By Daniel Sellers, MSCS, PA-C
If you suffer from migraine, you are not alone. Nearly 1 in 4 households includes someone with migraine. Migraines are painful headaches that may affect people episodically (<eight days per month) or chronically (eight or more days per month). Regardless of the frequency, migraines are a common source of disability – impacting the ability to be present for family functions or show up to work. For some, the pain is sharp and piercing, for others it may be dull and throbbing. Most migraines cause debilitating pain, nausea and sensitivity to light and sound. Some individuals have a prodrome, which may precede a migraine episode. Symptoms of a prodrome include visual disturbances, fatigue, mood swings and sensitivity to environmental stimuli such as lighting and odors.
For many people, certain foods, drinks and even stress can trigger the onset of a migraine. Some of the most common triggers include red wine, sharp cheese and dark chocolate, but triggers differ from person to person. Keeping a headache log can be helpful for tracking the frequency and severity of the condition, and for identifying triggers. In order for treatments to be the most effective, it is important to identify and avoid your migraine triggers.
There are two main ways to treat migraine – The first is called rescue therapy. When headaches do not respond to over-the-counter pain medications, neurologists typically prescribe medications like triptans that work to disrupt the onset and therefore rescue the migraine sufferer. When migraines are associated with severe nausea or vomiting, it can be challenging to keep pills and capsules down, so neurologist may prescribe injectable or inhalation medications in these cases.
On an individual basis, healthcare providers work with patients to identify possible causes and/or exacerbating factors. For example, hormonal imbalances, sleep disorders and neck problems can cause or contribute to migraine frequency and severity. If no direct, treatable cause can be identified, preventive treatment options should be considered. Preventive treatments include all-natural supplements and/or prescription medications. Traditionally, daily oral medications were most commonly used for migraine prevention. These treatments are effective at reducing migraines, but of course come with the potential for systemic side effects. In 2010, the FDA approved Botox® injections for chronic migraine prevention which proved to be very effective. Botox® is a neuromuscular blocking agent, which stops nerves from communicating with muscles or transmitting pain information. It is injected into specific areas of the head and neck to prevent migraines. Many people prefer Botox® for its favorable side effect profile however, rare and serious side effects can occur. In 2018, the FDA approved anti-CGRP therapy for both episodic and chronic migraine sufferers. Depending on the individual’s comfort level, these therapies can be self-injected, or healthcare provider-injected, monthly or quarterly. Anti-CGRP treatments work unlike any other treatment currently available, are highly effective, do not interact with other medications and have a low potential for side effects. If you are a migraine sufferer, you have options. Do not suffer in silence.
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Sarasota, FL 34233
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