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Migraine Headaches

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A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head.

There is no definitive cause for migraines, but some studies indicate a genetic link may be a factor. Some researchers believe that the trigeminal nerve, which controls feeling for much of the face and head, can be overstimulated by certain nerve cells. This causes a chemical cascade within the brain which causes blood vessels to enlarge, which then causes a release of neurotransmitters, resulting in inflammation and pain. 

  • Being female – women get migraines three times as often as men
  • If one or both parents had migraines
  • Age between 10-50
  • Medical conditions, such as:
    • Epilepsy
    • Depression
    • Sleep Disorders
    • Anxiety
    • Bipolar disorder

The most often seen triggers are listed as follows, but this is not all-inclusive:

  • Hormonal Changes in Women
  • Stress/Anxiety
  • Loud noises
  • Bright or flashing lights
  • Strong or unpleasant odors
  • Too much or too little sleep
  • Sudden changes in the weather
  • A variety of foods and beverages
  • Tobacco
  • Skipping meals
  • Too much/too little caffeine

Migraine headaches are different than regular headaches in that they have four distinct phases.  A person does not have to have every phase each time they suffer a migraine, but these phases are part of the migraine headache cycle and differentiate them from a run-of-the-mill headache.

Phase I is called the Prodrome Phase and it occurs up to 24 hours before the headache begins.  The signs and symptoms are weird and include increased urination, food cravings, mood changes, uncontrollable yawning, and fluid retention.  Researchers have not been able to explain these symptoms.

Phase II is called Aura Phase and those who experience it see flashing or bright lights and/or zig-zag lines and may feel like they are being grabbed or touched.  This can happen before or during the actual headache phase.

Phase III is called Headache because this is when the throbbing or pulsing head pain starts, typically on one side of the head.  Occasionally, a migraine will not involve head pain, but will include nausea and vomiting, sensitivity to light, sound and smells, worsened pain with movement of any kind.

Phase IV is called Postdrome, or after the headache has passed. The person will feel physically weak, extremely tired and even confused for up to a day after the migraine has ended.

woman with migrainePatients who have migraines reported so many variations that researchers had to come up with types to classify them all to make them easier for physicians to diagnose and treat. They are as follows:

  1. Migraine without aura (common)
  2. Migraine with aura (classic)
  3. Abdominal migraine – usually seen in children, with nausea, vomiting and stomach pain
  4. Vestibular Migraine – with or without headache, balance problems, vertigo, nausea and vomiting. Typically occurs to those who suffer from motion sickness
  5. Silent (Acephalgic) Migraine – Aura symptoms with no headache.
  6. Ophthalmic (retinal or ocular) Migraine – Causes temporary, partial or total loss of vision in one eye, with accompanying ache behind the affected eye. The headache may spread to the rest of the head.
  7. Hemiplegic Migraine – Temporary weakness or paralysis (hemiplegia) on one side of the body, which may be accompanied by numbness, vision issues or weakness. May be confused with a stroke, so medical attention should be sought.
  8. Brainstem Aura Migraine – This type is linked to hormonal changes in young adult women. Confusion, loss of balance and dizziness may occur before the headache, which starts in the back of the head. Vomiting, ringing of the ears, and trouble speaking are often observed. Symptoms will come on rapidly and medical attention is advised.
  9. Ophthalmoplegic Migraine – This type is characterized by vision changes, such as blurred or double vision or droopy eyelids. It is a medical emergency, as it involves pain around and possible pressure on the nerves behind the eye. It can also signal an aneurysm.
  10. Status migrainosus – This migraine often lasts 72 hours or more and often requires hospitalization for the intense pain and nausea involved. Medications may cause them.


Having laid the groundwork for what a migraine headache is and isn’t, it should be pretty obvious to any headache sufferer if their headache falls into the migraine category or not. Patients typically can describe the symptoms and phases of an average migraine.  However, migraine sufferers also have less severe, more normal types of headaches frequently.

Patients will need to make an appointment with Dr. McFarland to talk about their migraines and to see if they qualify for BOTOX injections.  That’s why it is very important for patients to carefully track their headaches for a month on a chart.  They’ll be asked to log which days they have a headache, if it is a migraine or not, and for how long it lasts, or if they were totally headache-free.  At the end of a month, we’ll have some very telling results. It is very important that the results be well-chronicled so that we know how to best proceed with treatment.

Severe chronic migraine sufferers typically have at least eight or more days that are associated with a migraine per month.  Remember, there are four phases to a migraine headache (prodrome, aura, headache and postdrome), so potentially the entire headache could last for days.  In addition, they will usually have seven or more days of headaches a month that aren’t migraines.  Their headaches, no matter what variety, will last four or more hours, every time they have them.  These patients are severely affected by their disease and will qualify for the use of BOTOX injection to treat their disease as the treatments are very expensive. 

