Migraine Treatment in Singapore

Migraine treatment in Singapore aims to make attacks less frequent, shorter and milder, so you can get on with your day. It usually combines medicines taken during an attack, preventive medicines, and lifestyle changes. When migraines keep returning, specialists such as neurologists and pain specialists may also offer targeted options like nerve blocks or botulinum toxin injections for chronic migraine.

Go to A&E or call 995 instead if you have a sudden, extremely severe headache; a headache with new weakness, difficulty speaking, confusion, a seizure, fever with a stiff neck, or loss of vision; a new or unusual headache during pregnancy or after childbirth; or an attack lasting more than 72 hours. Please do not wait for a clinic appointment.

The right treatment depends on how often your attacks happen, how much they affect your day, how often you take painkillers, and whether neck pain is also involved. Most people start with conservative care, such as medicines and lifestyle changes. Minimally invasive treatments like nerve blocks are considered when attacks are frequent or chronic. Surgery is rarely needed.

Conservative treatment uses medicines and everyday changes to reduce how often migraines happen and how severe they are. It is where almost everyone starts.

• Pharmacotherapy (Migraine Medicines): Acute medicines are taken at the start of an attack to shorten it. Preventive medicines are taken daily to reduce how often attacks happen, and are usually reviewed after 2–3 months. Your doctor will also check how often you use painkillers, because taking them too often can make headaches more frequent, and help you cut back safely if needed.

• Lifestyle Changes and Trigger Management: Small, steady changes can help reduce attacks: regular sleep and meal times, drinking enough water in Singapore’s heat, regular exercise, and breaks from the screen. A headache diary helps you and your doctor spot your own triggers. Physiotherapy for neck and posture can be added when needed.

• Cognitive Behavioural Therapy (CBT): CBT helps you manage stress, sleep and the worry that can build up around frequent attacks. Behavioural therapies like this are a recognised part of migraine prevention and work alongside your medicines.

Minimally invasive treatments use fine needles to target the nerves and muscles involved in your headaches, without open surgery. They are usually done as outpatient or day procedures with little or no downtime, and are considered when attacks are frequent, chronic, or not settling with medicines.

• Peripheral Nerve Block (Occipital Nerve Block): A peripheral nerve block targets a specific nerve to calm its pain signals. For migraine, this is usually the greater occipital nerve, which runs from the top of your neck over the back of your head. Local anaesthetic, sometimes with a steroid, is injected next to the nerve. It is used in specialist headache care for chronic migraine and for bouts of frequent attacks. It takes a few minutes in the clinic, and most people go back to their usual day straight after. How much relief it gives, and for how long, differs from person to person.

• Botulinum Toxin Injections: For adults with chronic migraine, your doctor may discuss small injections at set points on the head, neck and shoulders, usually repeated about every 12 weeks. This option is meant for chronic migraine, not for occasional attacks.

Surgery is rarely needed for migraine, and the evidence for it is more limited than for other treatments. It is only considered for a very small number of people with severe chronic migraine that has not improved with conservative and minimally invasive treatments, and only after careful specialist review.

• Occipital Nerve Stimulation: A small device is implanted under the skin to send mild electrical pulses to the occipital nerves at the back of the head. Studies show some short-term benefit for severe chronic migraine, but long-term results are still uncertain, and the device may need further surgery to adjust or replace it. Your doctor will talk you through the possible benefits, risks and alternatives in detail before you decide.

It may be time to see a specialist if migraines come on 4 or more days a month, you reach for painkillers on 10 or more days a month, or attacks are getting in the way of work, sleep or family time. At this stage, a structured plan often helps more than another box of painkillers.

Pain specialists are doctors with specialist training in diagnosing and treating long-lasting pain. Many first train in anaesthesiology before going on to further training in pain medicine. This gives them a detailed understanding of how pain signals travel along the nerves, and experience in treating pain with both medicines and targeted procedures.

For migraine, a pain specialist will usually start by reviewing your medicines, including how often you take painkillers, as using them too often can make headaches more frequent. Your treatment plan can then be adjusted, and if your migraines are frequent or chronic, procedures such as a peripheral nerve block or botulinum toxin injections may be discussed. Because sleep, stress, and neck and shoulder tension can all play a part in migraine, your specialist may also bring in physiotherapy and psychological support, so your care looks at the whole picture and not just the pain.

Your migraine is assessed by a pain specialist using our Painostic® approach, to understand what is driving your attacks and plan the most suitable treatment.

Where suitable, you may be offered medicines, lifestyle changes or minimally invasive treatments such as nerve blocks, so your migraine is treated in the least invasive way possible.

Procedures such as peripheral nerve blocks are done in the clinic, and most people go home the same day.

We work with insurance partners to help patients access cost-effective care, subject to your plan’s coverage.

Singapore Paincare treats migraine using Painostic®, our own assessment approach. It looks beyond scans and tests to understand how your migraine develops, what triggers it, and how it affects your body and mind. Your treatment plan is based on these findings, with minimally invasive options prioritised over surgery.

Developed by Dr Bernard Lee, Painostic® is guided by three proprietary protocols:

A detailed look at your migraine from every angle, because no two people experience pain the same way.

A structured way of choosing the treatment technique that suits you best.

If a procedure is right for you, careful needle placement so the medicine reaches the area that needs it.

You stay involved in every decision, and we explain each step in plain language. The aim is simple: fewer migraine days, and more good ones.

Your care begins with a detailed migraine assessment using our Painostic® approach. Your specialist will review your medical history and headache pattern: how often attacks happen, how long they last, what sets them off, and how they affect your work and sleep. We review the medicines you have tried, including how often you take painkillers, and examine your head, neck, shoulders and nerves. We also look for signs of other headache types, such as neck-related or medication-overuse headache, or anything that needs urgent attention. Not everyone with migraine needs a scan; imaging may be reviewed or arranged if your history or examination suggests it is needed.

Once your assessment is complete, you will receive a treatment plan tailored to your migraine pattern, health and daily needs. We will explain what may be contributing to your attacks, such as triggers, painkiller use, sleep, stress, or neck and shoulder tension, together with the treatment options available, their likely benefits and risks, the costs, and what to expect.

• Conservative Treatment: pharmacotherapy, including medicines for attacks and preventive medicines, with a plan to manage your triggers and, where needed, reduce painkiller use safely.
• Minimally Invasive Procedures: for frequent or chronic migraine, targeted treatments such as a peripheral nerve block, or botulinum toxin injections for chronic migraine, may be recommended. These are typically performed as outpatient procedures where appropriate.
• Rehabilitation Support: physiotherapy guidance, posture correction and exercise may be added when neck and shoulder tension contribute to your headaches.
• Integrated Care: additional supportive options, such as cognitive behavioural therapy (CBT) for stress and sleep, may be considered when appropriate to complement your treatment.

Your progress will be reviewed regularly, using your headache diary to track how many headache days you have, how often you need painkillers, and how you are coping day to day. Treatment may be adjusted based on your response, with the aim of reducing how often and how severely migraines affect your life.

Dr. Lee has over 20 years of clinical experience in pain management, including the diagnosis and treatment of headache and facial pain. He established the Chronic and Interventional Pain Management Service at Tan Tock Seng Hospital, founded Singapore’s first Women’s Pain Centre at KK Women’s and Children’s Hospital, and developed the Painostic® diagnostic methodology.

Dr Yoong has over 20 years of experience in pain management. He started Changi General Hospital’s Acute and Chronic Pain Services in 1998 and later led its Chronic Pain Service. He has served on the MOH Opioids Committee since 2018.

Last Updated 9 Oct 2026