Holy Name Medical Center Blog

Stopping the Pain of
Post-COVID Headaches

Posted by James A. Charles, MD, FAAN, FAHS
Neurologist, Director of the Headache Treatment Program for Children, Adolescents, and Adults at Holy Name Medical Center on April 6, 2021
James A. Charles, MD, FAAN, FAHS

Not long into the pandemic it became apparent that COVID-19 could create medical problems beyond the respiratory system; many patients suffered significant cardiovascular and neurological problems.

More than a year later, many of those issues have persisted and a number of survivors are dealing with lingering effects of the disease. About a third of these so-called “long haulers” have neurological problems, including fatigue and brain fog.

Persistent headaches are one of the most common of the neurological after-effects. The Centers for Disease Control and Prevention lists headaches as a symptom of COVID, and new headaches during the pandemic shouldn’t be ignored. For some patients, headaches are hanging around long after their coughs or fever have cleared.

These post-COVID headaches are often daily and persistent. They range in intensity and often veer toward debilitating, mimicking the pain of migraines.

Effective Therapies Block Pain

There are still many unknowns associated with this coronavirus, but the good news is there are effective treatments for post-COVID headaches. At Holy Name Medical Center's Headache Treatment Program, we have the latest and most effective therapies for persistent headaches that do not respond to office-based therapies. Our program is the only one in New Jersey offering infusion therapy and SPG blocks to patients of all ages.

Patients initially are evaluated in the office setting. Almost all post-COVID headache patients experience symptoms similar to migraine. Most experts feel that the coronavirus activates the trigeminal vascular system, which is thought to be the cause for migraine pain. In patients with preexistent migraines, the post-COVID syndrome amplifies the condition, causing severe disability.

Outpatient treatments available in a physician’s office include:

  • CGRP (calcitonin gene-related peptide) monoclonal antibodies are the first pharmacological treatments developed explicitly for the prevention of migraines. These biological compounds are injected once a month or can be administered quarterly by intravenous infusion. They are very targeted and effective and can be given in the office. Patients are then instructed to use these agents at home.
  • Gepants, a new class of effective oral drugs with virtually no adverse effects, are used for breakthrough migraine-like pain.
  • Conventional preventative and successful migraine medications have a role in the management of headaches along with neuromodulation electronic devices that use electrical currents to quiet overactive brain activity.

Patients with persistent headaches that either don’t respond or have a partial response to these therapies may be referred by their neurologist to the Headache Treatment Program at Holy Name Medical Center. The program’s infusion protocol is administered by nursing staff specially trained in the field of headache medicine. Our pharmacy department is superb, and our outpatient infusion therapy provides relief to about 90 percent of post-COVID patients. These therapies include:

  • Intravenous infusions of migraine blocking agents that are very targeted and effective.
  • SPG blocks for migraine-like pain that can’t be controlled by medication. The sphenopalatine ganglion (SPG) is a group off nerves near the nasal cavity associated with headaches. A numbing pain reliever is applied to these nerves using a small catheter through the nose. Relief can be immediate and lasting.
  • Ketamine, administered by specially trained nurses in pain-modulating doses.

No Need to Suffer

The coronavirus is adding fuel to the fire for those who suffered migraines prior to the pandemic. It ignites the whole system and often makes the headaches worse. I urge all my patients to get a COVID vaccine as soon as they can. I am hoping that the CDC puts migraines on the list of pre-existing conditions that warrant priority for the vaccine.

For them and others who have developed persistent headaches post-COVID, there is no need to suffer; our comprehensive office-based and hospital-directed program for children, adolescents, and adults is the best in the tri-state area. The ease of treatment, administration and the kind and professional staff at Holy Name are unique.

Dr. James Charles is board-certified in neurology and clinical neurophysiology and is also certified in headache medicine by the United Council for Neurologic Subspecialties. He is a Fellow of the American Headache Society and is a clinical associate professor of neurology at Rutgers–New Jersey Medical School. Dr. Charles has been practicing for more than 30 years and has published frequently on the subject of migraines. See www.jamesacharlesmd.com.

To make an appointment with Dr. Charles, call his North Bergen office located near the George Washington Bridge at 201-854-6614 or his other office that serves Hoboken, Jersey City, and Bayonne at 201-858-2457. Dr Charles will evaluate you with his office team and direct your treatment.

Any general questions about the Holy Name's Headache Treatment Program, call 1-877-HOLY-NAME