Chronic Headache: Is a CAM Therapy Worth a Try?

Désirée A. Lie, MD, MSEd

Disclosures

August 27, 2013

In This Article

What Would You Do?

Case 1: Tension-Type Headache

A 38-year-old single woman with chronic tension-type headache (TTH) for 5 years presents to your office seeking your opinion as a second opinion. She reports that she has attempted to treat her headaches with episodic analgesics and relaxation therapy consisting of yoga and meditation. The TTHs occur on most weekdays, often starting in the evenings; they can last as long as 1-2 days, requiring that she miss work 1 day per month on average. She describes her headaches as moderately severe, interfering with her social and work life.

The patient is on no regular medication. She is otherwise healthy, lives alone, and is well supported by friends and family. She reports that her job as an administrator does not cause excessive stress. Her neurologic examination is normal. She had a normal CT scan of the brain 2 years earlier, during a period when her headaches were particularly severe.

She is here to ask for your opinion on use of magnesium and coenzyme Q10, which she read about on the Internet, for reducing the frequency and intensity of the headaches. What do you recommend?

Case 2: Chronic Migraine Headache

A 45-year-old otherwise healthy married man with chronic migraine and a family history of migraines has tried prophylactic medications, including beta-blockers and verapamil. He continues to have migraine exacerbations regularly, requiring use of acute abortive agents. He describes the migraine headaches as moderately severe and sometimes incapacitating, often interfering with both his job as a car dealer and his family life.

The patient does not smoke, eats a healthy diet, has a low caffeine intake (1 cup of coffee daily), and exercises regularly. He would like to try acupuncture and hyperbaric oxygen as preventive therapies, as his current prophylactic regimen is ineffective. Are these options safe alternatives for him?

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