Brain health & rehabilitation
Chronic pain and migraine
A neurological assessment can help clarify persistent pain, headache patterns and the effect on sleep and daily life. The next step depends on the diagnosis and the treatments already in place.
Start with the question that matters to you
Pain can persist after an injury has healed, accompany another disease, or have several overlapping causes. Migraine requires its own diagnosis and treatment plan. The assessment starts with the pattern and impact of symptoms rather than assuming that a single brain mechanism explains everything.
A manageable path through assessment
Identify the pattern
Diagnosis, frequency, triggers and current treatment.
Choose a daily-life goal
What would meaningful improvement let you do?
Review the whole result
Pain, function, sleep, side effects and treatment burden.
The plan is individual. These stages describe the decision process, not a promised treatment result.
What the assessment needs to establish
- Where pain occurs, headache frequency, triggers, associated symptoms and changes over time.
- Previous diagnoses, scans when available, medication use and response to prevention or acute treatment.
- Sleep, movement, mood, work and the activities you would most like to regain.
- Any fatigue or post-exertional symptom worsening that changes what rehabilitation is tolerable.
How a care plan may be built
Treatment should be matched to the pain diagnosis and coordinated with your neurologist or pain specialist. It may involve established medication, individually appropriate movement or rehabilitation, and psychological support for living with persistent symptoms. Psychological treatment does not mean that pain is imagined. The Brain Center can assess whether a neuromodulation method is a suitable additional option; it does not replace assessment of a new or changing symptom.
Evidence and limits
NICE distinguishes chronic primary pain from pain caused by an identifiable underlying condition, while recognising that both can coexist. Its recommendations for chronic primary pain include activity adapted to the person and selected psychological approaches. These recommendations do not establish that rTMS, tDCS or any other stimulation method is effective for every pain or migraine diagnosis. The team should explain the evidence for the exact proposed use.
Prepare for a useful conversation
Bring a headache or pain diary if you have one, including medication days and activities affected. Agree a useful outcome before treatment: for example, fewer headache days, improved sleep or greater ability to complete a daily task. Review side effects and the effort of attending treatment alongside any change in pain intensity.
The length and cost of assessment depend on your needs. A diagnosis alone does not determine a package. Before making travel arrangements, the team should confirm what is proposed, where it takes place and the planned review point.
Questions before an assessment
Are migraine and chronic pain treated with the same plan?
No. Migraine, neuropathic pain, fibromyalgia and other pain conditions need diagnosis-specific decisions. A method proposed for one condition cannot automatically be assumed appropriate for another.
Why does the team ask about sleep and mood?
Both can affect how pain is experienced and managed, and pain can affect both. Assessing them helps build a fuller plan; it does not mean the pain is imagined.
How will I know whether an additional treatment is worthwhile?
Agree the outcome before starting, such as headache days or ability to do a daily task. Review that outcome alongside adverse effects, time, cost and the burden of attending appointments.
How your care is coordinated
St. George Hospital and the Douwes Brain Center, our outpatient neuromodulation department in Bad Aibling, coordinate the appropriate setting. Your existing specialists remain part of the plan. An inquiry does not commit you to a treatment course or promise an appointment with a particular physician.
Outpatient option
More about outpatient assessment
The Douwes Brain Center is our outpatient neuromodulation department in Bad Aibling. Its condition guides explain the assessment and individual options in more detail.
References
- NICE: chronic pain assessment and chronic primary pain management. Source
Send a free inquiry
The initial inquiry is free of charge. The International Office reviews your message and your case directly and gets back to you.
- Phone
- +49 8061 398-0
- Hours
- Mon–Thu 08:00–17:00, Fri 08:00–14:00 German time (CET/CEST); in the US Mon–Thu 2–11 a.m. ET, Fri 2–8 a.m. ET.
Munich Airport (MUC), about 60 minutes by car.