Jesse Hyde

ARNP, CRNA, NSPM-C

Pain Management

Migraine pain and what to do about it

By Jesse Hyde, ARNP, CRNA, NSPM-C
Pain Management Clinic at Osceola Regional Health Center

 

In light of June being Migraine and Headache Awareness Month, I would like to discuss chronic migraines along with common characteristics, diagnostic criteria, conservative treatments, and interventional treatments to help ease migraine headaches and symptoms.

 

Characteristics of migraine headache:

  • Throbbing or pulsating pain that often occurs on just one side of your head
  • Moderate to severe pain intensity
  • Usually lasts for 4-72 hours
  • Symptoms such as nausea, vomiting, sensitivity to light or sound, sensitivity to smells
  • Pain is aggravated with routine physical activity

 

Diagnostic Criteria:

Studies suggest that the misdiagnosis rate for chronic migraines is between 50-80%.  This high rate is significant and can lead to both unnecessary treatments and delays in appropriate treatments.  Diagnosing chronic migraines can be difficult as symptoms of migraine can overlap with other headache types.  Patients may also not be fully aware of the prevalence and characteristics of migraine and may not seek medical opinion.  The diagnostic criteria for chronic migraines is as follows:

  • Headache occurring on 15 or more days/month for more than 3 months
  • Headache has at least two of the following four characteristics:
    • Unilateral location
    • Pulsating quality
    • Moderate-severe pain intensity
    • Aggravated by or causing avoidance of routine physical activity such as walking
  • During headache at least one of the following:
    • Nausea and/or vomiting
    • Sensitivity to light or sound

 

Conservative Treatments:

Focus on non-invasive approaches to manage migraine symptoms and prevent further attacks.

  • Lifestyle modifications
    • Weight management
    • Dietary adjustments
    • Hydration
    • Stress management
    • Regular exercise
  • Alternative therapies
    • Physical therapy
    • Acupuncture
    • Transcutaneous electrical nerve stimulation
    • Chiropractic care
  • Pharmacological interventions
    • Wide variety of medications used to prevent migraines from occurring or reduce the intensity once migraines do occur
    • Require consultation with a medical professional

 

Interventional Treatments:

Focus on a mildly invasive procedure to help reduce both the frequency and intensity of chronic migraines.  These are typically considered if conservative treatments such as those listed above fail to reduce migraine symptoms.

  • Botox injection
  • Trigger point injections
  • Nerve blocks
  • Cervical spine interventions

 

If you have been diagnosed with chronic migraines and aren’t finding the relief you need, please contact the interventional pain clinic at Osceola Regional Health Center to schedule a consultation by calling 712-754-5326.  To learn more about interventional treatments for chronic migraine, please join us on June 24 for our Lunch & Learn at 12:00pm which will be held in the multi-purpose room at Osceola Regional Health Center. Reserve your lunch online at www.osceolarhc.org/lunchlearn.