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
So it’s been just 1 year since I started this blog, posting regularly every 2 weeks. That was one of my intentions for 2018 and I am so glad I made it happen. I have learned a lot more about headache management in the process. I also learned that I do actually know a lot … Continue reading Gratitude
Over the past year, I have covered many issues and situations in the care of kids and teens with a variety of headache diagnoses. What is the common denominator for all of them? SCHOOL! And your patient can find themselves either very supported or very challenged (or somewhere in between) in the school environment and … Continue reading School and the patient with headache
So in the past few posts I have talked about the effect of a concussion can have on a patient with an existing headache diagnosis. Now let’s take a look at a classic headache clinic presentation as case study. I am using a composite of patients and situations, commonly seen in primary care. Background: Joe is … Continue reading Migraine and concussion case study
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
In this post, I am going to introduce you to another primary headache, new daily persistent headache (NDPH). This primary headache is not often seen in primary care, but I think our clinic population has about 25% of teens with this diagnosis. There’s a good reason why a referral to a specialty headache program is … Continue reading Introducing……… New Daily Persistent Headache
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
So you have diagnosed your teenaged patient with tension-type headaches, what are the next steps to prevent and treat them? The same questions apply to TTH as to migraine: Does this patient need a preventive or daily medication? What is the rescue plan? And even more importantly, what about the lifestyle factors that can trigger … Continue reading Tension-type headache treatments
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