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.
Click to review information regarding CGRP inhibitors
Click to review Canadian resident access and coverage for CGRP medication
Click to review preventative treatment medications available in Canada
Migraines can be debilitating, but new advances in medicine are changing the way we treat them. CGRP inhibitors are a breakthrough class of medication designed specifically to target the pathways involved in migraine attacks, offering prevention and relief for many patients who haven’t found success with traditional treatments.
At your consultation, we’ll discuss your migraine history, past treatments, and overall health to determine whether CGRP inhibitors could work for you. By addressing the underlying cause of migraine pain, this therapy offers hope for long-term management and better quality of life.
Don’t let migraines control your days. With the right care and the latest medical options, you can take back control. Book your consultation today to learn more.
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.
Occipital Nerve Block - Watch this Video
Sphenopalatine Ganglion Block - Watch this video
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.
Living with chronic migraines can feel overwhelming and exhausting, but effective treatment options are available. Botox is an FDA-approved therapy that works by targeting the nerve signals involved in migraine pain, helping reduce both the frequency and intensity of your attacks.
During your consultation, we’ll carefully review your medical history and migraine patterns to determine if Botox is the right approach for you. With ongoing treatments tailored to your needs, many patients experience fewer migraine days and improved quality of life.
If migraines have been holding you back, we’re here to help. Schedule your consultation today and discover whether Botox could be a step toward lasting relief and more pain-free days.
Watch the video to learn safe and effective migraine treatment options during pregnancy.
Migraines during pregnancy can be especially challenging, as not all medications are safe for you or your baby. That’s why it’s important to work with a specialist who understands how to carefully manage your symptoms while prioritizing safety.
Our team takes a compassionate, personalized approach—reviewing your health, trimester, and unique migraine patterns to create a plan that’s right for you. Treatments may include lifestyle strategies, non-drug therapies, or carefully selected safe options to ease your pain.
You don’t have to endure pregnancy migraines alone. Schedule your consultation today and let us guide you toward safe, supportive, and effective relief.
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.