Understanding Headaches & Migraines

Headaches & Migraines

No matter who you are, you’ve probably experienced a few headaches in your life. It’s one of the most common reasons that keep people from going to work. Chronic primary headaches however, are a disease all their own. They are often triggered in normally healthy people by stress, emotional factors, foods, fumes in the environment, or even a change in the weather. These types of headaches affect over 50 million people in the United States. 

Tension Headache

This is a very common type of headache. Odds are, you’ve probably had one of these headaches in the last year. You will feel a steady pain, usually in the back of the head and along the sides of the neck. 

Migraine Headache

The migraine headache affects around 25 million Americans each year. Migraine headaches can be inherited, so if a family member suffers from migraines, you might as well. Migraines can cause an extremely painful throbbing on the side of the head. It can also cause nausea and vomiting, as well as sensitivity to noise and light. Sufferers of migraines often seek out a dark and quiet room during an attack. Just minutes before a migraine hits, your body often sends a warning whose symptoms vary – flashing lights, trouble speaking or an awareness that something is wrong. 

Cluster Headache

The cluster headache is more of a variant of a headache than a completely different type. They’re not nearly as common as the migraine and are usually found in men who smoke or drink heavily. They are called cluster headaches because, after the first one starts, they keep coming back for weeks and even months. Most of the attacks don’t last more than a few hours and are associated with severe pain in one eye which may water and become inflamed. The nose is also usually stuffy as well. During a cluster, each headache tends to strike at the same time of day as the last. More often than not, these headaches occur during nighttime hours.


There are a variety of at-home treatments for headaches and migraines you can try to ease your pain. 

  1. Rest in a quiet, dark room.
  2. Apply a hot or cold compresses to your head or neck, whichever feels best.
  3. Gently massage the effected area
  4. Drink small amounts of caffeine.
  5. Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others), and aspirin.

If you suffer from persistent headaches or migraines, contact Twin Cities Pain Clinic today to discuss treatment options.

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Peripheral Nerve Stimulation

Peripheral Nerve Stimulation is a treatment Twin Cities Pain Clinic offers to patients suffering from chronic pain. The benefit of peripheral nerve stimulation is that it can target nerves all over the body, instead of just those located in the spinal cord region.

StimWave system-product images-peripheral nerve stimulation

Stimulation can result in significant, long-term pain relief and has fewer side effects than other treatment options.

StimWave Lead-size next to penny-peripheral nerve stimulationHere’s how it works: One of our doctors places a thin, flexible lead inside the body, near the target nerve. The procedure is minimally invasive and is often completed in under 30 minutes.

A small, wearable device communicates with the lead wirelessly to send a mild electric pulse directly to the nerve and interrupt the pain signal. The patient controls stimulation using a small handheld controller.

The result is a dramatic improvement in the patient’s overall quality of life!

Examples of peripheral nerve pain StimRouter can relieve:

  • Post-surgery pain (knee, back, etc.)
  • Post-stroke shoulder pain
  • Complex Regional Pain Syndrome (CRPS)
  • Amputation pain
  • Neuromas
  • Neuralgia
  • Carpal Tunnel

Employee Spotlight: Annushka

Meet Annushka, Intake & Eligibility Peer Trainer at Twin Cities Pain Clinic! Annushka was nominated by her fellow staff members for her continued dedication to her job and helping new employees learn in the best way for them. She is a great team player and helps out anyone whenever they need it! Thank you for all you do Annushka!

What is your position / What are your daily responsibilities?

I am the Intake & Eligibility Peer Trainer. The I & E department schedules all new patient appointments, verifies that new and existing patients' insurances are active for their appointments. We input all of the patient information into the system and serve as the first point of contact for new patients and referring clinics. I like to think that we are the gate keepers for TCPC :). As the Peer Trainer I train new employees on the processes of the I & E department.

How long have you been with TCPC?

I have been with Twin Cities Pain Clinic for two years. When I started the I & E department was called Referrals and it was part of the front desk rotation. I became the Peer Trainer four months ago!

What are some of your hobbies?

I love to travel!!! My husband is an awesome travel buddy to explore with. I also do a lot of mother/daughter trips. We recently went on a trip to the Caribbean! I like to cook and try new recipes/dishes from different cultures. I love spending time with my nieces and nephews being the "fun aunty." I get to sugar them up and send them back home.

What is your favorite thing about working at TCPC?

My I & E team! They are the best group of people that I have worked with. Within the two years that I have been here the clinic has evolved so much and I like how the company strives to be the best for pain management.



Twin Cities Pain Clinic has been named a Top Workplace by the Star Tribune. This great award wouldn't be possible without our amazing staff members. Your hard work does not go unnoticed.

When to Use Ice or Heat on an Injury

Ice or heat?

