99% will get a headache sometime – 7.1 billion people.
90% will get a headache this year – 6.45 billion people.
About 16-17% will have a migraine attack sometime – 1.18 billion people.
About 3% have chronic migraine (15+ headache days per month) – 215 million people.
Headache and migraine a serious problem? You decide.
Cluster headache researchers have been interested in treatments focused on the sphenopalatine ganglion for the past few years. The sphenopalatine ganglion is a nerve center which seems to be key in the symptoms of cluster.
In the past, this ganglion has been targeted by drugs which basically keep the area from feeling pain. Other treatments actually aim to destroy it.
These methods have brought relief to some, though not all sufferers.
Now there are ongoing tests of a device to stimulate the sphenopalatine ganglion using a small implanted device. The device may be controlled by the patient, and so used on demand.
This is in some ways preferable to strong drugs or an irreversible surgery. But, of course, although minimally invasive it’s still surgery.
But with the severe limitations of treatment for cluster, this is one to watch. It’s a treatment that’s still very new, and still being studied. But so far, the results are good.
Even patients who have been rather unsuccessfully treated in the past for cluster found that this treatment was a big help, significantly lowering their pain and increasing their quality of life. Although it doesn’t seem to work for everyone, the fact that it’s helping a significant number and that it is a treatment that will likely be improved with study is very encouraging.
Some researchers have wondered if the same treatment would work for migraine. A small study suggested that it may help some migraineurs as well, which could be good news for those who have not yet found good treatment.
For more information, read:
Dr. Paul Spector, certified Health Fitness Specialist and director of Pantheon Medicine, wrote a fascinating article which appeared in the Huffington Post earlier this month (Women in Pain). In the article, he challenges the way that women with chronic pain are treated in the health field.
It’s the same old debate, in a way. We all want to see men and women treated “the same”, in the sense that they both get quality health care. On the other hand, getting “the same” treatment must mean that men and women are treated differently, simply because they’re physically different.
 |
Some of those differences are, of course, partly cultural. For example, men may be more reluctant to show weakness. Which means women are more open and more likely to tell their doctors about pain. Which could mean that women are perceived as “over-reacting” or “emotional”, when in reality they may just be coping better. Which means they may not be taken seriously.
Dr. Spector suggests four ways in which women are different:
Dr. Spector is actually responding to a discussion from the Centers for Disease Control and Prevention, the CDC Telebriefing on Deaths from Prescription Painkiller Overdoses Rise Sharply Among Women. In the discussion, Dr. Thomas R. Frieden (director of the CDC) suggests that, although men are more likely to die from an opioid overdose, the gap is narrowing.
What seems to be happening is that women are being prescribed more and more opioids (think methadone, codeine, hydrocodone, oxycodone, and meperidine).
Most of these deaths are not intentional – we’re not talking about an increase in suicides. Sometimes it would be an intentional overdose, or a mix of drugs or drugs and alcohol, etc, that would end in a death. There could also be situations when someone is sharing drugs with someone else.
From the standpoint of headache disorders, in the widespread problem of migraine disease women are more likely to have migraine. Both men and women can be stigmatized, there’s no doubt. But from a strictly anecdotal standpoint, it certainly seems like many women are written off and ignored in a way that I never have been.
Because of the prevalence of migraine in women, it does tend to be studied more than migraine in men. And that’s only natural.
But maybe there are problems with treatment for both genders – for different reasons and in different ways.
Do you feel that you’ve received poorer treatment because of your gender? How do you think doctors could do better? If you’re a doctor, what have you seen? What have you done to ensure that a woman or man with a headache disorder gets the treatment they need?
Does the “Sea-Band” and other so-called anti-nausea bracelets actually work to fight migraine nausea? Dr. Zoltan Medgyessy of the Berolina Clinic in Germany thinks so, and so do many migraineurs.
At last month’s International Headache Congress in Boston, Dr. Medgyessy reported on a study which involved the bracelets. Patients in the study had significant migraine symptoms, including nausea. Instead of taking nausea medication, they used a Sea-Band.
The Sea-Band, and other similar bracelets such as the Psi Band, use acupressure. Acupressure is a concept that comes from Chinese religion and philosophy relating to Qi or Chi. Qi is believed to be a living energy that permeates all things, usually connected with a kind of pantheism (in simplistic terms, everything is god).
More recently the medical world has shown interest in acupressure believing that pressure in certain parts of the body are certainly therapeutic. This could be partly because of the way that pressure to certain parts of the body release endomorphins, which can fight pain.
In spite of the benefits of touch that are well known, showing in scientific studies that therapies like acupressure work has been a challenge.
In this study, 83% of patients saw a reduction in nausea, although some nausea generally remained. 44% saw a “significant” reduction. Almost all the patients said that they would use the Sea-Band again.
Who wouldn’t want a drug-free, reusable (cheap!) treatment like that?
On the other hand, there are some serious limitations in the study itself.
First, remember that less than half saw a “significant reduction”, and we’re still not talking about actually getting rid the nausea.
The other problem is that there was no control group in this study. The placebo effect is high with any study – and we already know that it’s high in things like acupressure. For example, anti-nausea bands work a lot better for people who “expect them to work” when it comes to cancer nausea.
Would it work just as well to have a little wrist massage? Human touch instead of a device? Or do anything that you think may work?
It’s very likely that the numbers will be a lot lower in a controlled trial.
Of course most would continue using them. Few things are more disabling than migraine with nausea – it’s easy to grasp at anything, especially if it’s said to be “safe”.
But we need to see more studies to show that a device works better than human touch or other types of non-drug treatment.
Also, we need to encourage people to get complete treatment of migraine, not to just focus on symptoms.
More on the study:
In a massive study led by an international team of researchers, 5 new genetic regions linked to migraine have been discovered.
 |
And when I say massive, I mean massive. Researchers working with the Wellcome Trust Sanger Institute took the results of 29 different genetic studies, involving over 100,000 samples from both migraine patients and controls.
So in plain numbers, what was discovered?
Now, imagine that migraine involves a web of factors, including genetic factors. You can’t just say that “this one” causes migraine, and change it. You have to understand how things are linked together – how they impact each other – how they interact.
And that’s just what these researchers are doing. For example, 8 of the 12 regions were related to maintaining healthy brain tissue and function.
Some also related to an issue called oxidative stress. This relates to the body’s ability to detoxify and heal.
This is “early release” information – just a teaser – because the work is far from done. The research will be continuing, and will only be half done by the end of 2014.
But working together (patient, doctor, researcher), we will likely come up with a lot more insight into migraine even before that.
For more, read: Getting to grips with migraine