A recent article written by Donald B. Penzien, PhD, FAHS and Frederick R. Taylor, MD, FAAN, FAHS was published in Headache The Journal of Head and Face Pain. The following is a portion of the article. The authors conclude that hundreds of scientific studies have shown behavioral therapies for headache offer substantial improvement, and that treatment gains typically continue after treatment without the need for additional therapy…..

Medicines provide our chief means of treating headaches – so much so that many people have difficulty thinking of any other strategy. Plenty of nondrug techniques can ease head pain, such as massage, applying cold or heat, rest, and avoiding headache triggers. In fact, people have relied on these and other “alternative therapies” for head pain management for centuries. Early alternatives included faith healing, incantations, and superstitious rituals, bloodletting, poultices, and many more.

Today, we are fortunate to have a host of proven prescription and nonprescription medications at our disposal that can be quite effective for treating headaches. So why use non-pharmacologic alternatives? Nondrug therapies often are well suited for those who experience side effects with medications, or have an inadequate response to medications. Some people have preference for nondrug treatment, and women who are pregnant, planning pregnancy, or nursing should limit or avoid medication use. People with medication overuse or high-stress levels also benefit from nondrug approaches that emphasize lifestyle and behavior changes. When discussing nondrug treatments, we often prefer the term complimentary therapies to highlight that nondrug therapies need not be used in place of medications. Rather, drug and non drug treatments should be combined for added benefit.

Headache is not merely a problem of the body or the mind but rather a biopsychosocial disorder – a physical disorder subject to psychological, social influences, and environmental stressors. Moreover, chronic headache is a complicated problem that involves pain and suffering and can interfere with family, social, vocational and emotional functioning. Frequent and severe headaches are especially likely to cause these problems. So it is important to apply multiple forms of intervention to completely address the problems caused by headache.

Based upon exhaustive literature review, a multi-specialty consortium (including neurologists, family physicians, internists, emergency physicians, among others) recently concluded four different behavioral treatments are scientifically sound options for migraine prevention:

*  Relaxation training

*  Temperature biofeedback (for hand warming) combined with relaxation training

*  Electromyographic (EMG) biofeedback (for muscle tension reduction)

*  Cognitive behavior therapy (stress management training).

Don’t hesitate to ask your physician about referring you to a qualified professional, and invite your doctor to help coordinate your program of care. In fact, “complementary care” – the rational combination of established drug and alternative therapies – typically yields the best outcomes for patients with stubborn headaches.     Headache  The Journal of Head and Face Pain    May 2014

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