There are over 4 million chronic migraine sufferers in the US.  Chronic migraine is defined as a headache with migrainous features, which occurs on more than 15 days each month.  Many of these chronic migraine patients we see at the New York Headache Center have daily headaches.  By the time they come to our Center, many have seen several doctors, including neurologists and found no relief from a variety of drugs.  A new book just published by Oxford University Press may help doctors who care for headache patients to provide better care.  The book is Refractory Migraine, Mechanisms and Management.  Dr. Mauskop and Dr. Sun-Edelstein contributed a chapter to this book: Nonpharmacological Treatment for Refractory Migraine: Acupuncture, Vitamins and Minerals and Lifestyle Modifications.  An important message contained in the chapter and the one we always stress to our patients is that the best way to approach a refractory headache is not by trying one drug after another, but by combining drugs with nonpharmacological treatments, such as biofeedback, magnesium, other supplements, Botox injections, acupuncture and other therapies.