Headache & Pain Medicine

Headache and chronic pain arise from abnormal activity within specific brain regions, neural pathways, peripheral nerves, and interconnected networks that generate, transmit, amplify, inhibit, and regulate pain. Migraine, post-traumatic headache, neuralgia, and other complex headache and pain disorders demand more than simply suppressing symptoms.

Dr. Funk diagnoses and treats a broad range of headache and neurological pain conditions, including migraine with and without aura, chronic migraine, vestibular migraine, post-traumatic headache, post-concussion headache, cervicogenic headache, tension-type headache, occipital neuralgia, trigeminal neuralgia and other cranial neuralgias, neuropathic pain, radicular pain, peripheral nerve pain, and other complex headache and chronic pain presentations.

The diagnostic process begins by determining what type of headache or pain disorder is actually present and why it developed. Similar symptoms can arise from very different neurological mechanisms. Dr. Funk integrates the patient's headache and pain characteristics with a comprehensive neurological examination, medical history, injury history, medication effects, neuroimaging, laboratory findings, vestibular and oculomotor function, autonomic findings, cervical and peripheral neurological findings, and other objective diagnostic information when clinically relevant.

Dr. Funk then localizes the neurological structures and circuits contributing to the patient's pain. Depending on the condition, this may involve peripheral and cranial nerves, cervical nerve roots and sensory pathways, the trigeminal system, trigeminocervical complex, brainstem nuclei, thalamus, hypothalamus, cerebellum, cortical regions, autonomic pathways, vestibular and oculomotor systems, and the distributed neural networks involved in nociception, sensory integration, pain modulation, and migraine physiology.

This localization is especially important in migraine and complex headache disorders because headache may represent only one component of a much broader neurological presentation. Patients may also experience visual aura, photophobia, phonophobia, dizziness, vertigo, motion sensitivity, nausea, cognitive dysfunction, brain fog, fatigue, autonomic symptoms, sensory disturbances, balance abnormalities, neck pain, or abnormal visual and vestibular processing. Dr. Funk evaluates these findings together rather than separating them into unrelated symptoms.

Dr. Funk also investigates the underlying etiology and modifiable mechanisms contributing to recurrent headache and chronic pain when clinically appropriate. This may include evaluating post-traumatic, vascular, neuroimmune and inflammatory, metabolic, endocrine, nutritional, autonomic, musculoskeletal, peripheral nerve, medication-related, and other neurological or physiological contributors. Advanced laboratory testing, neuroimaging, and additional diagnostic studies may be incorporated when necessary to clarify the diagnosis or investigate secondary causes of headache and neurological pain.

A polysubspecialty approach is particularly important in complex headache and pain patients because the mechanisms producing pain frequently cross traditional neurological subspecialty boundaries. Dr. Funk integrates Headache and Pain Medicine with Brain Injury Medicine, Vestibular Neurology, Neuro-Ophthalmology and Oculomotor Neurology, Dysautonomia, Vascular Neurology, Neuroimmunology, Neuroendocrinology, Neuromuscular Medicine and Peripheral Neuropathy, Neuroimaging, and other relevant neurological subspecialties to understand the patient's complete neurological presentation.

Treatment follows the diagnosis and neurological localization. Rather than applying the same migraine or chronic pain protocol to every patient, Dr. Funk identifies the specific neurological systems contributing to the patient's symptoms and develops an individualized treatment strategy directed toward those targets.

Depending on the neurological localization and clinical presentation, treatment may incorporate targeted peripheral nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), vestibular and oculomotor rehabilitation, sensory and motor neuromodulation, neuro-optometric rehabilitation, balance and coordination rehabilitation, transcranial photobiomodulation, pulsed electromagnetic field therapy (PEMF), and other individualized neurological rehabilitation and neuromodulation strategies. Peripheral nerve stimulation can be directed toward specific nerves and neural pathways identified during the examination rather than applied as a nonspecific treatment.

Dr. Funk may also incorporate individualized nutraceutical and over-the-counter medication strategies directed toward relevant neurological and physiological mechanisms. When prescription migraine, headache, neuropathic pain, or other medication management is appropriate, he can educate patients regarding therapeutic considerations and coordinate or co-manage care with prescribing clinicians and other appropriate specialists.

The goal goes far beyond temporary symptom suppression. Dr. Funk identifies the neurological mechanisms generating, amplifying, or failing to adequately regulate the patient's pain and targets the specific brain regions, pathways, peripheral nerves, and neural networks involved. Through repeated, precisely selected neurological stimulation and rehabilitation, treatment is designed to promote adaptive neuroplasticity and modify the function of the neural circuitry contributing to headache and chronic pain.

For patients with complex migraine, persistent post-traumatic headache, neuralgia, neuropathic pain, or chronic pain who have failed conventional approaches, this individualized neurological strategy provides a fundamentally different objective: diagnose the condition, determine the mechanisms driving it, localize the neurological circuitry involved, and treat those systems as precisely as possible.