Rethinking Headaches: New Ways Of Treating And Looking At The Common Pain

Headaches are perhaps one of the more ubiquitous health problems, with as many as 90% of U.S. adults suffering through the pain of a pounding head at some point in their lives, according to the National Institute of Neurological Disorders and Stroke (NINDS).

Headaches may be common, but that makes them no less disruptive to a person’s ability to engage in life, work, school, or play. Because headaches affect so many people, researchers continue to investigate causes of headaches and possible ways of treating them. While common types like tension headaches are relatively well understood, more severe types like migraines continue to hold secrets researchers are working to unravel.

Most of the time, headaches do not indicate a more serious medical condition, according to MedlinePlus. In fact, most headaches can be alleviated by managing stress, drinking more water, or improving posture to reduce strain on the muscles that support the head and neck.

Only very rarely are headaches symptoms of more serious conditions, like brain tumors. Despite this, brain scans are relatively common and a controversy has arisen debating their use.

Brain scans: Life-saving or unnecessary cost?

Brain scans are a tremendously expensive enterprise, with about $1 billion in tests conducted each year, reports Health Day. Although federal guidelines don’t call for special brain scans to investigate ordinary headaches, doctors are increasingly calling for the tests.

From 1995 to 2010, the number of patients who underwent scans after visiting a doctor jumped from 5% to 15%. Dr. Brian Callaghan, an assistant neurobiology professor in the University of Michigan Health System, tells Health Day:

“Most people with headaches don’t need any testing.”

Only 1 to 3% of people who undergo brain scans are found to have a more serious health problem, like a brain tumor or malfunctioning blood vessel. Meanwhile, the expense and test anxiety can have a detrimental impact on patients.

Not all doctors agree, and other neurobiologists worry that skipping brain scans could leave some people with undiagnosed brain tumors, according to an article in Neurosurgery.

Nationally, the medical community including groups like the American College of Radiology has worked to raise awareness, urging people to skip brain scans for headaches that don’t include any abnormal symptoms like exceptionally bad pain, slurred speech, changes in vision, or difficulties in moving the arms or legs. In Neurosurgery, authors write:

“Although the intentions are laudable…these guidelines [for reduced testing] are inconsistent with the neurosurgeon’s experience with patients with brain tumor.”

Some patients, the authors write, have more benign-seeming headaches without additional, worrisome symptoms. Doctors warn that identifying brain tumors early increases the likelihood for successful treatment, and add that efforts to save money could cost patient lives.

Helping to add context to this debate, another study published in Neurosurgery found that 75% of neurologists practice defensive medicine, “performing additional tests and procedures out of fear of malpractice lawsuits.” This type of defensive medicine isn’t based on patient need or risk, but on doctors protecting themselves from legal action.

Rethinking pain medicine

Frequent headache sufferers may live on a steady diet of non-steroidal anti-inflammatory drugs (NSAIDs) that can cause ulcers and other gastrointestinal disturbances when taken regularly. A pharmaceutical startup has crafted an ingenious solution to help people avoid that problem: a topical gel.

This new medicine, called Topofen, allows the skin to absorb pain-relieving medication. Because this absorption process skips the GI tract, it saves patients related irritation. The company says this treatment is also targeted. Those experiencing a migraine, for instance, could place the gel directly on the face and neck to send pain-fighting compounds directly into the areas needing it most.

Research has found 77% of study participants experienced pain relief from taking Topofen, reports MedCity News. Although early study results are promising, the drug still needs to clear additional clinical research phases before it’s released to the public. Continue watching this blog for updates about the release.

Medication or meditation?

Researchers continue to probe into the profound benefits of meditation, and research from Wake Forest Baptist Medical Center has identified ways meditation can help headache sufferers reduce pain. Dr. Rebecca Erwin Wills says:

“We’re coming to recognize that meditation changes people’s brains…And we’re just beginning to gain understanding of what those changes mean.”

Meditation prevents atrophy in the hippocampus, researchers say, which is a portion of the brain involved in processing pain and implicated in headache development. Research published in Brain Structure and Function has found stress-related changes in the hippocampus exacerbate migraines, which in turn causes additional damage to this important brain region. If meditation helps to protect the hippocampus, researchers are hopeful this could provide protection against more severe types of headaches.

Erwin Wells’ research found people who meditated for eight weeks experienced shorter and less severe migraines than those who didn’t meditate. Scientists want to continue studying the effect in a greater number of patients and also explore the mechanisms behind meditation’s ability to lessen the impact of migraines.

What really causes headaches?

While a broad array of factors including stress and food may trigger headaches, many causes of headaches are still unknown. Why can some people experience stress or eat certain foods and not experience the painful price of a headache or migraine?

Research from the American Pain Society has linked frequent or severe headaches to mood disorders, especially related to depression or anxiety. Having one of these disorders increases the risk of developing chronic or especially painful headaches by 40%, researchers said. The risk was especially pronounced for people who were diagnosed with the mental health condition before the age of 21.

Meanwhile, having bad headaches or migraines can also impact mental health. People suffering from migraines are more likely to be diagnosed with depression, anxiety, or bipolar disorder, according to the Anxiety and Depression Association of American. Living in daily pain makes it more likely a person will feel depressed or anxious, but fortunately, help in the form of cognitive behavioral therapy or antidepressants may help.

What do you think about researchers’ new ways of treating and looking at headaches?

Image by Matt Brown via Flickr