Our Headache Specialty physicians are experts in diagnosing and treating headaches.

Do you have severe headaches that do not respond to your current medications? Do you have more than 15 headache days a month?

If you answered yes, you may have chronic migraine. Our goal is to provide excellent, comprehensive headache care. The best way to manage migraine headaches is with preventative treatment in combination with abortive medication.

The Neurology Center is staffed by neurologists that are all Board Certified in Headache Medicine including: Dr. Jack Schim, and Dr. Riya Luhar . In addition, the clinic is staffed by advanced practitioners who work closely with our physicians as a part of our headache team. Our main office is in Carlsbad, but we have additional offices in Poway, Escondido, La Jolla, and Temecula.


We are experts in botulinum toxin therapies and offer multiple in-office abortive treatment options including:

  • Nerve blocks
  • Trigger point injections
  • Toradol injections
  • Sphenopalatine blocks

As part of our evaluation process, we will try to ensure that any serious causes of your headache disorder have been ruled out. Some of these secondary causes include conditions such as aneurysms, tumors, infection and inflammation. Fortunately, most headaches are primary, such as migraine or cluster headaches, and once we have established that there are no worrisome causes for headache, our goal is to ensure that we diagnose the underlying headache disorder correctly. In the majority of the patients this means we are dealing with migraine. Once we have established the correct diagnosis, the next step is to develop a management plan for your specific headache disorder. This will include education about what we know about the causes of your headache disorder, the potential triggers that may be worsening the headache problem, and discussion about the variety of treatment options. Additional information about this may be found online at “the-headachecenter.com”, specifically in the headache class section.

One of the main goals of our treatment is to to develop a preventative approach for your headache disorder. This may require daily medications to reduce the headache frequency and severity. Importantly, painkilling medicines, particularly opiates, but even over-the-counter medications such as Tylenol, may aggravate the underlying headache disorder and could interfere with preventative treatments. As a result efforts will be made to wean you off of these medications and establish a preventative approach that can allow you to become headache-free. In some instances it may not be feasible to wean off of painkilling medications. In this situation we may refer you to a pain specialist.

In addition to preventative treatments, we have a strong focus on managing headaches acutely. This will require developing an acute treatment plan that will focus on quickly stopping the headache when it begins. If this approach fails, patients have the option of coming into the clinic on an urgent walk-in basis for acute care. Treatments include intramuscular injections of anti-inflammatories, anti-nausea medication, and nerve blocks. The latter involve injections around nerve endings that supply the head and scalp. Injections of local anesthetic in these regions may lead to complete resolution of a severe headache.

In summary, our goal is to work with patients in a partnership to establish a headache-free state wherever possible. In this partnership, the patient takes responsibility for their treatment. This may require making a variety of lifestyle changes that include diet, exercise, changing sleep habits, relaxation exercises, use of supplements, prescription acute therapy, preventive therapy, and rescue therapy in order to help us assist in the development of a comprehensive headache treatment.