Stress and pain go hand and hand, feed off each other, triggering more pain and headaches. One way to help our patients with chronic pain and headaches is to encourage mind/body techniques, like mindfulness, meditation, relaxation, CBT, yoga, Reiki and other modalities. One way to help get it started is to have them actually download … Continue reading App review: WebMAP Mobile, for adolescents with chronic pain
In this post, I will continue the conversation with Sarah Nelson, PhD, pain psychologist. Previously we talked about common psychological issues associated with headache, issues that affect coping and functioning for patients with chronic headache, dealing with resistance to accepting psychological help and barriers to care. What are the best screening measures to use in … Continue reading Psychology and headaches, part 2
Psychological factors are known to play a role in pediatric headache. We know that stress is the #1 trigger for migraine for people of all ages. We also know that stress is a contributor/cause of tension-type headaches (stress headaches). And finally we know that patients with constant/chronic headache often have increased pain and decreased functioning … Continue reading Psychology and headaches, part 1
In my last post I introduced the concept of concussion and the teenager with headaches. I would like to continue this topic by discussing what is helpful for these kids to help avoid disability and too much missed school. The first step we recommend is for them to see their PCP or even the ED … Continue reading Concussion and the headache patient
I have recently reviewed the basics of New Daily Persistent Headache (NDPH) so providers in the community can have a better understanding of this primary headache. It is often misdiagnosed, mainly due to unfamiliarity. And now that you have a better understanding, you will be able to recognize it more readily. One of the most … Continue reading The challenge of taking care of patients with NDPH
I have reviewed factors contributing to tension-type headaches, as well as some preventive strategies. In this post I will cover appropriate rescue medications, and talk about treatment for underlying anxiety, which often needs to be addressed for kids with tension-type headaches. Analgesia is a key part of a rescue strategy for TTH. Non-steroidal anti-inflammatory drugs … Continue reading Tension-type headache strategies
In this case study we’ll look at a fairly straightforward patient, with some twists and turns and decision points along the way. Case Study: Patty is currently an 18 year-old teenage girl with a history of migraine headaches since age 9. You have been seeing her for years, and this is her story. At the … Continue reading Migraine case study, part 3
Here are the case studies with your possible interventions. Case Study #1: Sally is an 8 year-old little girl who you have known since birth. She’s happy and friendly, loves to play soccer and school, especially math. She met all of her developmental milestones, though you do remember that she did have colic as an infant. … Continue reading Migraine case studies, part 2
So your patient has developed chronic migraine, which is defined as 3-4 migraine per week, 15 migraine days per month, and is predictably miserable. Developing chronic migraine does happen in pediatrics, but it happens much more often in older teens and adults. You’ve done what you could to prevent it from happening: did a course … Continue reading Chronic migraine, what to do?
There are 3 groups of medications that are used to treat a migraine attack: migraine abortives, analgesia, and adjuncts. We have covered the migraine abortives (those medications specifically designed to stop the migraine attack) and analgesia (used to reduce pain) in the past 2 posts. There are several medications that are used either in combination … Continue reading Migraine medications to the rescue…..adjunct and combination therapies
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