There is a lot of confusion around the topic of when to use ice on an injury or heat.  Using ice or heat is a cheap, easy, and safe treatment option to help with many common issues. The question is, when do you use heat and when do you use ice.

Ice is for injuries.

Using ice helps calm down damaged superficial tissues that are inflamed, red, hot and swollen. Inflammation is a healthy, normal, and natural process, but it can also be painful. Icing is a mild way of dulling the pain or inflammation and taking the swelling down a bit. If an injury is brand new, using ice can help “calm down” the new injury and bring some relief to the area.

Heat is for muscles, chronic pain, and stress.

Heat takes the edge off symptoms like muscle aching and stiffness. Chronic pain, especially back pain, often involves lots of tension, tightness, anxiety, and sensitization. Comfortable heat can help soothe the nervous system and calm the mind.

As much as using ice and heat can help injuries, it can also harm some injuries if used in the wrong aspect. Heat can make inflammation significantly worse and ice can aggravate symptoms of tightness and stiffness. Both can also just make any pain worse when it’s unwanted. Icing when you are already shivering or applying heat when you are already sweating can be mistaken by the body as a threat, which can actually make the pain worse. To most, ice seems to feel more threatening.

When using ice, you want to be careful when it comes to muscle pain. Sometimes you may think an area is injured, but it may just be muscle pain. You can occasionally have trigger points, painfully sensitive spots, which can be intense and easily mistaken for an injury or inflammation that can be iced. But, if you end up icing a trigger point, it can burn and ache even more. The most common areas people tend to make this mistake is with neck or low back pain.

Heat with inflammation is another area you have to be cautious of. If you add heat to a fresh injury, it is going to get worse. If you heat a freshly injured area that is already swollen and inflamed, it is only going to swell up more and become more painful.

Both heat and ice can be effective when used correctly and on the right type of injury. The most important thing to remember is to use whichever method feels best to you. If you are already warm and the thought of adding more heat to an area of the body doesn’t sound pleasing, don’t do it. Or if you are already chill and adding ice doesn’t sound ideal, you don’t have to do that either. You can always start using one method and if you don’t like it, switch to the other.

The main thing is to always listen to your body!

What Exactly is Degenerative Disc Disease?

First, let’s understand your spine. Your spine is made up of 24 bones, called vertebrae. Muscles and ligaments connect these bones to the spinal column. The many muscles that connect to the spinal column help support the upright posture of the spine and move the spine. The spinal column is what gives the body form and function. The spinal column holds and protects the spinal cord, which is a bundle of nerves that send signals to other parts of the body.

In between each vertebra is a soft, gel-like cushion called an intervertebral disc. The discs act as shock absorbers from everyday movements by helping to absorb pressure. Pressure on the body comes from anything such as sitting, walking, bending, and normal day-to-day activities. The discs also prevent the bones from rubbing against each other.

Degenerative disc disease is one of the most common causes of low back and neck pain. Degenerative disc disease is not a disease, despite the name, but rather more of a condition in which natural, age-related wear and tear on a disc causes pain, instability, and other symptoms. It is normally the result of aging on your spine, however, younger people can have symptoms as well. Spinal injuries can also start the degenerative process of your discs at an earlier time.

Loss of fluid also contributes to the degenerative process of discs. In a healthy, young adult, the discs consist of up to 90 percent fluid. As a person ages, the fluid content decreases, making the discs thinner and they start to become stiff. Because the discs become thin and stiff, they become less effective as a shock absorber and this can create pain and problems.

Common symptoms of degenerative disc disease include:

  • Pain that is worse when sitting. While seated, the discs of the lower back have three times more load on them than when standing.
  • Pain that gets worse when bending, lifting or twisting.
  • Feeling better while walking or even running than when sitting or standing for long periods of time.
  • Feeling better changing positions or lying down.
  • Periods of severe pain that come and go. These can last a few days to a few months before getting better. They can range from nagging pain to disabling pain. Pain can affect the low back, buttocks, thighs or the neck, depending on where the affected disc is, radiating to the arms and hands.
  • Numbness and tingling in the extremities.
  • Weakness in the leg muscles or foot drop, a possible sign of damage to the nerve root.

Risk Factors:

  • An acute or sudden injury, such as a fall
  • Obesity
  • Strenuous physical work
  • Tobacco smoking

If you are experiencing any sort of back or neck pain it doesn’t hurt to reach out to a professional to get it checked out. Normal wear and tear is bound to happen, but, over time can get worse or lead to other issues if not treated correctly or if risk factors are not addressed.

Employee Spotlight: Pa Ta

Meet Pa Ta, Medical Assistant at Twin Cities Pain Clinic. Pa Ta was nominated by her fellow staff members for her continued willingness to help and always having a great attitude. Pa Ta is always willing to help others to make sure the day runs smoothly. Thank you for all you do Pa Ta!

