Migraine Treatment in Beverly Hills
When migraines don’t respond, the problem may not be where everyone has been looking.
Severe recurring headaches are frequently labeled “migraine” when the real driver is a sensory nerve, an underlying neck problem, tight fascia, or a metabolic or blood-pressure issue. At The Fascia Institute and Treatment Center® of LA, we don’t just mask the pain — we work to find the cause and treat it, using a careful evaluation that can include labs, genetic testing, and diagnostic ultrasound.
Migraine is often the label — not the cause
Migraine is a real neurological disorder, and for many people it is exactly the right diagnosis. But “migraine” is also one of the most over-applied labels in medicine. When severe headaches keep coming back — and the usual medications only take the edge off — it is worth asking whether something else is driving them.
The overlap with the neck is striking. In one study, a group of patients carrying a standing diagnosis of migraine were re-examined; a meaningful share actually had a cervicogenic headache — pain generated by the neck — that had been missed or mislabeled.1 Occipital neuralgia, cervicogenic headache, and migraine share symptoms, frequently coexist in the same person, and are routinely confused with one another — yet each points toward a different work-up and a different treatment.2
That distinction matters because the fixes are different. A headache driven by an irritated occipital nerve, a stuck fascial layer in the neck, or an energy-metabolism problem will not resolve by cycling through migraine pills. It needs to be found first — and then treated at the source.
Why the neck can masquerade as a migraine
The nerves of the upper neck and the nerves of the face and head share the same relay station in the brainstem — the trigeminocervical complex. Because those signals converge, the brain can’t always tell a neck problem from a “head” problem. A tight, irritated structure at the base of the skull can produce pounding pain behind the eye that feels, for all the world, like a migraine.2
Two specific culprits show up again and again:
What a real migraine evaluation looks for
A severe, recurring headache can have more than one driver — and in stubborn cases it usually does. Rather than reaching straight for a prescription, we work through the causes that get skipped:
Not every headache needs every test. The evaluation is tailored to your history — the goal is to identify the specific driver, then match the treatment to it.
The tools we use to find the source
Most headache work-ups stop at a brain scan. A normal MRI is reassuring — it rules out the dangerous things — but it doesn’t show an irritated occipital nerve or fascia that has stopped sliding. A mechanical problem needs a mechanical look.
That’s why we start with Fascial Mapping® — a systematic, ultrasound-based exam that scans the neck and the base of the skull in real time to pinpoint exactly where the fascia has thickened, adhered, or lost its glide, and whether a nerve is being tethered. Alongside it, we use targeted labs for the metabolic and inflammatory picture, genetic testing where it will change the plan, and imaging when structure or instability needs to be clarified. Together, that turns “you have migraines” into a specific, treatable finding.
Treatments matched to what we find
Once the driver is clear, we have real options to address it — not just medication to blunt the pain. We match the tool to the cause:
Treatment is individualized and results vary. See pricing or book an evaluation to find out which of these fits your headache.
We look for the fix — not just the next prescription
Fascia medicine is built on the idea that connective tissue and the nerves running through it are treatable sources of pain. Dr. Jacques Courseault, MD pioneered ultrasound-guided fascial hydrodissection10 — the same principle we apply when a tethered occipital nerve is driving a “migraine.” Learn more about the science, and Dr. Courseault’s published research, across our network.
Migraine & headache evaluation FAQ
How do you know if my “migraine” is really coming from my neck?
We examine the upper-cervical and occipital nerves, the suboccipital muscles, and the fascia around them — looking for tenderness, referral patterns, and stuck tissue on ultrasound. Migraine, cervicogenic headache, and occipital neuralgia overlap and often coexist, so the aim is to identify which one (or which combination) is driving your pain.
My brain MRI was normal. Why do I still have headaches?
A normal MRI is good news — it rules out serious causes — but it doesn’t show an irritated occipital nerve, an active trigger point, or fascia that has lost its glide. Those are found on a hands-on and ultrasound exam, not a standard brain scan.
What is occipital neuralgia, and how is it treated?
It’s pain from irritation of the occipital nerves at the back of the head, often mistaken for migraine. Treatment targets the nerve itself — ranging from nerve blocks to ultrasound-guided hydrodissection that frees the nerve from surrounding fascia. It responds to a very different approach than standard migraine medication.
