Is A Decrease In Frequency The Only Benefit Observed With Botox
Other benefits can be felt by the person who receives Botox. Here are examples:
- The attacks are less severe
- The attacks are easier to control with acute treatments
- The «baseline headache» or «baseline neck pain» are less intense
- The tolerance to triggers is higher
- The person functions better overall
Some of those effects may be seen earlier with the first treatments, before the impact on the frequency appears. Always use a headache diary!
Will Your Migraines Get Better Or Worse In The Future
“This is my struggle! I just pray every day and hope someday I’ll be healed!” said community member Michelle Frazier. If only we knew what the future holds.
We all want to know when this Migraine pain is going to stop and if it ever will.
Will it get better? Will it get worse? Will my vacation, birthday or wedding day be a Migraine disaster? Will I be able to enjoy chocolate or wine or bright sunshine again? Is there any way I can stop chronic migraines in the future?
That’s what we want to know. Yet, doctors can’t give you a definitive answer, because Migraine attacks are generally unpredictable. A large study is finding what increases your risk of progressing from episodic to often disabling chronic migraine – something every person with Migraine should know.
The great news? Most of us WILL get better with age!
How Prevalent Are Migraines
Migraines are about three times more common in women than men, and may affect more than 12 percent of the U.S. adult population. Migraines often run in families, and can start as early as elementary school but most often in early adulthood. They often fade away later in life, but can strike at any time. The most common cause of recurring, disabling headache pain, migraines are also the most common underlying cause of disabling chronic, daily headache pain. While migraines are the No. 1 reason that patients see a neurologist, most cases are handled by primary care physicians.
Things that can make the headaches more likely to occur include:
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Pay Attention To The Weather
Changes in the weather can impact your migraine patterns. High humidity and hot temperatures can stimulate headaches, as well as rainy days. If the weather becomes uncomfortable for you, you may need to step inside and take a break from the outdoors. Of course, you cant always avoid going outside, but you can minimize your time spent in certain headache-inducing weather.
What Causes Chronic Migraine
Its not fully understood what causes chronic migraine, although there is evidence of changes in the brains of people with chronic migraine.
For a lot of people chronic migraine develops gradually with migraine attacks becoming more frequent over time. Around 2.5 out of 100 people with episodic migraine will develop chronic migraine each year.
The pattern of chronic migraine will vary depending on your individual circumstances. For some people it may return to episodic migraine, some people find it stays the same and others find that it gets worse.
There are some factors that can exacerbate your tendency to have migraine. These include:
- other pain conditions such as Fibromyalgia
- other conditions such as sleep apnoea or Postural tachycardia syndrome
Managing these can help with managing migraine and the effectiveness of migraine treatment.
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How Are Migraines Treated In The Er
Many medicines are used to treat severe migraine headache pain in the ER, including those listed on the next page. The ER doctor may also give you other medicines for nausea and may treat you for dehydration .
Medicines for Pain Relief
Researchers found that the medicines listed below work to lessen or stop migraine pain. Nearly all of these medicines are given as a shot or through an intravenous tube in your arm. Some NSAIDs can also be taken by mouth.
|Neuroleptics and antiemetics are medicines that change the way certain chemicals act in your brain. Some of these medicines may also treat nausea and vomiting.|
|Sumatriptan||Sumatriptan is a headache medicine that narrows the blood vessels in your brain.Note: People with heart problems, such as narrowing or hardening of blood vessels in the heart, should not take this medicine.|
|NSAIDs||NSAIDs are medicines that relieve pain.|
|Opioids||Opioids are medicines that relieve pain. But, these medicines are rarely used for migraines because of possible side effects and the fact that other medicines work well to relieve migraine pain.Note: Taking opioids repeatedly to relieve pain can lead to overuse. Opioids can be addictive.|
|Dihydroergotamine||Dihydroergotamine is a headache medicine that narrows the blood vessels in your brain.|
Medicines To Stop the Migraine From Coming Back
The doctor may also give you a medicine to help stop the migraine from coming back within the next day or two.
Richard Lipton Md Fahs Offers Advice To Clinicians Treating Persistent Migraine
The persistence of chronic migraine can be quite disheartening, causing patients who have tried multiple treatments with no results to feel that they are out of options. Richard B. Lipton, MD, FAHS, Director of the Montefiore Headache Center, Professor of Neurology at the Albert Einstein College of Medicine, and past president of the American Headache Society has treated numerous patients with this concern. Over the years, he has developed a strong grasp on when to move forward with a possibly effective treatment plan and when to change course. In an interview with the American Headache Society, Dr. Lipton explains how he chooses his treatment methods and offers advice to others treating persistent migraine.
Whats the biggest challenge physicians face when treating persistent migraine?By the time many patients see a headache specialist, they believe that they have tried everything. Then the challenge is to figure out why none of the treatments theyve tried in the past have worked. There are a number of common reasons treatments may fail. I would say the most common and most important, is that the diagnosis is either incorrect or incomplete. Many patients I see who have tried multiple therapies with little to no results come in with a diagnosis of migraine when really they have another head pain disorder.
