For years, experts have classified between migraines and tension headaches based on the symptoms described by patients, which include nausea, vomiting and sensitivity to light and sound - in addition to a one sided throbbing headache.
But Dr Elliot Shevel, the founder of The Headache Clinic, argues there is no difference between the two - and one cannot tell from the symptoms where the pain originates: instead, doctors should find the source of the problem.
Two weeks ago Shevel went to Vienna, Austria, to the sixth World Congress on Controversies in Neurology, where he debated his theory against one of the top migraine specialists in the world, Denmark's Professor Jes Olesen.
And Shevel, the only non-neurologist at the conference, carried his point.
"I was elated to win. I was really going up against the top guy," Shevel said this week.
Statistics show that about 6% of men and 18% of women suffer from migraines, with hormonal changes being blamed for the higher rate among females. However, Shevel said, the present classification of migraines did not include finding the origin of the pain, which meant patients got the wrong treatment.
"Everyone around the world uses this classification, which is a thumb suck from the experts [and is] not based on science or supported data," he said.
Shevel is a maxillofacial surgeon who stumbled on his theory on migraines when developing a way of treating muscle pain in jaws.
When he discovered the treatment eased migraines, he turned his attention to headaches.
He said most migraines originated in one of three places:
Jaw and neck muscles;
Arteries in the scalp; or
Nerves running to the scalp.
Sufferers can have the same symptoms from both muscle and arterial pain. But nerve pain was generally eased once the muscles or arteries had been sorted out.
However, muscle and arterial pain were not in the international classification - so headache specialists never investigated them as the cause of the problem.
He said study groups of migraine sufferers had shown that every patient also had tense muscles. But muscle tension was not part of the classification.
Instead, a throbbing headache was part of the diagnosis, even though only 47% of those studied had the symptom.
So why not include this data in the classification, Shevel asked.
Drug companies could only begin researching the correct medication if the classification included the relief of muscle or arterial pain. So Shevel has made it his goal to change it.
"Doctors have gone down the wrong path - it happens in medicine - and it takes time to change their mentality.
"I want to drag headache science kicking and screaming into the 21st century," he said.
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