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Daily Headache Treatment

Daily headache treatment can be difficult but not impossible! The following are guidelines to treatment.

For many of you who suffer from daily headache, treatments at this point may have been ineffective and frustrating. The key to management of daily headache is proper diagnosis. If you have been relying on a family physician or perhaps a general neurologist who does not specialize in headache, this could be part of the problem.

Stop all use of anti-inflammatories,

This means stopping over the counter meds and products containing pseudofed. This is what is causing analgesic rebound headache which eventually moves into chronic daily headache as more and more OTC's are used. Taking these medications more than 10 days per month will increase your risk of worsening hour headaches. Even over use of anti-inflammatories can cause migraine to transform into constant pain.

For daily headache treatment in our clinic, we use one or two days of steroid infusions, followed by a week of tapering off steroids to break this cycle of pain. Because that is what it is: a cycle of chronic pain.

Chronic medical conditions,

These need to be addressed. If you are anemic, the most common cause of this is iron deficiency. Address this with your doctor before starting iron supplementation, as excess iron can result in constipation. Skipping meals that results in hypoglycemia just fuels the headache more. This is a lifestyle change that you can easily correct.

Taking medication for hypertension is also a lifestyle issue. Many times I will see a patient whose BP is on the ceiling in our office, complaining of headaches and they casually mention they forgot to take their meds that day.

Sleep apnea is a known cause of daily headache that occurs upon awakening. Again this is lifestyle. If you have been diagnosed, weight losss and wearing the CPAP every night is the best remedy. If the machine is uncomfortable..try another! It has been my experience that the companies are willing to work with patients to get them fitted properly for CPAP.

Be willing to combine medications.

When I first see people with daily headaches, many times they have been tried on different anti-seizure medications one at a time, and usually quit at the first sign of a side effect. Some medications and therapies work well together and should all be done at the same time.

Most, if not all, neurological medications that are considered headache treatment take 90 days to have full effect. Side effects, if minimal should be tolerated until your brain gets used to the drug, they they wear off.

It is sort of like getting contac lenses..at first your eyes are irritated, but as each day goes by, the irritation is less and less, until you can't feel them anymore! I have found that Depakote and Elavil are best when treating daily headache. Here is a list of the most common medications for daily headache treatment and prevention.

Valproic acid (Depakote)
Topiramate (Topamax)
Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Trazadone

Psychological issues.

Anxiety and depression can make daily headache worse and even at times cause the beginning of headaches. Many people are unwilling to accept this concept and therefore reject treatment which may reduce their pain. I have had sucess with alternative therapies for mood and have placed patients on S-ame(s-adenosyl-l-methionine) which functions as a precursor to seratonin in the brain. Often just 100mg or 200mg per day is enough in the presence of mild anxiety or depression. Although it can be added in and taken with anti-depressants, you must discuss this with your provider first. Rarely, some alternative therapies can interact with medications and cause side effects.

Address the neck

Studies have proven that neck pathology, particularly at C2/C3 level can cause headaches, especially migraine. Treatments here should include physical therapy, chiropractic, and the proper medication. Several of the above medications are anti-spasmotics for muscle pain, and will bind to nerve tissue to dampen pain signals.

Mold in the home.

This is a rare cause of daily headache but none the less should be addressed. Mold abatement may solve the cause of headache. I have had some patients who improved tremendously when they switched jobs where there was exposure to fumes. Each time paint and chemical fumes were the cause of the headache and once eliminated is one of the easiest of daily headache treatment.

As you can see, daily headache treatment involves removing the offending agent and treating psychological conditions for maximum improvement.

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