Over half of those with migraine have other chronic pain disorders, and there may be a pathophysiological similarity between migraine and other chronic pain syndromes. A process of pain pathway hyperexcitability and a reduced pain perception threshold may contribute to the chronification of migraine and other chronic pain conditions via a central nervous system sensitization to pain. Sensory and nociceptive input from peripheral nerves that innervate the head and cervical structures likely contribute to central sensitization of pain, which may complicate migraine diagnostically. These peripheral structures offer a target for percutaneous interventions for the treatment of migraine. Lastly, opioids continue to be used in the treatment of migraine despite evidence demonstrating that their use is associated with migraine chronification, greater headache-related burden, and worse quality of life. We recommend slowly tapering opioids by ≤10% of total morphine milligram equivalents per month, as this is typically well tolerated by patients and avoids withdrawal symptoms and other undesired outcomes.