Headaches are not imaginary

Headaches are not imaginary: therapies can significantly reduce the frequency and intensity of attacks

09/02/2013

Headache is one of the most common types of pain besides back pain. About four to five percent of the German population suffers from daily and about 70 percent from chronic (recurrent) headaches.

Overall, migraine occurs in women about three times as often as in men and has a diverse clinical picture. In addition, there are four million people suffering from other forms such as cluster headache. New drugs and forms of therapy help a large part of the patients. But what can one do

Gregor Brössner, Head of the Outpatient Outpatient Clinic at the Department of Neurology of the Medical University of Innsbruck, aims at the so-called "attack therapy" so that the patient is painless within two hours or the pain intensity is at least significantly reduced.

„This can often be achieved with conventional painkillers or with special migraine medications - triptans. Untreated attacks usually take one to two days“, explains the doctor. Well you can reduce the number of attacks with drugs, such as beta-blockers, antiepileptics, calcium antagonists. „Here's the goal of halving the frequency“, so the expert. It is unrealistic to believe that immediately after taking a pain-free setting.

Recently, patients with chronic migraine received preventive therapy in Austria „botulinum toxin“ authorized. These patients have headaches for more than 15 days a month. At least eight days of it with migraine attacks. In addition, another therapy with preventive drugs has already been tried without success. The patient is injected with botulinum toxin at 31 points around the head, and the therapy is repeated after twelve or 24 weeks. The results showed a significant reduction in seizure frequency in some of those affected.

„However, we do not know how long the effect will last, there are still no long-term experiences with the therapy“, so the neurologist. Endurance sport, there were very good data for biofeedback: electrodes stuck on the neck measuring the muscle tension, which is displayed on a screen. Under the guidance of a physical therapist, you learn how to reduce your muscle tension by using breathing, relaxation, and concentration techniques, such as Jacobson progressive muscle relaxation. In acupuncture, the data is contradictory, in some studies showed positive effects, in others not.

That diets could help so far can not be clearly proven. Chocolate as a trigger is wrongly suspected in the majority of cases. In the pre-phase of a migraine attack, before the onset of headache, it comes through the processes in the brain cravings, „Food Craving“. We are often breastfed with chocolate. „You might as well eat gummi bears, then they would be accused of being triggers. If someone really has the impression that a certain food is aggravating migraine symptoms, then you should omit this one product“, says Brössner

The neurologists try to differentiate whether the headache is the disease itself - as in migraine, cluster or tension headache - or just the symptom of another disease such as. A cerebral hemorrhage or a brain tumor. Such a secondary headache can only be excluded by means of an exact diagnosis. When taking an anamnesis, the doctor must therefore pay close attention to the narratives of the patient. That's why a good doctor-patient relationship is important.

Brössner relates that many sufferers do not feel taken seriously and suffer from the prejudice that they would imagine the pain. „It is scientifically undisputed today that this has nothing to do with imagination“. New imaging techniques, such as functional magnetic resonance imaging, can sometimes even make the pain visible. We now know that the brain of patients with migraine or cluster headache simply works differently during an attack. In addition, some genetic causes of migraine have been discovered in recent years“, the doctor states. (Fr)

Picture: B. Proud