| Q: |
Are there other therapies that can work with preventive migraine medications?
| | A: |
There are several preventive complementary therapies for
migraine. Some have been researched extensively and found to be
effective; others have not been researched but have been used for years.
The most recent preventive therapy, which is yet to be approved by the
FDA, is the use of botulinum toxin (Botox) injections. Botox injections
were used for years to treat muscle spasms in the face and neck. It was
found that the treatment reduced the appearance of wrinkles, and it
started to be used for cosmetic reasons. People with migraine began
reporting an improvement in the frequency of their migraine attacks.
Studies have shown mixed results on the effectiveness of Botox for the
prevention of migraine attacks.
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| Q: |
Should I consider getting Botox for my migraine?
| | A: |
As with many complementary therapies, Botox may not be that
effective by itself, but when used with a comprehensive treatment
program it may be helpful. It will not, however, cure your migraine. You
may want to consider Botox injections if an effective trial of
medications along with an aggressive comprehensive approach to your
migraine treatment has failed to reduce the frequency of attacks. Botox
injections can be expensive, and health insurance companies may or may
not cover the treatment. My advice is that a better investment than
Botox would be a treadmill to walk on everyday, as long as you use it
and not allow it to become an expensive clothing rack.
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| Q: |
What is a nerve block for migraine?
| | A: |
A nerve block is an injection of a local anesthetic around a
nerve, causing an area to go numb. Occipital nerve block, for example,
involves an injection around the occipital nerves in the scalp on the
back part of the head. This procedure has not been well studied for the
treatment of migraine.
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| Q: |
How do trigger point injections help migraine?
| | A: |
Trigger point injections are used to help individuals with
headache or with neck and upper back tightness or tension. Small amounts
of salt water (saline) are injected with tiny needles into different
areas of the tense or tight muscles. As with Botox injections, we do not
know how this procedure helps prevent migraine; it may be more helpful
if you just have frequent headaches. The procedure carries with it no
real danger. However, before you make the financial investment it is
important that you have treated your migraine aggressively with
exercise, stress management, the reduction of as many triggers as
possible, and the use of appropriate medication.
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| Q: |
Can biofeedback or relaxation techniques be used to prevent migraine?
| | A: |
The use of a routine relaxation program is a very important part
of your comprehensive migraine treatment program. The use of biofeedback
for migraine prevention has been found to be very effective, especially
in children. Whichever technique you decide to use, it needs to match
your personality and belief system. You may want to experiment with
different techniques until you find the one that brings you the most
enjoyment and relaxation. It is very important that you maintain your
relaxation routine. Relaxation techniques are very helpful, but only if
you practice them regularly.
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