It’s a bit of everything – 4 big pillars – things that make a change:
#1. Education is key.
#2. Choose the right medication for them – preventive or acute. In regard to prevention you must treat the main problem - and take into consideration comorbidities. **Sleep** make sure people really are able to sleep well and have a good mood too. If very anxious or depressed this may influence their perception of the treatment, how they’re feeling and their perception of pain.
#3. It is a neurovascular disorder – think about the vessels – hypertension – try to stabilize blood pressure. Preventive treatment is focused.
#4. Acute treatment – avoid opiates – know when the right time with which drugs is, and what the options are if it doesn’t work. And that you have to give them resources.
Physicians are taught to treat acute pain, not chronic pain. She teaches – prevention and then acute comes last.
She sees that this is where her patients focus their attention but all the rest is SO important. If the prevention is right, the idea is not to have acute attacks.