New Insights into Headache Treatments

Category: News


by Karan Madan MD, MPH

Headache is one of the leading causes of chronic pain, lost work time and productivity. It’s also one of the leading reasons why patients seek health care services. Recent advances in understanding what causes headaches have led to several new treatment options. Years of research have improved the understanding of headaches and produced new treatment options that can be very effective, even in cases where nothing has worked before.

Headaches can arise from a variety of different causes: allergies, nerve problems in the head and neck area, trauma, overuse of medications and genetic factors. Successful treatment requires a through review of symptoms and potential causes of the headache. It’s not unusual to find two different kinds or causes of headaches in the same person. These patients usually have “difficult to treat” headaches. And it’s important to note that not all headaches are migraines.

Keeping a headache calendar that records the time, frequency and severity of each episode is one of the most effective tools in developing an understanding of both the cause and treatment of a person’s headache. After a thorough understanding of the cause and type of headache, an effective treatment can begin. Treatment options depend on both patient preference and past treatments which may have been tried.

Treatment depends on two important strategies:

1)      preventative treatment that reduces the number of headaches a person has and

2)      abortive therapy that tackles the headache once it begins.

Combining both types of treatment is important for successful, long-term improvement in people with more than the occasional headache.

There are many different medication options which can used for both reducing headache frequency and controlling headaches once they have begun. Introduction of nasal sprays, self- dissolving tablets and auto-injectors allows flexibility for treatment, even when a person cannot swallow tablets due to the nausea that can accompany a headache.

Non-medication treatments include avoiding certain foods and over-the-counter medications. Alternative medicine therapies provided by physical therapists, massage therapists, naturopaths, chiropractors and osteopaths can also be successful and provide very useful tools in treatment.

Some forms of headache begin with problems found in the neck or jaw. The head and neck have many different muscles, all of which can become injured and overused, leading to a tension headache. Treatment approaches include relaxation therapies and various types of injections including botulism toxin (BOTOX).  Joints found in our neck can radiate pain up into the head. Treatment of these problems can include injections or a procedure where electrical treatment of nerves (called Radio Frequency Lesioning) can provide a long-lasting benefit. The joint found in our jaw can also be treated with a variety of approaches, including special splints and injections.

Some very severe forms of headaches come from specific nerves and are called neuralgias. Treatment of these neuralgias can include medications, injections and a new procedure where a pacemaker-like device (called a neurotransmitter) can be implanted to pass a small amount of electrical current around these nerves and overwhelm the sensation of pain. This specialized implant can be used to effectively relieve even the most severe headaches which have never responded to other treatments.

As you can see, headaches can arise from a wide range of causes and can be treated by a variety of therapies. Therefore, it’s best to talk to your doctor to determine what may be causing your particular headache and the best course for treating it. The good news is that medical research has finally found some solutions to a health problem as old as mankind itself.