Headache & Migraine Clinic — London and Wiltshire

The Health Equation provides a dedicated clinic for people experiencing migraine, recurrent headache, facial pain and associated neck or jaw symptoms. The clinic is led by Gerry Gajadharsingh DO, Osteopath and Diagnostic Consultant in Integrated Medicine, drawing on approximately 40 years of clinical experience.

Headache and migraine can be straightforward, but many patients have persistent, changing or overlapping symptoms that require careful diagnostic reasoning. Our approach begins by establishing the most likely headache classification, identifying any features requiring medical investigation and exploring the wider factors that may be contributing to the frequency, severity or persistence of symptoms.

Consultations are available in Harley Street, London, and Alton Barnes, near Marlborough in Wiltshire.

Understanding Headache and Migraine

Headache is a symptom rather than a single diagnosis. It may arise as a primary headache disorder, such as migraine or tension-type headache, or occur secondary to another medical, neurological, musculoskeletal or systemic condition.

Migraine is a complex neurological disorder. It can involve far more than head pain and may include:

Nausea or vomiting
Sensitivity to light, sound, smell or movement
Visual, sensory or speech disturbance
Dizziness or altered balance
Neck discomfort and muscular sensitivity
Fatigue, cognitive change or “brain fog”
Symptoms occurring before or after the main headache phase
Migraine aura or other migraine symptoms without a prominent headache

Accurate classification matters because different headache disorders require different investigations, treatments and self-management strategies. A careful assessment also helps distinguish common primary headache disorders from symptoms that require further medical investigation or specialist referral.

Your Initial Diagnostic Consultation

All new patients begin with a 60-minute Diagnostic Consultation. Before the appointment, patients are encouraged to send relevant medical correspondence, imaging reports and recent blood-test results so these can be reviewed in advance.

The consultation may include:

A detailed history of the headache pattern, associated symptoms and possible triggers
Review of previous diagnoses, investigations and treatment responses
Screening for clinical warning signs that may require medical investigation
Neurological, cranial nerve, cardiovascular and musculoskeletal assessment where appropriate
Evaluation of the neck, jaw, posture and relevant cranial or facial structures
Consideration of sleep, breathing, hormonal, nutritional, metabolic and lifestyle influences
A clear explanation of the likely diagnosis and recommended next steps

Patients receive a comprehensive written report at no additional cost, usually within two working days unless further investigation or clinical information is awaited. The report can also be shared with the patient’s GP or another healthcare professional, with consent.

An Integrated Approach to Headache and Migraine

Headache and migraine are rarely explained by a single factor. A patient may have an established primary headache disorder while also being affected by neck or jaw dysfunction, altered breathing, poor sleep, hormonal change, nutritional factors, stress, medication effects or another medical condition.

Using the Integrated Regulatory Systems Framework™ (IRSF), Gerry considers the interaction between the respiratory, neural, circulatory, endocrine, immune and inflammatory, metabolic and musculoskeletal systems.

Depending on the findings, the management plan may include:

Explanation of the headache diagnosis and likely contributing factors
Osteopathic treatment where musculoskeletal dysfunction is clinically relevant
Breathing re-training supported by capnometry and HRV
Advice concerning sleep, hydration, nutrition, exercise and symptom triggers
Review of medication use and possible medication-overuse headache
Appropriate blood tests, imaging or other investigations
Discussion of evidence-based medical treatment options
Referral to a GP, neurologist or another specialist when indicated

This approach is designed to complement appropriate conventional medical care and provide a personalised strategy based on the individual clinical presentation.

Explore Headache and Migraine in More Detail

Our supporting pages provide further information about headache and migraine:

Headache and Migraine: An Introduction
An overview of how headache disorders present and why accurate diagnosis matters.
Classification of Headache and Migraine
An explanation of primary and secondary headaches, including migraine, tension-type headache and cluster headache.
Diagnosis and Management of Headache and Migraine
How headache disorders are assessed and the different elements that may contribute to an individual management plan.
Medical Treatments for Headache and Migraine
An overview of acute and preventive medication options and the importance of appropriate medical supervision.

