Headaches are a very common complaint that brings patients to a doctor’s office. Every patient with headaches deserves a careful evaluation to rule out serious conditions; fortunately, most are benign and not medically worrisome. However, the majority of patients that suffer from headaches remain poorly treated and suffer unnecessarily. One of the more common causes of recurrent headaches is migraine. Migraine headaches are due to changes in the chemistry of the brain that leads to periodic alterations in the size of blood vessels in the head and neck, and this can lead to severe pain, either localized or generalized, throughout the head. They are clinically associated with other symptoms such as nausea, vomiting, difficulty with light or sound, difficulty concentrating and even moving around. They run in families and frequently we will see several generations that are affected by it. They are more common in women, especially after the onset of menstruation. However, we see them in men and even young boys, and all of them require careful and thoughtful management.
As we learn more about the underlying cause of migraine headache, we are better able to tailor the treatment to patient’s needs. Highly efficacious medications are now available for most patients with migraine, either for the acute attack or to prevent recurrences. A good rule of thumb is that narcotics and other addictive medications should be avoided since we now have much more direct and rational therapies available.
The management of migraine requires the close cooperation of doctor and patient, as well as the rest of the treatment team, to identify potential cause of migraine, to manage the attacks, to prevent recurrences as much as possible, and to educate the patient about how best to deal with this situation. Typically, when a patient comes to us, the headaches are in charge of the patient. It is our goal to let the patient gain enough knowledge and to understand enough about how to treat them so that they are in charge of the headaches and minimize the impact that they could have on their day-to-day life.
For more information on this and many other chronic pain conditions, feel free to contact our treatment team.