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Treatment of Daily Persistent Headache Requires Perseverance

Q. I am suffering with new daily persistent headache. My headache began Jan. 21, 2012, and I have had it every day since. From what I have read, my situation is like others who have this condition. Medications do not seem to work, so I have continued to try new ones via a neurologist who specializes in headaches.  All tests are clear–MRI, MRA, MRV, CT scans, blood work and spinal tap. I have occasionally tried alternative methods–Botox, occipital nerve block, chiropractic care, naturopathy, Chinese herbalism, massage, yoga, Thai yoga therapy, none of which helped with the headache either.

I have read that this can last from months to decades.  Is there any current information on the most successful approaches to make the headache go away?

A. New daily persistent headache can be very challenging to treat. Very little can be gained by excessive testing or desperate, unproven remedies. Over the years, I have learned that this type of headache has no short-cut remedy. The typical approach, from an experienced headache specialist, will involve many medication tries, and the main idea is to not give up. There is always something else that can be tried.

Remember, all medications used for this type of headache are “off label” because there are no FDA-approved remedies for this type of headache. Also, when dealing with this type of headache, your doctor needs to take all associated conditions into consideration, such as anxiety, depression, insomnia, sleep apnea and others. The most successful plans include the treatment of the total package. If your doctor does not feel comfortable in these domains, perhaps someone else can help you.

Edmund Messina, MD, FAHS
Medical Director
Michigan Headache Clinic
Arbor Medicus, LLC
East Lansing, Michigan

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