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.
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.
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.
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.
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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