Moderate to mild migraine sufferers have less days of headache activity, with fewer migraines, less intensity and shorter duration.  These patients are treated with acetaminophen or NSAIDS as well as prescription oral or injectable drugs that work to either stop the migraine once it has started or prevented the migraine from occurring in the first place.  This type of treatment is typically handled by the patient’s PCP or a Neurologist.

After a patient qualifies for BOTOX injections, they will schedule appointments with Dr. Mark McFarland every three months to get the injections on a regular basis.  That’s because the medication wears off after this period and the chances of having more migraines increases when this happens.  After a while, the medication will help to prevent migraine attacks from occurring.  The research indicates that patients can see as many as 8-9 days fewer headache days in a month, which is a quite substantial reduction

If patients qualify for BOTOX injections, their insurance will cover the majority of the cost.  98% of insurers cover BOTOX for migraines. The BOTOX Savings Program also helps patients save on their treatments. Go to BOTOXSavingsProgram.com or call 1-800-44-BOTOX.

When a patient is treated with BOTOX injections, Dr. McFarland will inject them with approximately 32 injections into the shallow muscles of their scalp and forehead.  The needles used are very short and tiny in gauge (about the thickness of five hairs). The injections feel like little pinches and are tolerable.  Every patient is injected in the same proven muscle pattern that scientific research shows impacts migraines the most.

The injections take about 10-15 minutes to administer.  There is no downtime afterward and the patient is free to drive and return to work or activities immediately thereafter.  As with any injection of medication, there is a risk for complications, and Dr. McFarland will provide patients an information sheet explaining all of the possible side effects that could occur.  There will be a waiver form for patients to sign before the procedure.

Before leaving the office, the next injection appointment will be made for approximately three months, to keep the patient on schedule.  After the injections, the patient is free to leave, drive, return to work or their other activities.

Click here to learn about the Botox Savings Program.

Make an Appointment to Find out if Botox may be a treatment Option

Call (757) 596-1900, option 5, to schedule an appointment with Dr. McFarland. Visit our Contact Us page for information on office hours. Our office is located in Newport News, VA. We are 40 minutes from Virginia Beach and an hour from Richmond, VA.

What Our Patients Are Saying

  • All of their staff is very lovely and that really helps when you come in, mad at the world, because you’re hurting so bad. Dr. Mark McFarland is very thorough, and explains this very well! I drive from the Virginia Beach oceanfront just to receive care from him. – Holly Edwards  

Holly Edwards – Success Story (with Dr. Mark McFarland)

  • At OSC, they call him ‘the bionic man.’ All told, Don Hollomon has had neck fusion, both knees replaced and hip replacement. As Dr. McFarland describes it, “Each of those procedures puts metal in your body – metal knees, metal hip and a plate and screws in his neck. He’ll be patted down every time he tries to fly.” Despite having all those procedures, which also include a rotator cuff repair, today Don Holloman describes his physical condition this way: “When I was young, there… Read More

Don Hollomon – Hip Replacement Surgery

  • I injured my spine lifting a small boat engine onto my boat, from a floating dock.   Twisting and turning, while lifting and lowering 60 lbs. of engine on a moving dock, may not have been the best idea.  All of a sudden, I felt a dull pain in my lower back that got worse the more I moved.  Soon, I had terrible pain down my left leg, buttock and thigh.  In another couple of days, horrible calf cramps and numbness in the foot and leg developed.  My leg also felt weak, like it was going to… Read More

Rusty Woods – Lumbar Microdiscectomy

  • I had a lumbar fusion on June 8th of this year, performed by the McFarland team. Every step of the way exceeded my expectations. Dr. Mark McFarland listened to me, answered questions, and explained in a way that made me comfortable with the whole process. I had a lumbar fusion six years earlier (different hospital and doctor), my leg and foot have bothered me ever since. Don’t get me wrong, that surgery was necessary, and I was much better off after the 1st procedure than before. However,… Read More

Bill LaManque – Lumbar Fusion Surgery

  • I went to Dr. Mark McFarland for a back injury I sustained at work. He told me what he thought the cause was and that I should do Physical Therapy before considering surgery or other options. I 100% supported this decision. The Physical Therapists I worked with did an awesome job helping figure out what worked and what didn’t. The facilities and equipment was state of the art. The staff is very knowledgeable and answered all of my questions. And the best part is I felt like Dr. Jamie Swale… Read More

Corey Rodriguez – Physical Therapy for Work-Related Back Injury

  • Approximately 2 years ago, I tripped & ended up with a torn meniscus in my knee. The physician, at that time, quickly recommended surgery, which just was not an option for me. I have a full time job, house, 3 pets, a yard, etc. So I dealt with the pain & just hoped it would go away, certainly not get worse. After setting up a program at The Chesapeake for OSC’s Dr. Mark McFarland to speak to the Community about stem cell injections, I was very impressed with him & the information… Read More

