Pain specialists take into consideration the frequency and severity of headache, the results of previous therapy and diagnostic tests, and previous drug use, along with any other diseases that might affect treatment choices. If headaches are relatively infrequent, patient education directed at stress management and a trial of analgesics or nonsteroidal anti-inflammatory drugs is usually successful. Frequent headaches are often treated with prophylactic antidepressants, such as Elavil. Some patients require further assistance in breaking the pain cycle, such as biofeedback, cervical epidural steroid injections, other drug regimens, and psychotherapy. The pain is frequently described as throbbing or pounding, often settling behind one eye, and may appear every few days or only once in 6 months.
Victims are more often female, with a strong family history.
Typically, attacks last for 4-24 hours with nausea, vomiting, diarrhea, light and sound sensitivity, and possible aura present. For treatment to be effective, it must be initiated at the first sign of a migraine. A variety of drugs are used, including Midrin, Imitrex, intravenous lidocaine and anti-nausea medications. Prophylactic drugs for migraine include beta blockers, calcium channel blockers, and antidepressants. The pain physician carefully evaluates previous treatment, tests and the patient s history in order to diagnose the type or types of headaches for most successful treatment.