What is your position / What are your daily responsibilities?

I am a Medical Assistant for Twin Cities Pain Clinic. My responsibilities include rooming patients, completing vitals, and lab work.

How long have you been with TCPC?

I have been with Twin Cities Pain Clinic for three awesome months!

What are some of your hobbies?

In my free time I enjoy playing volleyball, spending time with my dog Nala, and cooking. I am a Packers fan, so I love watching them play as well. You can also find me bullet journaling and obsessing over my stationary!

What is your favorite thing about working at TCPC?

I really enjoy working with the staff at TCPC! They have all been very welcoming and helpful with my transition to TCPC.



Twin Cities Pain Clinic has been named a Top Workplace by the Star Tribune. This great award wouldn't be possible without our amazing staff members. Your hard work does not go unnoticed.

Tech Neck: How to Avoid Neck Pain

With all that our smartphones and tablets have to offer, we end up spending a lot of time on our devices, whether it's texting, emailing, or researching. Tech neck can begin to take place. Tech neck is a term coined to describe the position of the head and neck when the device is held at the chest or waist level, eyes focused down at the screen. Tech neck is pain, soreness, and stiffness of the neck that over time can lead to a variety of health issues including muscle strains, nerve impingement, and disk injury.

When the head is in a neutral position - when the ears are lined up with the shoulders and the shoulder blades are pulled in. There is relatively little stress on the neck. When the head falls forward, the weight on the spine increases drastically. According to Dr. K Daniel Riew, director of cervical spine surgery and co-director of spine surgery in the department of orthopedic surgery at the Daniel and Jane Och Spine Hospital at New York Presbyterian, “At just 45 degrees, your neck muscles are doing the work of lifting a 50 lb. bag of potatoes.” Over time, that added pressure on your spine can create unnecessary health issues.  

If you are experiencing neck pain, numbness and tension in your fingers, headaches and migraines, or pain between your shoulder blades, you may be experiencing tech neck. What happens is the more you look down at your device, the more your muscles with tighten up and put pressure on the discs. This makes the discs between your vertebrae wear out faster, and they can even bulge or rupture.

If it gets severe enough, surgery may be required. Posture re-education is an important key to decreasing the incidence of shoulder and neck pain from the effects of tech neck.

Some helpful tips to remember to ward off tech neck are:

  • Make sure whatever device you are using it is at eye level.
  • Take several short breaks throughout the day to get up and move around.
  • Pay attention to your posture. When sitting, place a towel or soft material between your low back and the chair to help provide lumbar support.
  • Make sure that your computer screen is at eye level. Even investing in a transitional, sit-stand desk so you can work from your feet a majority of the day.
  • Stretch. Stretching is a great preventative measure that can be done almost anywhere and should be integrated into the day.
  • Exercise. Especially if you have a desk job, taking short walks during the day or taking the stairs instead of the elevator can help add some movement into your day and get oxygen moving within the body.

In today’s world, it’s almost impossible to avoid technological devices. They are useful in many aspects of our day. But, having proper posture while using them and taking frequent breaks will help your back and neck from aches and pains.



Riew, K. Daniel, Dr. (2018, July 18). How to Prevent 'Tech Neck'. Retrieved from https://healthmatters.nyp.org/how-to-prevent-tech-neck/

Employee Spotlight: Carly

Meet Carly, Administrative Assistant at Twin Cities Pain Clinic. Carly was nominated by her fellow staff members for her continued effort in helping others and always going above and beyond her expected job duties. Carly always has a smile on her face and is always willing to help others out, it definitely makes the day run smoother. Thank you for all you do Carly!

What is your position / What are your daily responsibilities?

I am the Administrative Assistant for Twin Cities Pain Clinic and I mainly take care of templating for the mid-levels and doctors schedules for the clinic and surgery center. I also help with making sure appointments have been scheduled correctly, along with other daily office tasks.

How long have you been with TCPC?

I have been with Twin Cities Pain Clinic for a little over seven months now. I started out as a Patient Service Representative and have recently transitioned into the Administrative Assistant role.

What are some of your hobbies?

While not at work, some of my favorite things to do are checking out the many state parks that MN has to offer. I like to go camping and hiking with my boyfriend and our dog Kona. I love going on adventures discovering new breweries, restaurants, and outdoor activities. I also enjoy spending time with family and friends.

What is your favorite thing about working at TCPC?

My favorite thing about working at TCPC is the great sense of teamwork here. Knowing that myself, as well as my fellow coworkers have each other's back no matter what is a great feeling.