Elizabeth Gee – Stem Cell Therapy for Torn Meniscus

  • Dr. Mark Mcfarland is AWESOME. Dr. McFarland’s bedside manner, and the time he takes to talk and explain items to his patients is fantastic, and his skills as a surgeon are beyond words. Dr. McFarland recently performed Spine Surgery on my lower back and I am currently 3 months post surgery. I cannot express enough my gratitude to Dr. McFarland. I have had total relief from the pain and numbness I had been experiencing, and I am able to accomplish all the physical actions that I had been unable… Read More

Jerry Schrage – Lumbar Spine Surgery

  • I just want to say that my lower back was in bad shape. and I was in a lot of pain ,then I went to see Dr. McFarland and he took one look at my MRI and said he could fix that and I would not have anymore pain. After waking up from major lower back surgery, I had no more pain and was back to normal in six months. Dr. McFarland is the best at what he does and you should feel blessed to have him for your doctor. William… Read More

William Benton – Spine Surgery

  • Dr. Mark McFarland is a great doctor. He takes the time to listen to you and addresses the issues at hand. Talks to you in plain English, so medical terms are not for me to go home and google. Very impressed! What did I enjoy the most about my experience at OSC?  The nurses were great! Dr. McFarland was awesome! Just knowing what is wrong with me and having the ability to try and fix it…awesome! Suzanne… Read More

Suzanne Sulllivan – 5 Star Review/Rating for Dr. Mark McFarland

  • I would like to thank OSC (especially Dr. Mark McFarland, Shelly and the rest of his team). I have received nothing but the best care from the moment I began seeing them for my neck, back , hips and knees. My “KNEES”, oh my Lord – the incredible, bone grinding pain is gone!! Dr McFarland is an extraordinary doctor. He was patient with me during my “decision-making” process. He allowed me to become comfortable with the idea of knee replacement surgery and when I was ready – so was… Read More

Willie J. Senegal – Knee Replacement, Neck, Hip & Back Care

  • My name is Elizabeth S. Ambrose. I am 77 years old. I resided in Yorktown, VA until March, 2014, and now live in Simpsonville, SC. My physicians at Orthopaedic & Spine Center are Drs. Haynes, Sureja, and McFarland. Dr. Haynes treated me for rotator cuff surgery, which was very successful. Dr. Haynes referred me to Dr. Sureja who treated me with injections for 5 years. Dr. Sureja performed these injections with skill, care, and compassion. When he decided that he had gone as far as he… Read More

Elizabeth S. Ambrose – Spinal Fusion & Rotator Cuff Surgeries, Epidural Spine Injections

  • Serious neck pain and some lost range of motion brought me to OSC to see Dr. Mark McFarland. Dr. McFarland was very helpful by answering all of my many questions, while diagnosing my problem and recommending a course of action. After some initial conservative measures, we decided to proceed with a Cervical Fusion and Discectomy. As a professional pilot, I was a bit nervous about such a procedure. When the surgery day came, everything seemed to go like clockwork and the results were amazing…. Read More

Westley Stark – Cervical Fusion and Discectomy Surgery

  • I received an amniotic stem cell injection from Dr. Mark McFarland on October 7, 2015. I realize that everyone is different, but in my case there was no pain or discomfort from the shot, which was identical to the corticosteroid knee shots I had received in the past. There was no pain or discomfort ever following the shot. For the next 13 weeks, I wore a knee brace when walking around to hold the knee in place, and could take no aspirin or NSAIDs for pain. For the first two weeks, I did… Read More

Charles W. Meissner, Jr. – Stem Cell Therapy for Knee Pain

  • Dr. Mark McFarland was awesome. He understood my problem and has ordered an MRI to find out why I am experiencing severe back pain. Thank goodness I found the right doctor that wants to help me right away. For many reasons…this practice is by far more professional than other offices I have been to. Everyone there is on the same page as far as courtesy, speed, and professionalism. This was my first visit to see Dr. McFarland. First impressions ARE very important and lasting :). Robert… Read More

Robert Lockhart – 5 Star Rating/Review for Dr. Mark McFarland

  • I’ve had the sincere pleasure of knowing Dr. Mark McFarland for the past 15 years. In that time, he performed a lumbar microdiscectomy of my L1-L2, a cervical discectomy and disk replacement of my C6-C7, and repaired a torn meniscus in my right knee. In addition, he’s performed several epidural steroid injections and been my general ‘go to’ for all things orthopedic. I’ve experienced nothing but excellent outcomes, and Dr. McFarland has always exceeded my expectations. Back &… Read More

Christopher Davis – Lumbar & Cervical Spine Surgeries, Spine Care & General Orthopaedics

