Headaches

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Headaches can have a significant impact on your daily life. Sometimes it involves a dull, pressing pain that builds up slowly. Other times, it manifests as sudden, intense stabs of pain, attacks around the eye, or a throbbing headache accompanied by nausea and sensitivity to light and sound.

For some people, the pain disappears after a few hours. Others experience recurring attacks or live with headaches almost daily.

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A headache is not a single condition, but a collective term for various pain syndromes with diverse causes and neurological mechanisms.

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Scientific research shows that in various forms of headaches, it is not just the nerves and muscles of the head and neck that play a role, but also brain networks involved in pain processing, sensory sensitivity, and pain regulation.

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At BRAI3N, we investigate how the nervous system and the brain contribute to persistent headache complaints.

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‍Drawing on our neuroscience expertise, we evaluate whether targeted neuromodulation can be a meaningful additional treatment option.

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More information

how to Treat?

What is it?

What causes headaches?

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Headaches can have various causes.

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Some forms arise from a neurological condition where the processing of pain and other sensory signals is altered. Other forms are related to neck issues, nerve damage, medication use, or an underlying physical condition.

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The brain itself contains no pain receptors. Headache signals can originate from nerves, blood vessels, meninges, and structures in the head and neck, among other sources.

These signals are transmitted to the brain via various nerve pathways, where they are processed and influenced.

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An important system in this process is the trigeminocervical system.

This system connects pain information from the face and meninges with signals from the upper cervical vertebrae. It is linked to the brainstem, the thalamus, and various brain regions involved in pain perception and regulation.

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In certain types of headaches, changes in these systems can contribute to an increased sensitivity to pain and other stimuli.

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What types of headaches are there?

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Migraine

Migraine is a neurological condition that usually manifests as recurring attacks of moderate to severe headache.

The pain is often throbbing or pulsating and can be accompanied by nausea, sensitivity to light and sound, and a significant limitation of daily activities.

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Some patients experience an aura prior to the headache, such as flashes of light, zigzag lines, or temporary sensory or speech disturbances. However, many patients have migraine without aura.

Migraine is now considered a complex neurological network disorder.

Several systems play a role in this, including the hypothalamus, brainstem, thalamus, cerebral cortex, and the trigeminovascular system.

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These brain regions are involved in pain processing, the regulation of stimuli, and the development of the various phases of a migraine attack.

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Tension-type headache

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Tension-type headache is one of the most common forms of headache.
The pain is often described as a pressing or tightening sensation, as if there is a tight band around the head.

The symptoms may be accompanied by sensitivity in the muscles around the neck, shoulders, and scalp.

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Withepisodic tension-type headache peripheral pain mechanisms are thought to play a significant role.

Withchronic tension-type headache changes in central pain processing may also contribute to the persistence of symptoms.

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Prolonged stress, sleep problems, and increased muscle tension can influence the symptoms, but they are not necessarily the sole cause.

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Cluster headache

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Cluster headache is a particularly intense form of headache that usually occurs on one side of the head, often around or behind the eye.

The attacks begin suddenly and typically last from 15 minutes to three hours.

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During an attack, other symptoms may also occur, such as:

- A tearing or red eye.
- A stuffy or runny nose.
- A drooping eyelid.
- Pronounced urge to move or restlessness.

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In episodic cluster headaches, attacks occur in periods, alternating with longer symptom-free phases.
The hypothalamus and the trigeminal autonomic system play a significant role in the neurobiology of cluster headaches.

This helps explain, among other things, why attacks often occur according to a recognizable daily rhythm.

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Cervicogenic headache and occipital neuralgia

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Some forms of headache originate from structures in the cervical spine.

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With cervicogenic headache, pain from the neck can radiate to the back of the head, the temple area, or the region around the eye.

The pain may increase with certain neck movements or prolonged postures.

The upper cervical nerves, including the second cervical nerve (C2), play an important role in sensory and pain conduction from this region.

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A related but distinct condition is occipital neuralgia. This often involves sharp, shooting, or electric-like jolts of pain in the back of the head, along the path of the occipital nerves.

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Neck-related headache symptoms can also occur after a whiplash injury .

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Due to the connection between the cervical nerves and the trigeminocervical system, pain originating in the neck can be felt in other parts of the head.

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Trigeminal neuralgia and trigeminal neuropathy

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Not all pain in the head area is a headache in the strict sense.

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Trigeminal neuralgia causes sudden, very intense shooting pains in the face.

Attacks can be triggered by everyday activities such as talking, eating, brushing your teeth, or touch.

In classic trigeminal neuralgia, pressure from a blood vessel on the trigeminal nerve often plays a significant role.

Trigeminal neuropathy, on the other hand, is caused by damage to or impairment of the trigeminal nerve and can cause a more persistent, burning, or tingling pain.

These conditions require a specific neurological assessment.

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You can find more information on our page aboutfacial pain.

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Medication-overuse headache

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When headache medications are used too frequently, they can contribute to the development or persistence of frequent headaches in susceptible patients.

This is known as "medication-overuse headache," formerly also called "rebound headache."

The condition usually occurs in people who already have migraine or tension-type headaches.

Depending on the medication used, regular use over several months can increase the risk of this type of headache.

Treatment focuses on, among other things, reducing or stopping the overused medication and better managing the underlying headache condition.

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Headache caused by an underlying condition

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Sometimes a headache is caused by another medical condition.

Possible causes include infections, inflammation, vascular disorders, brain hemorrhages, or the consequences of a head injury.

A sudden, exceptionally severe headache, especially when accompanied by neurological deficits, fever, or changes in consciousness, requires urgent medical evaluation.

