FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SELF-DIAGNOSIS OF MIGRAINE HEADACHES NEEDS CONFIRMATION BY DOCTOR

Question: I have headaches every day. I've tried everything for them, but none of the medicines seem to help very much. What is a good medicine for migraines?

Answer: Almost everyone has a headache from time to time. Most of us have ones that are brief and comparatively mild. A change of activity or a non-prescription pain medicine is usually all that is necessary to bring relief. Unfortunately, not all of us have infrequent, brief and mild headaches. About 45 million Americans have severe, disabling ones.

There are several conditions that can cause this type of serious headache, including the specific condition you cite -- migraine. About 6 percent of men and 18 percent of women have migraine headaches. Typically, the pain starts on one side, but the entire head may become involved as the condition progresses. The pain is usually throbbing and intense, and physical activity, bright lights or noise frequently makes it worse. Nausea is also a very common complaint with migraine headache.

For many migraine sufferers there are additional "warning" signals originating from the nervous system. Flashing lights, unusual smells, numbness or tingling, or even the inability to move a body part occurs before and/or during the headache. These additional symptoms usually go away when the headache abates. Unfortunately, this may take hours or even days.

Your headaches may or may not actually be migraines since most people use the label to describe any headache that is sufficiently severe to interfere with normal activities. To doctors, the term "migraine" has a very specific meaning and refers to headaches caused by spasm and then dilation of the arteries inside the head. Other causes of daily headaches can include arthritis in the neck, anxiety and depression, rebound from frequent use of pain medicine, and withdrawal from caffeine.

Because there are so many possible causes of recurring headaches, it is really important to see your doctor for an accurate diagnosis. If your headaches are due to one of these other factors, the treatment will be different than if you are discovered to suffer from migraine headaches.

For migraine sufferers, as strange as it may sound, we live in a wonderful time. There are presently a large number of drugs available to treat migraine. Some of these are used to reduce the frequency of headaches while others are taken to stop the pain once a migraine has started. In the last few years there have been six new products approved by the Food and Drug Administration for the treatment of migraine, and there are at least ten more that are currently under investigation. These products complement the list of previously approved prescription and non-prescription products.

Each migraine medicine is effective at giving relief for some migraine sufferers. Unfortunately, no drug has been discovered that is always effective for all people with migraine. Therefore, under the guidance of your doctor, you may need to try several different medicines before finding the single one or combination that works for you.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.