to grow, integrating this kind of mind–body strategy into migraine care becomes an increasingly important part of modern neurology.
Read article
June 29, 2026
Migraine status
Intravenous treatment for severe migraine
When you need intravenous drugs, in an ER or our office
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe