Robbins Headache Clinic

For more than 25 years, headache sufferers in the Chicago area have found relief from their pain, thanks to our cutting-edge treatment based on the latest advancements in the field. Dr. Larry Robbins, M.D., and Nurse Practitioner Brooke Phenicie, NP-C, use a comprehensive combination of remedies for migraines, tension headaches and cluster headaches. To start your individualized treatment plan, call and make an appointment.

2610 Lake Cook Road, Suite 160
Riverwoods, IL 60015


Treatment of headache at all ages. Hundreds of clinical tips/pearls. What to do when nothing works. Psychological conditions that often accompany severe headaches. Cutting edge medications and non-medicine approaches.”

Hailed as “…the #1 resource for what to do for those with very difficult to treat headaches“….

Treating Difficult Headache

It is important to minimize medication. While pharmacothreapy may be the cornerstone of treatment, we don’t want to rely solely on medication. Addressing triggers may help (particularly stress and sleep). It “takes a village” to help a severe pain patient, and we must recruit other “villagers”. A multidisciplinary approach is vital. For those with posterior (occipital, cervical) pain, physical therapy may be of benefit. With moderate or severe structural cervical pathology, various cervical injections (facet blocks, epidurals) may help. Refractory Chronic Migraine (RCM) is frequently comorbid with anxiety, depression, bipolar, or ADHD. A good psychotherapist is often invaluable. Aberrant “pill taking” behavior may also be addressed through therapy. Acupuncture occasionally is useful, as is massage. We encourage at least 20 minutes per day of any type of exercise, and core work (yoga/pilates) may be of benefit. Even 5 minutes of exercise at a time is encouraged. We must encourage active coping. Many RCM patients are passive copers, relying on their next pill for any relief. The psychotherapists and physical therapists are vital in improving self efficacy and fostering active coping. Passive coping is a major predictor of disability. Improving functioning is one goal of therapy. Resilience is a key construct when dealing with chronic pain. Resilience has a strong genetic basis via the serotonin transporter gene. Two long arms of the gene are good, while 2 short arms predict a possible lack of resilience. Abuse as a child contributes to chronic pain as an adult, and many with RCM have had sexual, physical, or emotional abuse. Improving a patient’s functioning requires a concerted multidisciplinary effort, which usually includes an... read more

Trouble Sleeping? Get Yourself Some Nature!

For those who have trouble sleeping, consider taking a walk in a park, or at least looking out a window. People who live close to green spaces and bodies of water are less likely to report having bad sleep, according to a sample of 245,000 Americans. The research, led by community health professor Diana Grigsby-Toussaint of the University of Illinois at Urbana-Champaign, found this effect was strongest in men and people over 65 years of age. “Studies show that inadequate sleep is associated with declines in mental and physical health, reduced cognitive function, and increased obesity,” said Grigsby-Toussaint in a statement. “This new study shows that exposure to a natural environment may help people get the sleep they need.” People who live near parks and natural green spaces are more likely to engage in moderate and vigorous physical activity, and even light exercise helps people sleep better. Research suggests that people who take walks are also reaping mental health benefits like less depression and lower stress levels – things that can aid in getting a good night’s sleep. Spending prolonged time outdoors helps align the body to natural day- and night-time, which helps strengthen the hormone signal melatonin that’s responsible for those feelings of sleepiness you get in the evening. The analysts found that people who reported having the worst sleep – 21 to 29 days of restless nights out of 30 – also had the lowest odds of being exposed to natural green spaces. The effect was especially strong in men and people over 65 years old, but the relationship was weak in women. “We speculate that women... read more

Severe Headache in Pregnancy: When to Worry

If a pregnant woman with high blood pressure and no history of headache suddenly develops a headache that quickly gets worse, she could be at risk for pregnancy complications, including preeclampsia, which put the mother and fetus at risk. These and other findings from a new study conducted by researchers at Montefiore Health System and Albert Einstein College of Medicine of Yeshiva University, offer the first clinical recommendations for making diagnostic decisions about headaches in pregnant women. The study, the largest of its kind, was published online in the journal Neurology. “Headaches during pregnancy are quite common, but it is not always easy to distinguish between a recurring, preexisting migraine condition and a headache caused by a pregnancy complication,” said lead author Matthew S. Robbins, M.D., director of inpatient services at Montefiore Headache Center. “Our study suggests that physicians should pay close attention when a pregnant woman presents with a severe headache, especially if she has elevated blood pressure or lack of past headache history. Those patients should be referred immediately for neuroimaging and monitoring for preeclampsia.” Preeclampsia typically occurs during the second or third trimester of pregnancy and may be related to an abnormal interaction of blood vessels that supply the placenta. Symptoms and signs can include high blood pressure, headaches, blurry vision, or abdominal pain. Some patients  may have no symptoms. Depending on the severity and the age of the fetus, treatment ranges from bed rest for mild preeclampsia to premature delivery if the condition is severe. Dr. Robbins and colleagues analyzed records of every pregnant woman with headache who had been referred for a neurological consultation at... read more

Kids and Concussions

According to the National Athletic Trainers’ Association, sports-related concussions account for more than half of all emergency room visits by children aged 8 through 13. A child who has had a concussion is one and a half times more likely to have another, and those who have had two concussions have a threefold greater risk of the same injury happening again. Many parents question whether they should let their kids participate in sports like football and soccer, in which head injuries are most common. Concerns about concussion have been cited as a reason for a decline in Pop Warner, the nation’s largest youth football program. A growing number of parents now weigh the risks of concussion when helping their children decide which sport to pursue. The Institute of Medicine and the National Research Council of the National Academy of Sciences reported in 2012 that tackle football players sustained the most concussions among high-school-age athletes, with 11.2 reported among 10,000 “athletic exposures” – the number of practices and games in which an athlete participates. Lacrosse was the next riskiest with 6.0 concussions per 10,000 athletic exposures, although a recent study found ice hockey and wrestling to be more hazardous than lacrosse. Among girls, soccer is associated with the highest risk – 6.7 concussions per 10,000 athletic exposures, according to the academy study. While many focus on the risks of heading a ball, a new study of high school soccer players found that contact with another player was by far the most frequent cause of concussions among female and male players. The study’s authors, from the University of Colorado School of... read more

Caffeine and Migraine

A former migraineur believes eliminating caffeine from her diet five years ago has kept her headache free. She had been in the habit of having one cup of coffee in the morning that was made of half strength caffeine (half-caf), followed by a glass of iced tea at lunch, and sometimes chocolate in the evening. She weaned herself slowly off of all caffeine, experiencing withdrawal headaches as she continued to eliminate the caffeine. She is now 55 years old, and has been through menopause in the past three years. She wonders had this discovery occurred simultaneously with menopause, she might question which was responsible. However, since, the discovery preceded menopause, she feels certain that the cause was attributable to the caffeine.  Edward Messina, MD at The Michigan Headache Clinic in East Lansing, Michigan weighs in on her situation….. Caffeine has long been a controversial topic in the headache world. Due to the very large diversity of patient profiles and headache types, which we currently classify into about 200 categories, it is certainly conceivable that certain patients have an exquisite sensitivity to the drug, while others have no sensitivity whatsoever. Many headache remedies incorporate caffeine and many patients report aborting headaches with an anti-inflammatory and a single cup of coffee. There are case reports of caffeine being useful in treating hypnic headaches as well as caffeine withdrawal headaches. On the other hand, caffeine is a common ingredient in the combination medications which cause medication overuse headaches. It is a question of the setting in which caffeine is used, or abused. In my experience, many patients have quit caffeine at my... read more

Migraine Musings

How about some inspiration for the weekend? Nikki Albert at the Brainless Blogger offers up some beautiful quotes just for migraineurs….. * Find a place inside where there’s joy and the joy will burn out the pain. *  Breathe. Relax. Rest. *  You are so brave and quiet I forget you are suffering. *  Get your Zen on. *  Rest and drop the guilt. *  The pain doesn’t go away. You just make room for it. *  A moment to thank all the migraineur loved ones who care for us when we can’t do much at all and are hiding in the shadows. Who do a little extra because we cannot do much at all. Who help us out when it counts. Who love us when we need love. Who support us when we need support. Who are there for us when it seems we are alone. To all those who really matter to us... read more

Kids’ Headaches Increase This Time Of Year

Findings from Nationwide Children’s Hospital physicians find that headaches increase in fall in children. It’s a trend that may be due to back-to-school changes in stress, routines and sleep. Common triggers include poor hydration, and prolonged screen time. “When we saw many of our families and patients in clinic, the families would report that their child or teenager’s headaches would increase during the school year,” said Ann Pakalnis, MD, lead researcher, attending neurologist and Director of the Comprehensive Headache Clinic at Nationwide Children’s Hospital, Columbus, Ohio. “So, we decided to go back and look at emergency department visits for that time periods and see if there were more visits here at certain seasonal variations during the year.” Results found that when monthly emergency department visits are grouped seasonally, there is an increase in headaches in the fall in children ages five to 18-years-old. “We see a lot of headaches in young boys, from five to nine years of age, and in boys they tend to get better in later adolescence.,” said Dr. Pakalnis. “In teenage girls, migraines oftentimes make their first presentation around the time of puberty and unfortunately tend to persist into adulthood.” The increase in fall headaches may be attributed to many factors, including academic stressors, schedule changes, and an increase in extracurricular activity. “Your brain is like your cell phone,” said Howard Jacobs, MD, a headache specialist at Nationwide Children’s. “If you don’t plug your cell phone in, it doesn’t have energy, it doesn’t work well. If you don’t plug your brain in by providing energy, it doesn’t work well and that causes headaches.” According to... read more

Salt and Migraine

Have you heard that drinking salt water can stop a migraine? Some people believe adding lemon juice can help as well. Tammy Rome, who has a Master’s degree in Professional Counseling, and is a skilled Herbalist and Reiki Master, also happens to be a migraineur. She shares her extensive experience at as well as on her own blog, Brain Storm. Tammy weighs in on the “salt cure” phenomenon here… I understand the urge to stop using pharmaceutical medications in favor of more natural approaches. We are all tempted by the fantasy of a quick fix without harmful effects. Some of the drugs used to treat migraine have nasty side effects. I’m not exactly pleased with some of the side effects I have to deal with. If I really thought something natural would help, I’d beat you to the head of the line to get it. Let’s look at this realistically for a moment. We’ve all heard that dehydration is a potential trigger. If you’ve ever been to the ER, you know that the first thing they do is start an IV fluid drip. Have you ever looked at the label on those bags? Sure, it’s water. But there’s often sodium (salt) and dextrose (sugar) in the bag, too. By the time many of us end up in the ER we’ve been hurting for days. It’s likely that we haven’t eaten or drank much in at least 2-3 days. Plus, if we’ve vomited at all, our risk for dehydration goes way up. On rare occasions, IV fluids are all you need to stop an attack in progress. Example #1... read more

Is a Migraine Essential Lavender Essential Oil?

Paula K. Duma, who writes for loves lavender for many reasons. Ever since she took a trip to Provence, France years ago, she’s “been smitten with lavender.” Here is her story on how the aromatic flower enriches her life and can help with migraine pain…. It’s planted by my mailbox. It’s a staple in my favorite roasted chicken recipe. It’s tucked into my drawers to make clothes smell fresh. Now, a caring naturopathic friend tells me I’ve got to try it – it’s the new migraine essential. That begs for a little fact-checking first. Indeed, recent research supports how it can help relieve migraine attacks as an alternative migraine treatment. A 2012 study conducted by Iranian and German scientists and published in the medical journal European Neurology concluded that “inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches.” Maybe. We would all like to believe that something that smelled so very good would be the fix for our pain forever. Yet as mama always said, wishing doesn’t make it so. The study’s goals, funding sources and methodology all look legitimate enough. An excerpt: Lavender essential oil has been used as an anxiolytic drug, a mood stabilizer, a sedative, spasmolytic, antihypertensive, antimicrobial, analgesic agent as well as a wound healing accelerator. We have studied for the first time the efficacy of lavender essential oil inhalation for the treatment of migraine in a placebo-controlled clinical trial. They evaluated 47 patients with a definite diagnosis of migraine headaches, giving half a dose of 15 minutes lavender essential oil inhalation, and the other half liquid paraffin... read more

Sitting Too Much Can Lead to Anxiety

There are lots of articles out there that tell us sitting too long is bad for our bodies. Now there are studies that say being sedentary can also have a negative impact on our minds. In a recent review of studies, Australian researchers found evidence of a link between emotional stress and sitting. Basically, the more sedentary someone was, the more likely he or she was to feel anxious. Megan Teychenne, who helped lead the study published in BMC Public Health, said she had seen a lot of research about the physical toll of too much sitting – heart disease, type 2 diabetes, etc. But “we wanted to see if sitting time was linked to mental illness as well.” If the connection holds up, Teychenne, of Deakin University’s Centre for Physical Activity and Nutrition Research near Melbourne, said she sees a few possible reasons why sitting might lead to emotional distress. Many people are spending more time at the computer. Too much sedentary screen time might disrupt sleep by keeping the nervous system aroused. Adequate sleep is a great stress buster. Spending all that time online might also mean that people aren’t interacting with others, leading to to social withdrawal – another known driver of anxiety, she said. Only nine studies so far have examined a possible link between sitting time and anxiety. “It’s very clear that much more research needs to be done in this area,” Teychenne said. Hundreds of studies have, however, left absolutely no doubt that exercise is good for mental health, said Dr. Aditi Nerurkar, medical director of the Cheng-Tsui Integrated Health Center at Beth... read more

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