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Pain Psychology to treat chronic migraines?

I suffer with very aggressive chronic migraines. No treatment seems to help. My insurance refuses to pay for botox injections. Currently, I am receiving nerve block injections in the back of my head and in my face and temples to alleviate the pain to no avail. My neurologist has referred me to his nurse practitioner due to him being backed up and wants me to receive nerve blocks every 2 weeks vs. every 3 months. However, the practitioner REFUSES to do them every 2 weeks saying it could cause scar tissue. He has suggested that I see a pain psychologists. This really made me feel that yet again I had another doctor saying to me that the pain in my head that I live with on a daily basis is NOT real when in fact it is.

The thing is my neurologist has NEVER suggested this form of treatment. I plan on not going back to see his practitioner and only deal with my neurologist. Has anyone tried seeing a pain psychologist? I find this absurd and I was very much offended.

Chronic migraine without aura and status migrainous
occipital neuralgia
Nerve disease
Medication overuse headache

Health issue began in 2003 with partial paralysis (left side) w/o diagnosis until 2009. I'm now 39 years old.

Preventative medications only. Stadol nasal spray only narcotic i'm using as needed as per neurologist.

Thanks for reading.

  1. I see a pain management psychologist once a week and have done so since 2008. He saved my life! He is the only person who really "gets it" and understands the pain aspect of having migraines. He gives me an outlet to talk about my pain and has given me many tools to handle the pain, which I have every day. I highly recommend it. I think it is important to find someone at a pain management clinic or PM practice.

    1. ChronicMommy76,
      That's awful, so sorry to hear that you are not getting the treatment you deserve. The practitioner is right that scar tissue can occur, however it can occur over long term use of Botox too. I currently get Botox every 3 months and also 2 nerve blocks in between.

      Do the nerve blocks help you? Then maybe it's time to request a visit with the neurologist to discuss long term care plans. If you don't feel comfortable in that office anymore, then by all means find another neurologist.

      Also I'm surprised that given your extensive history, that your insurance company denies to pay for Botox. In the long run, it will likely be less costly to them. Sometimes, insurance companies say no the first time, but upon receiving further medical records they eventually give in. Your doctor's office should be helping to get Botox approved. IF they are not, typically most insurance companies have a way for you to appeal a decision. It may take some work, but it might be helpful in the end. Here's some info about how to file an appeal to your insurance company:

      As far as the pain psychologist goes, I understand why you are offended. It makes you feel as if they don't believe you. Unfortunately this happens a lot to Migraine patients. If you feel that you are emotionally stable and handling your conditions well, then you know it's not right for you. I think some doctors throw it out as a suggestion when they don't know what else to do to treat you.

      On the other hand, there is never any shame in talking to someone. Having a chronic illness is a tough burden on you and those around you. A pain psychologist may even be able to teach you some coping mechanisms to deal with the pain, like biofeedback or meditation. Learning these techniques doesn't mean the pain isn't there, it could just give you other options to try when the pain is hard. For me personally, deep breathing and yoga make me feel stronger in fighting my pain and I learned that from a pain management class.

      I hope I've given you some resources that will help.
      -Katie Moderator

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