Headache, Migraine and Facial Pains
Headache has been a headache for patients and numerous treating doctors. In general this is a disease of the sensitive, intelligent, responsible individual with a type A personality with a major contribution from stress. This puzzling pain condition causes considerable suffering, loss of productivity and affects quality of life. Treatment includes management of migraines, and headaches with their origins in the neck- Cervicogenic headaches. In our experience by the time patients of migraine seek active help their neck is additionally involved already. The muscles attaching the head to the neck and parts of neck to the body are invariably involved. Migraine headache is usually hereditary cause an unbearable pain on one side of the head. It leads to severe headaches.
The associated symptom may then include vertigo dizziness, nausea vomiting and visual disturbances. It is also our experience that the distress from a headache can at times be so severe that there is a sympathetic discharge with palpitations, sweating raised blood pressure restlessness etc.
The clinical picture may vary from the occasional headache to splitting attacks of migraine which may be proceeded by warning signs (aura). These attacks are triggered many times by stress, hunger, sleep deprivation, overwork, exposure to the sun, certain foodstuff, periods, travel, morning alarm etc. Occasionally, headaches could be a warning sign for serious rise in the pressure inside the skull which may need to be investigated in detail, and referred to an appropriate specialist if the need arises.
Any treatment plan has to include stress management for sustained success
In consultation with different specialties, we aim to give our patient the best chance of preventing an attack of headache, and learning to minimize the impact of headache on the social, physical and emotional quality of life.
Treatment options may include
Counseling for coping practices pacing of activity , and most importantly recognition of stressors etc. In this context yoga and pranayama are of immense value. Certain pranayamic practices appear to be custom designed for migraine. These are taught in addition to the stress reduction practices.
Acupuncture is very useful for aborting impending attacks. The patients are taught these points so that they can treat themselves before the attack becomes serious.
With this they feel empowered.
Interventions in migraine,: IMS, is the single most important intervention that addresses migraine logically .We at ashirvad owe our success in Migraine patients to IMS
Nerve blocks : Injection of steroid around the nerves that carry pain sensations from the head and face can be used in refractory pains .
Injections into the Neck like trigger injections, Botox injections into the muscles of neck Simple physical therapy, Is a constant feature of migraine management iin our clinic.
The region of the face may be involved in severely disabling conditions like Trigeminal neuralgia, glossopharyngeal neuralgia, Post herpetic neuralgia, Temporomandibular joint dysfunction, dental pains, Cancer pains, post surgery pains etc. in which pain reaches severe intense levels not responding to simple pain killers.
Treatment for such severe cases may include
Simple treatment like IMS
Injections and Radiofrequency ablation of the Trigeminal Ganglion,
Injections of Sphenopalatine ganglion,
Injections of stellate ganglion, etc
Injections of minuscule doses of Botox into deep muscles of the face.
Along with medications and rehabilitation strategies, these may offer effective pain relief in such cases.