BACK IN THE SADDLE
When I was 16 years old , I had a horse-riding accident . The horse ran under a cement pylon , and the guidewire caught the entire left side of my body , knocking me off the back of the horse . I ’ m now 52 years old , and I have an almost constant headache . My maternal grandmother had headaches , and one of my daughters has them , too . I do notice that certain triggers , such as various foods and especially stress , aggravate my headaches . But I still keep wondering ; could a head injury from my younger years cause me to have migraines even into my golden years ?
It sounds like you have a family history of migraines , and I suspect the head injury was just a trigger that started a pattern to which you were already predisposed . While you certainly would be expected to develop headaches from the head injury , I don ’ t think your headaches are related anymore . A chronic daily headache pattern often will persist even when the original trigger is no longer present . Migraine headaches are a lifelong condition that can become chronic over time if not aggressively managed . This could be related to medication overuse or could just have developed as a pattern over the years .
To help decrease your headache frequency , you
need to try daily preventive medications , stop taking short-acting pain relievers that could be leading to rebound , and maintain a healthy lifestyle by getting plenty of sleep , eating well and exercising regularly , including stretching . Other alternative treatments that might be helpful are acupuncture , biofeedback , physical therapy , herbs and vitamins . Depending on how long the daily headaches have been present and what you have taken in the past , you may now be a candidate for Botox ® for chronic migraines . ( Learn more about this type of treatment in “ Fringe Benefits ” on page 12 .)
Susan Rubin , MD , NorthShore University HealthSystem , Glenview , Ill .
ONE DAY AT A TIME
My wife is suffering from a headache that has lasted for four years . She ’ s tried dozens of different medications , none of which give her any relief . At first , her doctors suspected she had migraine , but they eventually determined that wasn ’ t the case . Then they said it was a “ dead nerve ” and gave her an injection , which did not change anything . If medical practitioners suspect a nerve issue is involved , could they do a nerve block to see if they are correct ?
It is possible that your wife may be suffering from new daily persistent headache ( NDPH ). This is a headache that starts one day and never goes away . Most sufferers can even recall the exact day the headache started and have experienced daily headaches since that time . It typically occurs in a person with no past history of headache .
NDPH is extremely difficult to treat but occasionally will respond to some of the daily preventive medications we use for very frequent migraine and tensiontype headaches . Should these treatments fail , I have had occasional success in treating this condition with greater occipital nerve blocks or with Botox . In fact , the discussion of a “ dead nerve ” makes me suspect that your wife ’ s physician was considering deadening the nerve with a nerve block .
Although NDPH can be difficult to treat , your wife should not give up . The treatments mentioned above are occasionally helpful and should be given a chance .
Ira M . Turner , MD , The Center for Headache Care and Research , Island Neurological Associates , PC , Plainview , N . Y .
Maintain a healthy lifestyle by getting plenty of sleep , eating well and exercising regularly , including stretching .
www . headwisemag . org | National Headache Foundation 9