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Cannot Stand These Headaches Anymore; What Can Be Done Besides Taking Pills?

Headaches can be crippling. They can start with or without a history of trauma or illness. We see many moms with headaches whose mothers or children also suffer with the condition.

Not all headaches are equal and not all the treatments are the same. The list for possible causes and types is quite long. Sometimes they can get better or worse after a pregnancy due to hormonal changes. Those who suffer with migraines will many times see changes with their periods.  I have treated many patients through the years. Have seen them coming through the office with dark glasses, avoiding the noise. Some will vomit. Many will be missing school or work. Some will have great difficulty caring for their little ones right here, in Sarasota.

First of all, a complete medical evaluation by your primary care physician, your neurologist, or your pain medicine physician is needed. Pills are commonly used and a great way to treat many headaches. But, we still have patients who do not want to take them or did not respond well to them.

A few non-medication ways of treating headaches include:

Acupuncture

Relaxation

Essential oils

Meditation

Biofeedback

Physical therapy

Electrical stimulation units

Exercising

Diet adjustments

Quitting smoking and alcohol

Avoiding stress

I do want to review some interventional therapies, which might not be well known and can provide long lasting relief.

Botulinum toxin (Botox)

Approved by the FDA for treatment of migraine headaches. Many patients who received it for cosmetic reasons told their physicians about it. They reported improvement in the headaches. Research confirmed the efficacy. The points injected follow a similar distribution of the ones used for treatment of wrinkles. The effects can last between 4-6 months. And yes, you will have the cosmetic benefits on your forehead too. 🙂

Sphenopalatine Ganglion Blocks

(A mouthful) These will be used in the case of a severe headache attack. The physician inserts local anesthetic-covered swabs through the nostrils in the office while the patient is being monitored. There is a plate at the base of the nose through which fibers communicate to this collection of nerves called the sphenopalatine ganglion. The local anesthetic numbs these fibers, thus blocking the headache temporarily. This is an alternative to IV medication in the ER.

Occipital nerve blocks

The physician is treating pain that starts in the back of the head and goes all the way up on one or both sides to the back of the eye. These injections help understand and treat the cause of the headaches. The relief is immediate. Many patients report permanent or months of pain relief.

Trigger point injections

If the headaches are due to the muscles issues, these injections help get rid of that pain. Muscles can hurt a lot. If this is the cause of the headaches, you should get physical therapy along with the injections for better results.

Facet joint injections, medial branch blocks, and ablation/denervation/radiofrequency

Car accidents are much more common than I would like to see anywhere, and Sarasota is no different. Many talk about “whiplash injuries.” These happen when your neck is jerked back and forth during an accident. They can also happen with falls or any other direct impact to the head. For the whiplash injuries and arthritis of the neck we block the sensation to the spinal joints. By blocking it, the patients will feel much less or no pain. These techniques have been used for over 40 years to treat these little joints. Up to 75-80% of the patients who experience significant relief with the blocks or facet injections will obtain long lasting relief with the more permanent procedures.

This is only a review of therapies that are helpful for headaches. It is most important that you discuss any treatments with your healthcare provider. Make sure whoever is doing your injections is certified and has the right experience to perform them. Never lose hope.

You can also look for help at:

www.migraine.com

www.migraine.org

http://iasp-pain.org/Advocacy/Content.aspx?ItemNumber=1093.

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