Do I have to stop my current migraine medications?
No. Our goal is to find and treat an underlying driver so you rely on symptom medication less over time. We coordinate with your existing neurologist or physician rather than replacing appropriate migraine care.
Will you actually run labs and genetic testing?
When they’ll change the plan, yes. The evaluation can include targeted labs for metabolic and inflammatory factors, genomic screening, and imaging — but only what’s relevant to your history. The point is a specific answer, not a blanket panel.
Where are you located, and do you see patients from across LA?
We’re in the Golden Triangle of Beverly Hills, about 5–10 minutes from Century City and convenient to greater Los Angeles. Some evaluation steps can be handled by telehealth for California patients; the hands-on ultrasound exam and procedures are done in the clinic.
Book a migraine evaluation in Beverly Hills
If severe headaches keep coming back and nothing has truly worked, find out whether a nerve, your neck, your fascia, or a metabolic factor is the reason. Book an evaluation with Dr. Jacques Courseault, MD at our Beverly Hills clinic.
The Fascia Institute and Treatment Center® of LA · 415 North Crescent Drive, Suite 130, Beverly Hills, CA 90210 · (424) 378-3488 · fit@fasciala.com · ~5–10 min from Century City
- Yi X, Cook AJ, Hamill-Ruth RJ, Rowlingson JC. “Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis?” J Pain. 2005;6(10):700–703. PMID 16202963.
- “A pain in the neck: occipital neuralgia vs. cervicogenic headache vs. migrainous cervicalgia.” Curr Pain Headache Rep. 2025. PMID 40691746 · doi:10.1007/s11916-025-01419-7.
- Do TP, Heldarskard GF, Kolding LT, Hvedstrup J, Schytz HW. “Myofascial trigger points in migraine and tension-type headache.” J Headache Pain. 2018;19(1):84. PMID 30203398 · doi:10.1186/s10194-018-0913-8.
- Fernández-de-las-Peñas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. “Trigger points in the suboccipital muscles and forward head posture in tension-type headache.” Headache. 2006;46(3):454–460. PMID 16618263.
- Cevoli S, Favoni V, Cortelli P. “Energy metabolism impairment in migraine.” Curr Med Chem. 2019;26(34):6253–6260. PMID 29932030.
- Gaul C, Diener HC, Danesch U. “Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial.” J Headache Pain. 2015;16:516. PMC4393401 · doi:10.1186/s10194-015-0516-6.
- Zhang H, Yang X, Lin Y, Chen L, Ye H. “The efficacy of greater occipital nerve block for the treatment of migraine: a systematic review and meta-analysis.” Clin Neurol Neurosurg. 2018;165:129–133. PMID 29421172 · doi:10.1016/j.clineuro.2017.12.026.
- “Novel ultrasound-guided hydrodissection with 5% dextrose for the treatment of occipital neuralgia targeting the greater occipital nerve.” Diagnostics (Basel). 2024;14(13):1380. PMID 39001270 · doi:10.3390/diagnostics14131380.
- Centeno CJ, Elliott J, Elkins WL, Freeman M. “Fluoroscopically guided cervical prolotherapy for instability with blinded pre and post radiographic reading.” Pain Physician. 2005;8(1):67–72. PMID 16850045.
- Courseault J, Kessler E, Moran A, Labbe A. “Fascial hydrodissection for chronic hamstring injury.” Curr Sports Med Rep. 2019;18(11):416–420. PMID 31702723 · doi:10.1249/JSR.0000000000000650.
The Fascia Institute and Treatment Center® of LA is part of a wider network. Explore fasciainstitute.org, our New Orleans flagship, and Dr. Courseault’s research and publications. If severe headaches come with joint hypermobility or an EDS diagnosis, our dedicated Hypermobility Clinic and its EDS blog cover the connection. Within this site, start with Fascial Mapping®, Hydrofascia Release™, hypermobility & EDS, and Fascia Medicine.
This page is for general education and is not a substitute for individualized medical advice, diagnosis, or treatment. Migraine is a recognized neurological disorder; this page describes how underlying and coexisting drivers are evaluated and, where present, treated. An evaluation does not guarantee a specific diagnosis, timeline, or outcome, and results vary from person to person. If you have a sudden, severe, or “worst-ever” headache, or headache with fever, weakness, confusion, or vision loss, seek emergency care.