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Why can headaches become chronic?

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In some patients, headache attacks become increasingly frequent or pain persists between attacks.

One possible explanation is that the processing of pain signals changes.

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Normally, pain-registering and pain-regulating systems work together to interpret signals from the body.

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With long-term pain, these processes can become less efficient. As a result, certain stimuli may be perceived more intensely, and the nervous system may react with increased sensitivity.

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This is associated with, among other things,central sensitization.

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In the case of migraine, changes in stimulus processing, brainstem activity, and the interaction between various brain networks also play a role.

Brain regions such as the anterior cingulate cortex, the insula, and the prefrontal cortex are also involved in the processing and regulation of pain.

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These insights help explain why headaches cannot always be understood solely by the location of the pain.

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Read more about how these systems work on our page about chronic pain.

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How to treat

Treatment that addresses the root cause

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Headache treatment depends primarily on the underlying condition.

That is why it is important to carefully identify the type of headache and rule out potential secondary causes.

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For migraines, acute medication, preventive medication, and specific treatments targeting the calcitonin gene-related peptide (CGRP) may be indicated.

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For cluster headaches, acute treatment options include oxygen therapy and certain triptans, while preventive medication can help reduce the frequency of attacks.

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For cervicogenic headaches, specialized physical therapy and treatment of neck-related issues can play an important role.

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When headaches do not respond sufficiently to previous treatments, medication is poorly tolerated, or symptoms remain chronic, neuromodulation may offer an additional treatment option.

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Neuromodulation: influencing the processing of pain signals

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Neuromodulation is a treatment approach in which we aim to specifically influence the activity of nerves and brain networks.

The goal is to alter the processes involved in pain signaling, stimulus processing, and pain regulation.

Scientific research shows that various forms of non-invasive neuromodulation can provide clinically relevant results for certain headache conditions.

In this process, various nerve pathways and brain networks can be engaged.

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At BRAI3N, this is one of the neuroscientific approaches that can be considered for selected pain conditions.

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Peripheral nerve stimulation

A key area of research is the electrical stimulation of nerves connected to the trigeminocervical system.

This includes, among others, stimulation of the trigeminal nerve, the vagus nerve, and nerve structures in the back of the head.

These nerves are connected via the brainstem to systems involved in headache and pain regulation.

For certain forms of migraine, various peripheral neuromodulation treatments have now been included in international clinical guidelines.

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Stimulation of the occipital region and C2

The nerve pathways originating from the upper cervical region also represent an interesting target.

The second cervical nerve (C2) contributes to the sensory innervation of the back of the head and is connected via the trigeminocervical complex to systems involved in headaches.

By electrically stimulating this region, we aim to influence the processing of pain signals.

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Stimulation of involved brain networks

In addition to peripheral nerve stimulation, techniques that attempt to directly influence brain activity are also being investigated.

Examples of this include transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS).

These techniques can influence brain regions involved in pain processing, sensory sensitivity, and cognitive or emotional regulation.

Neurofeedback is also being studied as a method for learning to regulate specific patterns of brain activity.

Not every neuromodulation technique has the same level of scientific evidence for every type of headache.

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What does the scientific research say?

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Scientific interest in neuromodulation for headaches has increased significantly in recent years.

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In 2025, the International Headache Society published an international guideline on non-invasive neuromodulation for migraine.

This guideline confirms that various techniques can play a role in the acute treatment or prevention of migraine.

There is also scientific evidence supporting the use of neuromodulation for cluster headaches and various forms of facial and occipital pain.

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At BRAI3N, we use these scientific insights to carefully assess which treatment options may be relevant for an individual patient.

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Not all applications are at the same stage of scientific validation.
Where available research results and the clinical picture warrant it, we may consider an additional treatment and systematically monitor its effect.

This aligns with our philosophy: Inspired by Science, driven by care.

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The BRAI3N treatment process

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1. Assessment

We begin with an evaluation of your headache symptoms, medical history, and previous treatments.

In doing so, we pay attention to factors such as the location of the pain, the duration and frequency of attacks, triggers, neck pain, sleep, stress, and medication use.

AnqEEG measurement and analysis provide additional information about electrical brain activity.

This measurement can help investigate certain neurophysiological processes, but it is not a standalone diagnostic test for headaches and cannot determine the cause of the pain on its own.

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2. Targeted treatment

When neuromodulation is considered, we examine which nerve pathways or brain networks may be involved in the symptoms.

Depending on the type of headache, treatment may focus on peripheral nerve pathways, the cervical region, or brain areas involved in pain regulation.

We will discuss the treatment goals, the available scientific evidence, and the expected possibilities and limitations.

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3. Stabilization

During the treatment process, we monitor how your headaches evolve.

We look at factors including:

- The frequency of the headaches.
- The duration and intensity of the attacks.
- The use of pain medication.
- The impact on sleep and daily functioning.
- The extent to which the treatment provides relief.

Based on this progress, the treatment plan can be adjusted.

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4. Maintenance

When the headaches decrease, we look at how to best maintain this improvement.

Depending on the underlying condition, continued medical follow-up, medication, lifestyle adjustments, or additional treatments may remain important.

Not every patient follows the same path or requires maintenance treatments.

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Do headaches continue to affect your daily life?

Do you have frequent headaches, or do your symptoms persist despite previous treatments?

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At BRAI3N, we investigate which neurological processes may be involved and whether neuromodulation can offer a meaningful additional treatment option.

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During an initial evaluation, we will discuss your symptoms, previous examinations, and the possibilities for an individualized treatment plan.

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