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Eat Natural Whole Foods
Its important to eat natural whole foods to prevent migraines.
Meredith Barad, MD, clinical associate professor of anesthesiology, perioperative, and pain medicine at Stanford University, recommends Minimizing caffeine and sugar. Minimize processed foods in your diet, and avoid chemical triggers like MSG and nitrites, which may trigger migraine in some people.
Additionally, Dr. Barad says, Stay away from carbs and sugar. Instead, eat a protein and veggie when youre hungry. And if you dont recognize an ingredient on a food label, do not put it in your body!
Why Is It Important To Diagnose These Headaches
If you or a loved one find yourself dealing with these types of headaches, its extremely important that you contact your healthcare provider for diagnosis and treatment. Theres no reason to continue suffering and rely on OTC medicines which, as Dr. Soni noted, become less effective over time.
The pain in a patients life can also be a big impediment.
When you look at someone suffering from chronic headaches, they typically dont show outward signs of an illness or disability, she says. Its an invisible illness. And, she adds, chronic headaches particularly chronic migraines are under-diagnosed and under-treated as many patients never seek care.
A patient with one of these chronic conditions isnt able to perform at 100% at all times, and that can affect all aspects of their life from work to family to relationships with friends. It can also directly affect other areas of their health, as Dr. Soni mentions, from sleep to exercise.
Treating these chronic conditions, especially ones with so many unknowns, can be frustrating for patients and healthcare providers alike. There may be patients with whom we try every treatment we can and theyre still living with this chronic pain.
Ultimately, many patients benefit from an interdisciplinary treatment that includes medication, mental health, a pain psychologist, physical therapy and even occupational therapy. The focus, Dr. Soni says, is on function and improving the quality of life.
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How Does Botox Work
Nerves communicate by releasing molecules to their targets: the muscles, the sweat glands but also the sensory organs of the skin. The molecules released bind to receptors and induce actions: muscle contraction, sweat production, sensory modulation. Botox prevents nerves from communicating with their targets. If the target is a muscle, it will stop contracting. If the target is a sweat gland, it will stop producing sweat!
In chronic migraine, we know now that sensory nerves become inflamed and hypersensitive . The inflammation is caused by different molecules that may be released by the sensory nerves. Botox blocks this, and that has a «calming» effect on the pain. There are studies done on animals showing that Botox modifies the electric activity of the pain network of the face and neck.
In summary, Botox works by an effect on sensory nerves that modulates pain.
An effect on muscle contraction may also play a role but is not thought to be the key mechanisms for migraine.
The story of Botox is interesting because it starts with an observation of effect on people which led to a scientific understanding on how it works.
How To Treat A Migraine
If you experience migraines, visit your doctor to rule out any underlying conditions.
Your doctor can also recommend and prescribe painkillers or other medications that might work for you.
If you suspect that certain foods trigger your migraines, try eliminating them from your diet to see if that makes any difference.
For detailed information on how to follow an elimination diet, see this article. Also, consider keeping a detailed food diary.
Some research supports the use of supplements for treating migraines, but the evidence on their effectiveness is limited. Below are summaries of the main ones.
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What Are Additional Symptoms Of A Migraine
Some people have additional symptoms before or after a migraine starts. These symptoms are called auras and can include:
- Numbness or a feeling of pins and needles in your arms, legs, fingers, or face
- Problems with your vision
- Trouble speaking
- Weakness or difficulty moving your arms, legs, or face, although this is rare
Acute Treatments For Chronic Migraine
Acute treatments are medications taken at the first sign of migraine headache. These treatments dont prevent migraine, but they offer pain relief during an episode. Most of these drugs must be taken at the first sign of migraine for best results.
The most commonly prescribed
Various drugs are available to help prevent migraine headaches from occurring. In 2010, doctors began prescribing botulinum toxin for this purpose.
A 2013 analysis concluded that this therapy reduces monthly attacks by or more in some people. But it may also cause adverse effects that could prompt some to discontinue therapy.
Other effective preventive treatments include:
- certain anticonvulsant drugs
- calcium channel blockers
These drugs are less likely to cause intolerable side effects. Some arent specifically approved for migraine prevention, though.
A new class, , have been introduced as another option for migraine prevention.
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What Is A Migraine
A migraine is a common disorder characterized by recurrent, throbbing headaches that can last up to three days.
Several symptoms distinguish migraines from normal headaches. They typically involve only one side of the head and are accompanied by other signs.
These include nausea and hypersensitivity to light, sounds and smells. Some people also experience visual disturbances, known as auras, before getting a migraine .
In 2001, an estimated 28 million Americans experienced migraines. Research has shown greater frequency in women than men .
