Friday, August 17, 2012

Treating Migraine

Pain Clinic
Patients with chronic pain conditions such as migraines are sometimes referred to a pain clinic by their GP. A consultant in chronic pain management explains what chronic pain is, different types of pains and what treatments and procedures may be offered at the pain clinic

Menstrual migraines

Menstrual migraines usually occur within two days either side of the first day of a woman’s period. If menstrual migraines are a problem, they can be prevented using either non-hormonal or hormonal treatments.
The non-hormonal treatments that are recommended are:
  • non-steroidal anti- inflammatory drugs (NSAIDs) - a widely used type of medication that helps reduce pain
  • triptans - medicines that reverse the widening (dilation) of blood vessels, which is thought to be a contributory factor in migraines
Hormonal treatments that may be recommended include:

During an attack

Most people find that sleeping or lying in a darkened room is the best thing to do when having a migraine attack.
Others find that eating something helps, or they start to feel better once they have been sick.
There is currently no cure for migraines. However, a number of treatments can be used to ease the symptoms.
It may take time to work out which is the best treatment for you. You may need to try different types or combinations of medicines before you find the most effective ones.
If you find that you cannot manage your migraines using over-the-counter medicines, then your GP can help.

Painkillers

Many people who have migraines find that over-the-counter painkillers, such as paracetamol and aspirin, can help to reduce their symptoms.
When taking paracetamol or aspirin, always make sure you read the instructions on the packaging and follow the dosage recommendations. Children under 16 should not take aspirin unless it is under the guidance of a healthcare professional. Aspirin is also not recommended for adults who have, or have had in the past, stomach problems, such as a peptic ulcer, liver problems or kidney problems.
Some people find that the painkiller codeine makes migraine worse. This can be because it increases the nausea associated with the migraine.
Taking any form of painkiller frequently can make migraine worse. This is sometimes called 'medication overuse headache'.
Painkillers are usually the first treatment for migraine. They tend to be more effective if taken at the first signs of a migraine attack. This gives them time to absorb into your bloodstream and ease your symptoms.
Some people only take painkillers when their headache becomes very bad. However, this is not advisable because it is often too late for the painkiller to work. Soluble painkillers (tablets that dissolve in a glass of water) are a good option because they are absorbed quickly by your body.
If you cannot swallow painkillers because of nausea or vomiting, suppositories may be a better option. These are capsules that are inserted into the anus (back passage).
If over-the-counter painkillers are not effective, your GP or specialist may prescribe you a stronger painkiller.

Triptan medicines

If ordinary painkillers are not helping to relieve your migraine symptoms, triptan medicines might be the next option. Some triptan medicines, such as sumatriptan, are available without prescription over the counter. Others require a prescription from your GP.
Triptan medicines are not the same as painkillers. They cause the blood vessels around the brain to contract (narrow). This reverses the dilating (widening) of blood vessels that is believed to be part of the migraine process.
Triptans are available as tablets, injections and nasal sprays.
Triptan medicines only work for some people. If one type of triptan medicine does not seem to work, ask your GP about other types.

Anti-inflammatory medicines

Some people find that anti-inflammatory medicines such as ibuprofen are effective in treating the symptoms of migraine.
You can buy ibuprofen over the counter at a pharmacy, and it is available on prescription. However, do not take ibuprofen if you have, or have had in the past, stomach problems, such as a peptic ulcer, or if you have liver or kidney problems.
Diclofenac, naproxen and tolfenamic acid are anti-inflammatory medicines that are only available on prescription.

Anti-sickness medicines

If nausea is a symptom of your migraine, you can take anti-sickness medicines. These are prescribed by your GP and can be taken alongside painkillers.
As with painkillers, anti-sickness medicines work better if taken as soon as your migraine symptoms begin. They usually come in the form of a tablet, but are also available as a suppository.

Combination medicines

You can buy a number of combination medicines for migraine over the counter at your local pharmacy. These medicines contain both painkillers and anti-sickness medicines. If you are not sure which one is best for you, ask your pharmacist.
Many people find combination medicines convenient. However, the dose of painkillers or anti-sickness medicine may not be high enough to relieve your symptoms. If this is the case, you may prefer to take painkillers and anti-sickness medicines separately. This will allow you to easily control the doses of each.
Ask your GP or pharmacist if you are not sure which medication is most suitable for you.

Migraine clinics

If you are not responding to treatment or your migraines are not being well managed, your GP may refer you to a specialist migraine clinic for further investigation. Reasons for being referred include:
  • doubt over the diagnosis of migraine
  • a rarer form of migraine is suspected
  • other headaches besides migraine are present
  • treatment is not working well for you
  • your migraines or headaches are getting worse and/or more frequent

Treatment for pregnant women

In general, migraine treatment with medicines should be limited as much as possible when you are pregnant or breastfeeding.
If medication is essential, then your GP may consider prescribing you a low-dose painkiller, anti-inflammatory or anti-sickness medicine for the shortest possible time. Aspirin and triptans should be avoided.

1 comment:

  1. Pretty cool post. It’s really very nice and useful post.Thanks for sharing this with us!it’s my first visit.
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