Posted on January 31, 2010.
Management of chronic headaches Headache is a very common phenomenon known. Many headaches are secondary to underlying disease and, therefore, management of chronic headaches presents significant difficulties for the physician because of the lack of effective treatments.
Chronic headache affects approximately 4-5% of adults in the United States. headache chronic tension-type (type-occipital headache) and chronic migraine are the most common types of chronic headaches. Diagnosis of chronic headache is difficult because of the absence of physical diagnosis. Overuse of drugs to relieve severe headaches can cause rebound headaches.
Very important to have accurate information on the location of pain, quality and intensity of pain, pain triggers and symptoms associated with the implementation plan prior to treatment.
chronic migraine has the following characteristics:
aec Over a period of 4 to 72 hours
aec Unilateral location
aec Pulsating quality
aec moderate to severe
aec Aggravation by walking stairs or routine physical activity
aec Association with nausea and vomiting
aec Photophobia
migraine is often triggered by diet, menstrual cycle, and exposure to sunlight or the smell of caution. Chronic migraine is defined as the occurrence of migraine attacks over 15 times per month for over six months.
Chronic tension-type headache has the following characteristics:
aec Pain in supporting quality
aec bilateral, occipital, or any other place
aec mild to moderate
aec Is not aggravated by walking stairs or routine physical activity
aec associated with nausea but no vomiting
Tension headache is often associated with a sensitivity of muscles in the neck, shoulder, arm, jaw and face and skull base. Chronic tension-type headache should be held more than 15 times per month over six months.
Treatment:
chronic headache is very difficult to treat. In addition, many low efficiency of currently available treatment options. For treatment of pain of moderate to severe migraine, triptans are the treatment of choice. Opioids may also be useful as drugs failed when other treatments fail. In the days now Botox is available for the treatment of migraine and chronic. Tension-type (occipital) and cluster headaches are usually treated with NSAIDs and muscle relaxants as options for initial therapy. Triptans reserved for cases where initial treatment does not relive the pain. Botox injection plays an important role in the ongoing management of medicine for the treatment of tension headaches. For the treatment of occipital headache the first line drug treatment, and the second line of treatment is steroids and / or Botox to relive muscle spasm occipital nerve damage. The third line of treatment is the most effective treatment of occipital headache days today is the stimulation of peripheral nerves. Electrical stimulation of the occipital nerves permanently eliminates occipito-type headache.