Treatments

16 February 2012

Questions about Botox in the UK

In July 2010, Botox was approved as a preventive treatment for chronic migraine in the UK by the Medicines and Healthcare Products Regulatory Agency. But is there enough evidence for Botox? Should it be offered (funded) by the NHS (National Health Service) across England and Wales?

Medicine watchdog NICE (The National Institute for Health and Clinical Excellence) is saying "not yet". They feel that more data is needed, and they’re asking the makers of Botox (Allergan) to provide it.

Although the people with NICE admit that Botox seems to have some benefits in recent studies, they claim that the benefits have been small – small enough that they could be explained simply by the way the studies were conducted.

Proffesor Carole Longson, director of the health technology evaluation centre at NICE said,"Without this additional evidence, potentially we will be unable to advise the NHS that this drug is good value for money for these adults because there are currently too many uncertainties."

But NICE remains open to comments on their recommendation before they make it official. The deadline will be the 8th of March, after which NICE will put together it’s final guidelines.

The Migraine Trust and The British Association for the Study of Headache prepared a joint statement in response to NICE. As a part of their statement they said:

We know that BOTOX® is effective for some but not all patients who suffer from chronic migraine. We also know that many other preventative treatments are not effective for treating chronic migraine and that they can cause unacceptable side-effects. It would be extremely unfortunate if this treatment is denied to those who have exhausted all other options and those who have responded well to the treatment. The Migraine Trust advocates that this treatment should be made available to those who fail to respond to at least three preventative treatments to have a fair chance to see if BOTOX® treatment will work for them.

Read the full statement here.

15 February 2012

Botox for Migraine – how does it actually work?

James Information, Treatments 31

Botox, or onabotulinumtoxinA, is an emerging and at times controversial treatment for migraine. Many patients have found relief through Botox treatment, although others have found that it wasn’t very helpful for them. Par for the course when it comes to migraine treatment.

But just why does Botox help – at least some patients?

The most obvious answer seems to be the way it relaxes muscles. Certainly if tense muscles were triggering migraine attacks, or if they were a part of the chain-reaction or vicious-cycle of migraine, we would expect to see some relief if those muscles were relaxed.

And that still could be part of the answer.

But the pain of migraine (in fact, even the pain of tension-type headaches), does not come from muscle tension. Sure, it could be a part of the cycle, but is that really enough to explain the relief that many get from Botox?

Dr. Alexander Mauskop from the New York Headache Clinic writes about his observations:

I have seen some patients who would report that injecting muscles around the head eliminated pain in the injected areas, but that they still had pain on the top of the head. There are no muscles on the top of the head and we usually do not inject Botox there, but in those patients who do have residual pain on the top, injecting Botox stops the pain. Recent research has shown that Botox in fact also exerts a direct analgesic (pain-relieving) effect. This is supported by my and other doctors’ observation that Botox also helps other types of pain, such as that of shingles or trigeminal neuralgia.

He goes on to point out that we need some solid studies to confirm what many doctors and patients are seeing.

He finishes by saying that Botox seems to help by reducing the pain messages that are being sent to the brain. Without the flurry of pain messages to the brain, the migraine chain reaction can’t begin. In fact, some patients report that, after Botox treatment, they sometimes feel like a migraine is about to start, but it never does.

If you’ve had Botox treatment, how does this compare with your experience? Leave a comment!

16 January 2012

23 and 1/2 hours: What is the single best thing we can do for our health?

James Information, Tips, Treatments 0

There may be few surprises in the overall message of this video (although some of the details are quite interesting), but we all need motivation… and what a great way to start a Monday!

The author is Dr. Mike Evans. Dr. Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael’s Hospital. Check it out…

22 December 2011

Easy ways to get Nausea-Fighting Ginger

James Tips, Treatments 1

We’ve talked before about how excellent ginger is at fighting migraine-related nausea. But what’s the best way to take it? Just grab a ginger root and start gnawing?

No, there are better ways, and most of them aren’t hard at all. Here are some suggestions:

Buy candied ginger: This has been my traditional method. I buy organic candied ginger and keep it on hand for emergencies. This is probably the most expensive method of the ones we’ll talk about today.
Ginger Chews: Somebody recently gave me a box of Ginger Chews (Gin Gins), and I’m a convert. I don’t want to wait for nausea to hit – I just want to eat them all now. For those who want something less hot than candied ginger, this is a great way to go. Ginger People Original Gin Gins are available at Vitacost. Ginger Chews are also available on amazon.
Make your own candied ginger: Making your own is surprisingly easy – like, really easy. According to the author of this recipe, you may find it hotter than the store bought variety, but it’s a lot cheaper. Read How to Make Candied Ginger
Ginger Ale: The store-bought variety may not have a lot of ginger in it, unless you buy a quality brand. However, there are some great ways to make your own super-yummy ginger ale.

There are other options too – ginger tea, for example. But whatever you do, be sure you have something on hand that you can take for your tummy. You’ll probably be surprised at how well this natural treatment works, which is why it’s gotten the attention of researchers and specialists.

19 December 2011

Exercise Fights Migraine (a study of comparison)

James Discoveries & Stats, Tips, Treatments 2

It shouldn’t be surprising that exercise is a migraine-fighter, but a recent study published in the journal Cephalalgia in October helps to put the benefits in perspective.

Walking – an excellent way to start

The study of 91 women who had migraine attacks with headache 2-8 times per week. The migraineurs were split into three groups. One group was given topiramate (Topamax), the next was put in a relaxation program, and the last group in an exercise program.

Which helped the most?

Over a three month period, with a follow-up of 3 and 6 months. The surprising result was – that all three groups experienced about the same benefit.

Some patients even found that their symptoms dropped by 75% – a remarkable improvement for any kind of treatment of such frequent migraine attacks.

Considering the possible side effects of topiramate and other medications, and the additional and long term benefits of exercise, it’s clear what we should be focusing on here.

I admit I was surprised at the language of the doctoral student who carried out the study, Dr. Emma Varkey. She says,"Our conclusion is that exercise can act as an alternative to relaxations and topiramate when it comes to preventing migraines, and is particularly appropriate for patients who are unwilling or unable to take preventative medicines."

So we take medicines, and if that doesn’t work we go the alternate route of exercise? I think that this study and a mountain of related research should be putting things the other way around. Let’s find wise, safe ways that migraineurs can exercise, and help them long term, instead of taking money out of their wallets and encouraging them to rely on a pill.

For many migraine patients, it’s going to be a combination – exercise, medication, and other treatments such as relaxation techniques. We need to look to long term benefits and treatment as well as short term relief.

Read more about headache and exercise here, and then get started with these Headache exercise tips…

More on the study from Science Daily: Exercise Just as Good as Drugs at Preventing Migraines, Swedish Study Suggests