How Can I Treat What Is Seemingly More Of A

How can I treat what is seemingly more of a genetic type chronic migraine issue? I've had then since I was 40 and am now 54. I had a partial hysterectomy at 38. I am 5'7" @ 162". I've continued to gain weight due to my sedentary lifestyle/career. No desire for exercise due to chronic migraines on each end of the pain scale but mostly mid scale daily. I do take alternating pain medications which are causing rebound migraines. I know this but I have a very low tolerance for pain and must keep up my job. I've been on about every abortive medication there is, prophylactic medications which caused me great fatigue or brain fog, all to no avail. Oh and I've been through a course of allergy shots and gluten free diet that proved not the issue. What do you suggest?