Headache and Migraine Resources

Since 2014, Gerry has regularly reviewed and discussed emerging research relating to headache, migraine, pain and neurological health. The following articles provide further information about diagnosis, treatment and self-management:

Comparison of 25 Migraine Medications

Dietary Zinc & Migraine Risk

Common Misunderstandings About Migraine

New Daily Persistent Headache – Largest Review

Medication Overuse Headache Treatment – 1 Year Outcomes

Migraine Diaries & Hotlines

The Health Equation Blog

Book a Diagnostic Consultation for Headache or Migraine

All new patients should book a 60-minute Diagnostic Consultation with Gerry Gajadharsingh DO.

This is appropriate when headaches or migraine are becoming more frequent, changing in character, interfering with everyday life or failing to respond adequately to treatment. The consultation provides time to clarify the likely diagnosis, review previous investigations and treatments, examine relevant contributing factors and develop a personalised management plan.

Patients with complex symptoms, previous imaging, specialist correspondence or blood-test results are encouraged to send these documents before the appointment.

Book a Diagnostic Consultation

Patient Experiences

Patients attending the Headache & Migraine Clinic often have symptoms influenced by several overlapping factors. The following accounts describe individual experiences of Gerry’s diagnostic and integrated approach.

I couldn’t recommend Gerry more highly. He is hugely knowledgeable and takes the whole picture into account. I came to see him for migraines that were getting both worse and more frequent – with the help of blood tests and dietary changes, breathing exercises and osteopathic manual techniques he managed to free me of my headaches in a matter of weeks. He is simply fantastic!

Katharina Haindl

Gerry was particularly helpful for me when I suffered from acute headaches/neck pain. I visited his clinic and his holistic approach of questioning, diagnosis, and suggested remedial action was extremely thorough (incl. everything from breathing techniques, ‘health’ of nervous system and subsequent impact on my headaches/neck pain). Within a few weeks and a couple of sessions, the symptoms had improved markedly. I have taken away a number of tools & techniques (many of which are quite simple) to manage these issues going forward. I would highly recommend Gerry for any headache/migraine/neck pain related issues. Informative, professional and well run practice. Thank you Gerry & Susie.

James Mason

For more than wo decades I had experienced persistent headaches and facial pain which had resulted in numerous trips to opticians, dentists, a Maxillofacial Surgeon and a neurologist culminating in a non-specific diagnosis of ‘atypical facial neuralgia’ and being prescribed powerful medication to try and control my symptoms. Unfortunately no one was able to find a cause of my chronic pain and I’m afraid I put up with it as I thought I had run out of options. A work colleague had known Mr Gajadharsingh for many years and suggested that I see him, as he might be able to identify contributing factors and help treat my symptoms. I am very glad that I made that initial appointment as Gerry has, following a rigorous medical history, been able to help me with a course of (robust) osteopathy, massage and techniques I can do myself such as working on my posture and controlling my breathing, and all without the aid of medication. For the first time in many years I am virtually pain free, and if I do get an episode of pain, I am able to cope with it. I found Gerry to be extremely professional, knowledgeable, empathetic and very kind, and he was able to help me with my symptoms. I have no hesitation in recommending Gerry as a first class osteopath, and wish him and his practice continued success.

Gill Swain-Coad

Gerry’s rare insight, which draws”Gerry’s rare insight, which draws”Gerry’s rare insight, which draws”Gerry’s rare insight, which draws on many strands of medical, patient centred and holistic practice helped me deal with a sudden onset of migraines in midlife. Neither conventional physiotherapy nor medication had helped, Gerry’s careful unpacking of the symptoms and wider context and causes has helped me spot the very early signs. I’m now equipped with a set of simple relaxing exercises and some help from breathing techniques to deal with stress, and I have been almost symptom free for a year now. I can thoroughly recommend Gerry’s caring and skilful approach.

Rachael Ross

When to Seek Urgent Medical Attention

Most headaches are not caused by serious disease. However, urgent medical assessment is required if a headache:

Begins suddenly and is extremely painful
Follows a recent significant head injury
Occurs with new weakness, facial drooping, loss of sensation or difficulty speaking
Occurs with confusion, marked drowsiness, a seizure or loss of consciousness
Is accompanied by sudden loss of vision or significant new visual disturbance
Occurs with a high temperature, stiff neck or a rash that does not fade under pressure

In these circumstances, call 999 or attend A&E. Do not wait for an appointment at The Health Equation.

For a severe headache associated with jaw pain while eating, scalp tenderness, blurred or double vision, or other new neurological symptoms, seek an urgent GP appointment or contact NHS 111.