Twin Cities Pain Clinic has been named a Top Workplace by the Star Tribune. This great award wouldn't be possible without our amazing staff members. Your hard work does not go unnoticed.

The Importance of Stretching

Almost everybody knows that physical activity and exercise are very important. But, what a lot of people don’t know is how important stretching is. There are five components of physical fitness, and flexibility is one of them, with the other four being cardiovascular fitness, muscular strength, muscular endurance, and a healthy body.

A stretching program can help bring alignment to the joints of your shoulders, hips, knees, and ankles. When the body is properly aligned mobility is increased and inflammation of the joints is reduced. Stretching consistently can improve range of motion, help relieve stiffness and muscle aches, help prevent injuries, and help improve structural problems.

A stretching routine has many benefits to it. Besides increased flexibility, stretching helps improves circulation and blood flow, align the body, relaxes and relieves stress, increases oxygen flow, enhances coordination, and helps relieve pain.

When stretching or starting a stretching routine its always good to consult with an expect first. But, some general tips to keep in mind while stretching would be:

  • Wear comfortable clothing that won’t constrict movements
  • Don’t force your body info difficult or painful positions – stretching should be pain free
  • Move into a stretch slowly and avoid bouncing
  • Hold stretches between 15 to 30 seconds to adequately lengthen and improve range of motion
  • Stretch on a clean, flat surface that is large enough to move freely
  • Repeat a stretch between 2 and 5 times

Another thing to remember is to get into a routine of stretching after you exercise. Stretching after a workout will assist in your body releasing lactic acid from muscle cells faster. Stretching increases blood flow and improves circulation which helps the muscles heal quicker as well. Stretching after exercise helps with soreness too, as you are less likely to get sore if you stretch.

The most important thing to remember when stretching or doing any form of exercise is to listen to your body. What works for one person may not be the right avenue for the next person. Stretching, like any exercise also takes time to see a difference. Keep working towards your goal one day at a time and seek help when necessary.

Why Persistent Pain Patients Need Quality Sleep

Does pain make the sleep worse or does poor quality sleep make the pain feel worse? It’s actually both. The subjected intensity of pain decreases when a person is well rested. It is estimated that 50-80% of chronic pain patients report sleep disturbances. The worst is when pain and sleep form a downward spiral, leading to quality of life going down as well. Pain makes it hard to sleep, and poor sleep makes the pain subjectively worse.

During a normal night’s sleep, we cycle from light sleep to deep sleep to REM (rapid eye movement) sleep up to five times. When you feel tired in the morning, it’s normally because you didn’t get enough deep sleep and REM sleep.

Sudden severe pain can wake you up from a deep sleep, but milder pain can negatively impact sleep quality as well. Milder pain can cause microarousals. Microarousals are periods of time when you are shifted back into light sleep. Though you’re not likely to be aware of these microarousals happening or remember them the next day, you will probably wake up feeling like you didn’t sleep much at all.

Poor sleep can cause migraines. Getting enough sleep helps protect against migraine attacks.

Poor sleep can make you vulnerable to infections. Sleep helps heal and repair the body, especially your heart and blood vessels. If you don’t give your body time to heal and repair, your immunity system can lower, making you susceptible to other infections.

Poor sleep can make you sick in the long run. Sleep disturbance is associated with a wide array of distress and symptoms spanning from obesity, insulin resistance, type 2 diabetes, metabolic syndrome, and cardiovascular disease risk.

Poor sleep can negatively affect various aspects of brain function. This can include cognition, concentration, productivity, and performance. Getting good sleep then, can actually help improve problem-solving skills and enhance memory performance.

Poor sleep can wreck your mood. 40% of psychiatric mood disorders are preceded by insomnia, and insomnia sets in at the same time as another 20% of mood disorders.

Lifestyle changes that can help improve sleep

  • Don’t watch TV in the bedroom.
  • Don’t eat a big meal before bed, as digestion can disrupt sleep patterns.
  • Put away your cell phone, tablet, or laptop, and anything else that has a lit screen at least an hour before bedtime.
  • Don’t consume caffeine in the evening.
  • Try relaxation techniques such as meditation or yoga to reduce stress.
  • Keep your room dark, cool, and quiet.

Finding a nightly routine can help with getting better sleep. Find what works for you, whether it’s reading before bed, or preparing for the next day. Better sleep is not always going to happen instantaneously, but with practice and consistency, sleep can improve over time.



How Does Pain Affect Sleep? (2017). Retrieved from https://www.tuck.com/pain-and-sleep/

Leech, J. (2018). 10 Reasons Why Good Sleep Is Important. Retrieved from https://www.healthline.com/nutrition/10-reasons-why-good-sleep-is-important#section3

Chronic Pain and Sleep. Retrieved from https://creakyjoints.org/support/pain-management/sleep/