It’s estimated that 12 percent of Americans get migraine headaches, women are three times more prone to as men. The American Headache Society published new recommendations in the November-December issue of the journal Headache.
According to new guidelines, prescription pain medications should not be the first treatment for migraines. Doctors shouldn’t consistently order unnecessary brain scans for patients with these severe headaches.”Our aim is to encourage doctors and patients to think carefully about medical care that can be harmful or unnecessary,” said Dr. Elizabeth Loder, president of the American Headache Society. Opioid painkillers like OxyContin and Vicodin, and the barbiturate butalbital pose serious long-term risks.
The risk of dependency associated with these drugs is evidenced by the growing epidemic of prescription painkiller abuse in the United States. Nearly three out of four prescription drug overdoses are caused by opioid painkillers, according to the U.S. Centers for Disease Control and Prevention.
Using too much of these pain medications can also lead to a condition called medication overuse headache, said another expert. “This ends up being a second problem patients have,” Loder noted. “There is a lot of research that opioids actually increase the sensitivity to pain in the head. Medication overuse headaches are difficult to treat ” said Dr. Rebecca Erwin Wells, assistant professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, N.C.
In addition, brain scan studies should not be performed on patients with stable headaches that meet criteria for migraine. Also, CT scans should not be used in a non-emergency situation as a diagnostic tool for headache patients when MRI is available. “MRI can diagnose more conditions that may cause headache that CT scans can miss. Unlike CT scans, MRIs use powerful magnets and do not expose patients to radiation. “MRI is of better value and safer,” Loder explained.
Headache specialists also said that surgery targeting migraine trigger points is still experimental and is not recommended. “We lack sufficient evidence to say the benefits of surgery outweigh the potential harms or that it is even helpful,” Loder cautioned. Before new drugs can be approved for use, they must go through rigorous testing that meets a certain standard, she added.
Contact your family physician if you need help controlling your symptoms and managing your pain due to migraine headaches.