HeadWise HeadWise: Volume 1, Issue 1 | Page 11

BACK IN THE SADDLE When I was 16 years old, I had a horse-riding accident. The horse ran under a cement pylon, and the guidewire caught the entire left side of my body, knocking me off the back of the horse. I’m now 52 years old, and I have an almost constant headache. My maternal grandmother had headaches, and one of my daughters has them, too. I do notice that certain triggers, such as various foods and especially stress, aggravate my headaches. But I still keep wondering; could a head injury from my younger years cause me to have migraines even into my golden years? including stretching. Other alternative treatments that might be helpful are acupuncture, biofeedback, physical therapy, herbs and vitamins. Depending on how long the daily headaches have been present and what you have taken in the past, you may now be a candidate for Botox® for chronic migraines. (Learn more about this type of treatment in “Fringe Benefits” on page 12.) Susan Rubin, MD, NorthShore University HealthSystem, Glenview, Ill. ONE DAY AT A TIME My wife is suffering from a headache that has lasted for four years. She’s tried dozens of different medications, none of which give her any relief. At first, her doctors suspected she had migraine, but they eventually determined that wasn’t the case. Then they said it was a “dead nerve” and gave her an injection, which did not change anything. If medical practitioners suspect a nerve issue is involved, could they do a nerve block to see if they are correct? It sounds like you have a family history of migraines, and I suspect the head injury was just a trigger that started a pattern to which you were already predisposed. While you certainly would be expected to develop headaches from the head injury, I don’t think your headaches are related anymore. A chronic daily headache pattern often will persist even when the original trigger is no longer present. Migraine headaches are a lifelong condition that can become chronic over time if not aggressively managed. This could be related to medication overuse or could just have developed as a pattern over the years. To help decrease your headache frequency, you need to try daily preventive medications, stop taking short-acting pain relievers that could be leading to rebound, and maintain a healthy lifestyle by getting plenty of sleep, eating well and exercising regularly, It is possible that your wife may be suffering from new daily persistent headache (NDPH). This is a headache that starts one day and never goes away. Most sufferers can even recall the exact day the headache started and have experienced daily headaches since that time. It typically occurs in a person with no past history of headache. NDPH is extremely difficult to treat but occasionally will respond to some of the daily preventive medications we use for very frequent migraine and tensiontype headaches. Should these treatments fail, I have had occasional success in treating this condition with greater occipital nerve blocks or with Botox. In fact, the discussion of a “dead nerve” makes me suspect that your wife’s physician was considering deadening the nerve with a nerve block. Although NDPH can be difficult to treat, your wife should not give up. The treatments mentioned above are occasionally helpful and should be given a chance. Ira M. Turner, MD, The Center for Headache Care and Research, Island Neurological Associates, PC, Plainview, N.Y. Maintain a healthy lifestyle by getting plenty of sleep, eating well and exercising regularly, including stretching. www.headwisemag.org | National Headache Foundation 9