  • I have had lower back pain for a long time. It was manageable at first, but then it started causing increasing pain making it difficult even to drive. Dr. Mark McFarland prescribed medication and a 4 week course in physical therapy. Dr. Tom Toothaker, DPT was in charge of my therapy. He had me do a series of exercises concentrating on my particular problem. Two sessions a week for 4 weeks and my back doesn’t hurt as much anymore. I am doing daily exercises at home and hopefully soon all the… Read More

James Coates – Physical Therapy for Back Pain

  • I want all to know what a fantastic doctor Dr. Martin Coleman is. Recently, Dr. Coleman repaired my torn rotator cuff with wonderful results. Before the surgery and during my recovery, Dr. Coleman talked to me so that I could understand, listened to my questions, allayed my fears, and was super encouraging as I recovered. In this hurried world in which we live, it is so nice to have a busy professional take the time that you need with you. I can’t say thank you enough to Dr. Coleman, and I… Read More

Cynthia Belle Petersen – Rotator Cuff Repair Surgery

  • I have the highest regards for O.S.C., Dr. Sureja and Dr. McFarland. They have taken extreme care in seeing to my well-being, the latest, the installation of a spinal stimulator, which in the testing stage, was a godsend.

David Wooten – Spinal Cord Stimulator for Chronic Pain

  • I had a Kyphoplasty procedure on 4-18-18 at OSC. My physician was Dr. Mark McFarland. He was very informative and spent time explaining the procedure to me. I was very satisfied with him and his staff, especially Stacy, Mary and Zach. I will review the results in a couple of weeks. Thanks so much! Susan T…. Read More

Susan Long – Kyphoplasty for Vertebral Compression Fracture

  • After more than thirty years of conservative treatments, including Physical Therapy, epidurals, anti-inflammatory medications, and surgical interventions (total left knee replacement in 2005, total right knee replacement in 2009), it was concluded that I needed both hips replaced in order to experience sustained pain relief. The pain was located in both groin areas, lower back and radiated down my left leg. Prior to surgery, the pain intensified even when sitting and changing position in… Read More

Barbara McRae – Jiffy Hip Replacement

  • I started seeing Doctor McFarland in 2005. He and the staff at OSC have always been wonderful! I’ve had 2 surgeries, with success, and know my Degenerative Joint Disease and Arthritis will always be treated correctly at OSC! Terri Kilgore

Terri Kilgore – 5 Star Review for Mark McFarland, DO

  • I suffer from Spinal Stenosis. I have had it now for about 6 years. The pain started in my back, then gradually worked its way into my buttocks, thighs and legs. It was horrible and I had trouble doing anything! I originally saw Dr. Mark McFarland for my problem and he diagnosed Spinal Stenosis. He was wonderful to work with and he told me that I had 3 options: spine surgery, a spinal cord stimulator or to live with the pain. I chose the spinal cord stimulator. I then met with Dr. Jenny… Read More

Barbara Clark – Pain Management for Spinal Stenosis/Spinal Cord Stimulator

  • I am a 69 year old male and my name is Harry Szczutkowski. I had to have neck surgery done in which my disc had to be replaced. I have been blessed in a way, that when I needed them, I have found the best doctors in their fields. Dr. Mark McFarland is right up there among the top of the list.  His skills as a surgeon are first class and he has compassion, and is positive and caring.  He is on top of the playing field. I would like to take this time to thank you, Dr. McFarland, and may… Read More

Harry Szczutkowski – Cervical Spine Fusion

  •   I have seen several doctors at OSC over the years; most recently Dr. Martin Coleman. I was referred to him by Dr. Mark McFarland for shoulder surgery which was successfully completed. Dr. McFarland helped me with back surgeries and knee replacements.  In the past, my mother saw Dr. Raj Sureja and we both felt the same about his services and knowledge. Each experience with the Doctors at OSC has always worked out well. And any interaction with the staff there has only shown me… Read More

Diana J. Rondinelli – Shoulder Surgery, Spine Surgeries, Knee Replacements & Pain Management

  • I was very impressed with results of my procedure with Dr. Mark McFarland. Everything he told me concerning my recovery was spot on! I could notice weekly, sometimes daily improvement during recovery. I would totally recommend Dr. McFarland and OSC to anyone seeking relief from spinal injury or degeneration. What I enjoyed most about my treatment with him were the positive results!           Raymond… Read More

Raymond Adams – 5 Star Rating/Review of Dr. Mark McFarland

  • My name is Gene Mason and I am 89 years old. I had three back surgeries 50 years ago and have been plagued with back problems ever since. Two years ago, back pains had reached the point where I felt the need for some sort of corrective action. I had about a year of epidurals and physical exercises. They were effective at first, but only for a short period of time. The neurosurgeon in Williamsburg referred me to the University of Virginia for treatment. The surgeon there told me that, though… Read More

Gene Mason – Spinal Cord Stimulator for Pain Relief

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