Headache Treatment

There are different options for the treatments of headaches. Often treatment includes more than one approach which is representative of the multi-factorial causes and symptoms of headache and migraine. This guide aims to briefly outline options available in the treatment of headache and migraine.

Recent and ongoing research has demonstrated the potential that disorders of the neck have to aggravate migraine and other forms of headache. Even though the types and causes of headaches can differ widely, there are some common threads that prevail that make particular treatment approaches effective in reducing, if not eliminating, them. Headache treatment, using chiropractic, spinal manipulation, mobilisation, soft tissue work and exercise, is validated in a number of research studies.

Most conventional pharmacological prevention treatment is in the form of tablets taken daily. As many of these drugs were found to help headache by chance, they are also used in other areas of medicine too e.g. mood disturbance, neuropathic pain, and epilepsy. For simple intermittent migraine rescue therapies are usually best. Analgesics can sometimes be effective but the family of drugs called Triptans has revolutionised this area of treatment over the last 15 years. There are 7 key drugs which can be taken as tablets, with nasal sprays and injection.

In cases where patients feel soreness over the greater occipital nerves, it is possible to inject a mixture of local anaesthetic and steroid around these nerves as a type of preventative treatment. The injection procedure is termed a greater occipital nerve block. As the name suggests the technique aims to reduce the symptoms relating to the greater occipital nerve which runs above the hairline and outside of the midline at the back of the head.

Another local treatment that is under review in clinical trials is the injection of Botox (botulinum toxin). Although the regime is tailored to the patient’s needs, the injections are normally given in the forehead and temples as well as the central neck. In addition to the above physical and medicinal approaches it is sometimes valuable to introduce behavioural interventions such as counselling and relaxation techniques. Botox was licensed last year for chronic migraine and is available mainly privately although you may try your local PCT(2011).

Behavioual treatments including biofeedback, relaxation techniques and conitive behavioual therapy have also shown good results with migraine and other headaches.

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