The underlying cause of migraines is unknown, but hormones, stress and dietary factors may play a role (
Given that evidence is usually based on personal accounts, the role of most dietary triggers is controversial.
However, studies suggest some people with migraines may be susceptible to certain foods.
Below are 11 of the most frequently reported dietary migraine triggers.
What Are The Causes Of Headaches
We want to make sure that the causes are not life-threatening or serious.
Your healthcare provider will determine this through a thorough intake of the history and character of the headaches, as well as a physical examination of your neurological system.
If there are any warning signs, you will be referred for blood tests and possibly CT or MRI scans of the head.
If everything is clear, your healthcare practitioner will categorize your headache based on its characteristics. These include:
- Chronic daily headache Types included in this are: chronic migraine, chronic tension-type, new daily persistent, and hemicrania continua, all defined by the type of pain.
Chronic daily headaches are the most common headaches experienced by people and are the focus of this article.
The World Health Organization states that 1 out 20 adults suffer from these types of headaches every day.
Its causes can be broken down to the basics: diet, lifestyle and nutrition. Some causes of common headaches include:
- Food allergies
Now does it make sense that popping 4-8 painkillers a day would target these causes?
It may temporarily decrease the pain, but the underlying causes are still there. Diet provides the basis of the environment by which your body functions, and a poor diet only causes poor bodily function.
When insulin rises, it causes a massive drop in blood sugar, leading to blood flow changes to the brain, causing headaches.
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Consider Complementary Medicine Therapies
Cowan suggests trying acupuncture, herbal remedies, and moxibustion, a therapy that involves burning herbs on targeted parts of the body. If you use traditional Chinese medicine , make sure the physician is certified and licensed. While Western medicine has been around for just 250 years, TCM has been around 2,500 years and Ayurvedic for 5,000 years in India. Just be smart and check credentials.
Chronic Migraine Management In Italy
On the basis of the results of a worldwide web-based survey, the mean total direct annual cost per CM patient in Italy was estimated to be 2648 versus 828 for EM . Similarly, a study conducted in an Italian tertiary headache center reported that the total annual cost per CM patient was 2250 versus 523 for EM . Most of the cost of CM is carried by the National Health Service .
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How Are Migraines Diagnosed
Unfortunately, doctors cant use blood tests to determine if you are or will be affected by migraines. You should make an appointment with your doctor if youre experiencing unexpected or frequent migraines. They can give you an official diagnosis and make sure that your migraines arent the result of an underlying medical condition.
Your doctor will assess your family history and your symptoms in order to give a diagnosis. It may be beneficial for you to keep a log of your symptoms, which can help you doctor understand your condition. How Can Aromatherapy Be Used for Migraine Relief? Although no conclusive evidence has shown that essential oils will treat migraines, some research demonstrates a potential positive effect.
How Are They Treated
Both migraine and chronic migraine can be treated with the same drugs. These include medications that treat the pain and symptoms as well as drugs that treat the underlying cause of migraine. In some cases, there are medical devices you can use to interrupt the headache. Still, no treatment is perfect.
Because of that, chronic migraines can take a toll on your personal life. If you get painful headaches for half of each month, you lose days of work or school and precious time with friends and family. Itâs common for people with chronic migraines to also have depression.
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How Is Chronic Migraine Treated
Treatment of chronic migraine is focused on managing lifestyle choices and headache triggers, managing migraine attacks and providing preventive treatments to reduce migraine attacks.
Lifestyle changes include:
- Beginning treatment for any existing mood disorder or sleep problem.
The typical treatment plan for managing migraine attacks includes:
- Treating migraine attacks early when pain in mild begin with a simple pain killer and slowly increase the dose as needed to the max tolerated dose, unless the headache is severe at the start or will become severe. In such cases add a triptan to the above medication to improve efficacy. Avoid use of opiates if possible. Your doctor will devise a treatment plan to avoid worsening chronic headache by overusing medications.
- Treat associated side effects, such as nausea.
- Consider other treatment techniques, including transcranial magnetic stimulation and transcutaneous supraorbital nerve stimulation.
Preventive treatment is aimed at reducing the number of headaches. Preventive treatments include:
- Beta blockers, such as propranolol , atenolol and metoprolol
- Angiotensin blockers, such as candesartan
- Tricyclic antidepressants, such as nortriptyline , amitriptyline
- Anticonvulsants, such as topiramate , sodium valproate
- Calcitonin gene-related peptide , such as galcanezumab , fremanezumab , erenumab
What Else Can I Do To Prevent Migraines
While there are no sure ways to keep from having migraine headaches, here are some things that may help:
Eat regularly and do not skip meals.
- Keep a regular sleep schedule.
- Exercise regularly. Aerobic exercise can help reduce tension as well as keep your weight in check. Obesity can contribute to migraines.
- Keep a migraine journal to help you learn what triggers your migraines and what treatments are most helpful.
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