Treatment Options for Chronic Migraines
Approximately 12% of Americans suffer from migraines. However, only 1% of the population suffers from chronic migraines. A chronic migraine is defined as a severe headache occurring 15 or more times a month, for more than three months.
When diagnosing chronic migraines, it is important to know the exact number of days every month that a person suffers from a headache of any kind. This can be done by keeping a headache diary or marks on a calendar. Many patients only take note of their severe, debilitating headaches, but it is important to keep track of every headache. Even the most minor headaches can help a physician make a proper diagnosis.
There are many treatments for chronic headaches, and your doctor may use a variety of treatment options in order to help you find the relief you are searching for.
Treatment Options for Chronic Migraines
Acute Treatments for Chronic Migraines
Acute treatments typically involve medications that are taken at the first sign of migraine headaches. They don’t prevent migraines, but help reduce the pain and symptoms that accompany chronic migraines.
These medications frequently include:
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- NSAIDs (non-steroidal anti-inflammatory drugs)
- Triptans: Triptans are prescription drugs that block pain pathways to the brain. It can be taken as pills, shots, or nasal spray.
- Antidepressants: A tricyclic antidepressant can prevent migraines.
Preventative Treatments
Currently, Botox is the only FDA-approved preventative treatment for chronic migraines. Botox works for migraine headaches because it blocks chemicals called neurotransmitters that carry pain signals from your brain. Botox acts as a roadblock in that pathway. It prevents the pain from getting to your nerve endings around your head and neck.
Interventional Treatments
If conventional methods to treating chronic migraines is ineffective at reducing your pain, there are alternative treatment options.
- Biofeedback: Biofeedback teaches you relaxation techniques to monitor and control certain responses to pain and things related to pain, such as stress or muscle tension.
- Acupuncture: acupuncture is helpful for headache pain. The needles are inserted into specific areas to help relieve pain.
- Cognitive Behavioral Therapy: This type of psychotherapy teaches patients how their behavior and thoughts affect the way they perceive pain.
The “Migraine Procedure”
For patients who experience debilitating chronic migraines, there is a cutting-edge treatment available. The “Migraine Procedure” (also referred to as the “Omega” or “Reed Procedure”) utilizes an implantable neurostimulating system, similar to a pacemaker. The battery consists of 4 neurostimulator electrodes and is implanted under the skin, on the chest, abdomen, or buttocks.
This procedure was the result of a theory from the 1960s that supports the hypothesis that nerves are able to carry two signals at one time. Because of this, the neurotransmitter sends a neural message of pain which overrides the competing pain signal. What this means is that the implanted device sends a stronger, false signal to the brain which cancels out the pain signal from your migraine pain.
The neurotransmitter responds to a remote controlled by the patient, essentially allowing them to press a button to make their pain disappear. The remote allows the patient to turn the electrodes on or off and control the level of stimulation needed to reduce their pain.
The “Migraine Procedure” is not permanent and is a very successful interventional therapy with a success rate of over 80%. The battery of the neurostimulator can last between 8-10 years.
Dr. Skaribas is the only doctor in the greater-Houston who performs this procedure.