Read our latest advice on Coronavirus (COVID-19)


Our hospitals and community services are open - we are here to help

Headache centre clinics

Caring for patients with headache and facial pain disorders


Coronavirus: pain service update

In response to the coronavirus (COVID-19) outbreak, please read our advice and information before sending any referrals.

Location

Clinics are held from Monday to Friday on a weekly or monthly basis, depending on the clinic.

Clinics and treatments offered

The headache service offers state-of-the art treatments for headache and facial pain disorders. Apart from medications to treat and prevent headaches, we run specialised weekly clinics for injectable and neuromodulation therapies. We also offer a 'one stop' clinic where injectable treatments are administered after the clinical appointment on the same day, if appropriate.

  • Headache procedure clinic

    • Botulinum toxin therapy for chronic migraine (PDF 125KB) – we run one of the largest botulinum toxin service in the UK for patients with migraine. Botulinum toxin clinics run daily four days a week. We recently published our data on Botulinum toxin administered according to the NICE UK criteria in migraine in a prestigious neurology journal (Andreou et al, 2018)
    • Greater occipital nerve blocks (PDF 120KB) – Greater occipital nerve blocks clinics run daily for four days per week
    • Multiple cranial nerve blocks (PDF 267KB) – These include supraorbital, supratrochlear and auriculotemporal nerve blocks
    • Minimally invasive sphenopalatine ganglion (SPG) blocks
    • Sphenopalatine ganglion (PDF 342KB) and trigeminal ganglion pulsed radiofrequency treatments. We benefit from a specialist team of interventional pain consultants who specialise in these minimally invasive procedures, which we sometimes offer to difficult-to-treat headache and facial pain patients. These are performed in the day surgery unit at Guy's and St Thomas'. We have recently published our clinical outcomes for this procedure in both chronic cluster headache and SUNCT and SUNA (Lazzari et al, 2020 and Ornello et al, 2020).
  • Psychology and physiotherapy

    • Psychology for headache and facial pain
    • Our team includes a psychologist who specialises in headache and facial pain behavioural techniques
    • Migraine acupuncture clinic: This clinic is run twice a week and provides acupuncture treatment according to the NICE UK guidelines
    • Physiotherapy.
  • Non-invasive headache neuromodulation clinic

  • Invasive headache neuromodulation clinic

    We are one of the few services in the UK who specialise in invasive neuromodulation approaches for chronic intractable headache and facial pain conditions. We benefit from a highly qualified neuromodulation team who assess patients in our clinic. The therapies we offer include:

    • occipital nerve stimulation
    • cervical spinal cord stimulation.
  • Calcitonin gene-related peptide (CGRP) monoclonal antibody clinic

    • Ajovy (fremanezumab) (PDF 135Kb). This novel treatment has recently been approved, in June 2020, by the National Institute for Health and Care Excellence (NICE) as a preventative treatment for chronic migraine. It is administered as a subcutaneous injection either once a month or every three months (quarterly).
  • Fast-track cluster headache clinic

    This fortnightly clinic is for patients with a confirmed or probable diagnosis of cluster headache who are currently in bout (or expecting to be very soon). We provide a one-stop service, providing advice and/or treatment (including nerve blocks). If you would like to refer to our fast-track cluster headache clinic, please visit the clinics page.

  • Facial pain clinic

    People with chronic facial pain often see many different specialists before they receive the correct diagnosis and appropriate treatment. Our monthly clinic aims to provide better care for people with facial pain by providing specialist care for complex and difficult-to-treat facial pain conditions. The team includes a pain specialist, a neurologist, a neurosurgeon, an oral surgeon and nurse specialist.

  • Headache research

    Our focus is on clinical and pre-clinical headache research, understanding the neurobiology of headache conditions, investigating the efficacy of new pharmacological and neuromodulation treatments for headache and facial pain disorders. Our clinical trial research unit is located at Guy's and St Thomas'.

    Find out more about research and clinical trials at Guy's and St Thomas'.

    We have a dedicated team leading ground-breaking research aimed at improving our understanding of headache conditions and investigating novel treatments for patients. We also work in close collaboration with the headache research team at King's College London.

    Our clinical research programme is focused on:

    • understanding disease pathophysiology
    • investigating new innovations
    • advancing current treatments
    • improving the quality of life of headache patients.

    Our current research work includes local, national and international clinical studies in areas such as:

    • novel headache medications
    • neuromodulation
    • pain management strategies.

    If you are interested in being a part of any of our research studies or would like more information please contact us directly on 020 7188 3237 or email panarc@gstt.nhs.uk.

    Find out more about research and clinical trials at Guy's and St Thomas'.