Pounding Headache or Migraine? There’s Options for Relief

For those who suffer with migraine or chronic headaches, the frequent, painful episodes often interfere with daily activities and employment. In fact, the World Health Organization ranks migraine among the world’s most disabling medical illnesses. Almost 30 percent of migraine sufferers experience decreased productivity in work and school.

Often patients suffer alone, secluding themselves in darkened, quiet bedrooms to endure days of intense pain, aura, sensitivity to light and sound, and vomiting, hoping not to have to go to a hospital emergency room.

“Migraine is an invisible disease and an invisible disability,” said Dr. Reed. “Aside from low back pain, more years are lost from migraine than from any other disability, beginning from young adulthood,” says Deborah Reed, MD, a neurologist at University Hospitals.

Migraine can often be a source of misunderstanding, and patients are often not provided with the support they need. “We have seen the patient get blamed for triggering their migraine and questioned if they got their headaches after eating chocolate, drinking wine or other known contributing factors,” says Dr. Reed.

Migraines: Actually a Disease

Migraine is more than just a headache, and more than pain and sound and light sensitivity. “Thinking slows down, and patients feel fatigued,” says Dr. Reed. People with migraines should not suffer in silence.

Nearly one quarter of households in the U.S. include someone who suffers from the condition, according to Dr. Reed. “We can help,” Dr. Reed said. “We have better treatments now. The new medications have fewer side effects.”

The first step is to get an examination to diagnose migraine, says Dr. Reed. An MRI scan can detect areas that have increased neuron, or brain cell, activity during a migraine. New medications target neuropeptides to fight the inflammation that occurs in the brain, which dilates blood vessels and stretches nerves, causing the pain of a migraine. “The new medications target these neuropeptides and reverse their effect on blood vessels in the brain,” says Dr. Reed.

Relief for Migraines and Other Types of Headaches

Most patients who are suffering from ongoing headaches start with a visit to their primary care provider (PCP). PCPs can assist patients by prescribing preventative medications to stave off migraine. Other integrative techniques such as acupuncture or dry needling may be beneficial to prevent migraines when used over time.

For headaches that aren’t migraines, physical therapy can often provide relief. What’s known as a cervicogenic headache results in head and neck pain from musculoskeletal origin or trauma. Physical therapy can offer significant relief for many of these patients.

Stacy Ruffing, PT, DPT, OCS, a physical therapist at University Hospitals, says it’s important to find a physical therapist who provides orthopedic treatment, to provide the greater level of expertise needed in headaches. “We provide hands-on, manual treatment, working over the muscles and manipulating joints,” Stacey said.

Physical therapists may also prescribe exercises for posture, and chest and back muscles. “Patients are surprised when they feel relief so quickly from a headache they had for months or even years,” says Ruffing.

Physical therapists can diagnose whether someone has a cervicogenic headache and would benefit from their care, or if they should see a neurologist or other specialist. The sooner you start the appropriate headache treatment, the sooner you can return to your normal activities and regain quality of life.

When to Go to the ER

When a headache comes on suddenly without a history, it’s important to seek care immediately. If someone is also experiencing vision changes or has trouble talking, it may be a stroke and you should go straight to the emergency room.

“As soon as you experience light and sound sensitivity and nausea, you should make an appointment to see a physician and get medication,” said Dr. Reed. “But sometimes a headache is different. If there is no identifiable cause and it’s severe, or if there is vomiting and dehydration, go to the ER. If it is the first time you’ve had a headache and the throwing up lasts four to six hours, and it’s not going away – seek help.”

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Our multidisciplinary team of headache specialists collaborate to diagnose, treat and assist with ongoing care – from medication management to complex interventions.