Chronic Headache & Migraine Care

At HDMD Medical Aesthetics, we offer a comprehensive, multi-disciplinary approach to the treatment and management of chronic migraines and tension headaches.

We understand the complexity of these conditions and pride ourselves on working collaboratively—not just as a team of healthcare professionals, but as partners in your care. Our expert team includes a medical doctor, physiotherapist, massage therapist, and evidence-informed chiropractor, all working together to address the full spectrum of causes and contributing factors.

Your Care Pathway

1. Initial Phone Intake (15 minutes)


Prior to your appointment, please complete the Chronic Headache & Migraine Intake Form via the Jane App.
We also recommend starting a Headache Journal to track headache days, triggers, and patterns. You can download the free Canadian Migraine Tracker App here:

Dr. Hannah Duyvewaardt will call to review your health history and headache experience. This call helps determine whether any investigations are needed before your in-person consultation.

2. In-Person Consultation & Treatment (30 minutes)


You’ll meet with Dr. Duyvewaardt for a thorough history, physical exam, and tailored treatment plan. Options discussed may include:

  • Lifestyle and pharmaceutical interventions

  • Peripheral nerve blocks

  • Trigger point injections

If appropriate, treatments such as injections may be provided during this session.

3. Follow-Up Appointment (Phone, Video, or In-Person)


Follow-ups are personalized based on your care plan:

  • In-person for ongoing trigger point or nerve block injections

  • Phone or video for medication reviews or treatment adjustments

Chronic Headache & Migraine Treatment Options

Your personalized plan is shaped by your unique history, symptoms, and triggers. Treatment may include a combination of the following:

1. Lifestyle Modifications

Small changes can make a big difference in reducing headache frequency.

  • Sleep: Maintain a consistent sleep schedule

  • Caffeine: Monitor and moderate intake

  • Exercise: Gentle, regular movement can reduce frequency

2. Supplements

  • Magnesium: May reduce headache frequency

  • Omega-3 Fatty Acids: Help regulate inflammation

  • Creatine: Supports brain energy metabolism

3. Pharmaceuticals

We provide evidence-based medication options tailored to your needs.


Click to view medication PDF guide created by Dr. Duyvewaardt.

4. Manual Therapy

  • Massage Therapy: Helps relieve muscle tension contributing to headaches

  • Physiotherapy: Targets posture, mobility, and muscle imbalances

  • Chiropractic Care: Evidence-informed spinal and musculoskeletal adjustments

5. Peripheral Nerve Blocks

Injections that target key nerves involved in chronic pain signalling.

These are minimally invasive options that can offer significant relief.

6. Trigger Point Injections

Trigger points—tight bands of muscle that cause referred pain—can be a major contributor to migraines.

  • What they are: Localised injections into muscular trigger points

  • Common areas treated:

    • Upper trapezius

    • Scalenes

These can help relieve muscle tension that contributes to headache symptoms.

7. Therapeutic Botox

Botox is a Health Canada-approved treatment for chronic migraines in select patients.


View the information and patient documents here.

Migraine Medication Guide

If you experience chronic migraines, finding the right treatment plan can make a world of difference. We’ve created a free Migraine Medication Guide to help you better understand available options and feel more confident discussing treatments with your healthcare provider.

This guide includes:

  • An overview of common migraine medications

  • What to expect from each treatment

  • Tips for managing side effects

  • Questions to ask during your consultation

Want to Learn More?

Curious about what migraines are, what an aura means, or the latest treatment options available?


We've created a dedicated page filled with trusted information, helpful explanations, and recommended resources to help you better understand your symptoms and the science behind your care.

You’ll also find links to insightful episodes from:

Whether you're looking to explore causes, prevention tips, or new treatment options — it's all in one place.

Click the button below to explore the Patient Education page and learn more.

  • Frampton JE, Silberstein S. OnabotulinumtoxinA: A Review in the Prevention of Chronic Migraine. Drugs. 2018;78(5):589-600.

  • Ashkenazi A, Blumenfeld A. OnabotulinumtoxinA for the treatment of headache. Headache. 2013;53 Suppl 2:54-61.

  • Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010;50(6):921-36.

References

If you’re living with persistent migraines or tension headaches, our team is here to help you find lasting relief.

Book your consultation today.
Let’s work together to reduce the impact of chronic headaches on your life.