Health magazine offers ways to cut down on migraines, including Botox

Cefaly and botox work in children and teens as well. - JR

Health magazine describes migraine cures including a forehead band, diet choices and Botox. (BIGSTOCK)

By Nancy Szokan September 8

People who suffer migraines know that not even the best medicines may get rid of all the pain all the time. “Preventive medications help 50 percent of patients by about 50 percent,” Sheena Aurora, an associate professor of neurology at Stanford, tells writer Aviva Patz. In September’s edition of Health magazine, Patz suggests three of the “more promising, less traditional” alternative therapies that can be used along with drugs or by themselves as part of a migraine-relief strategy. And she includes comments from both clinical specialists and migraine sufferers. They are:

Cefaly: This is an FDA-approved band, worn across the forehead, that electrically stimulates the trigeminal nerve, said to be where migraine pain begins. Worn for 20 minutes a day (whether the user has a headache or not), Cefaly reduced monthly migraine days by 30 percent among participants in a study published in the journal Neurology last year. A tester for the magazine reported she used to get three to five migraines a week; in the four months after she started using Cefaly, she had only two. 

Elimination diet: Some foods are known to activate an inflammation response that triggers migraines. The most common of these triggers are red wine, aged cheese, cured meats, MSG, dairy, artificial sweeteners, chocolate and gluten. Clinics typically recommend cutting out all these foods for six weeks, see if you feel better, then add them back into your diet one at a time to see which ones may cause pain. “Not all migraine sufferers have food sensitivities, but for those who do, eliminating a problem food can cut headaches by 50 to 60 percent,” says Merle Diamond of the Diamond Headache Clinic in Chicago. Consult a doctor before beginning this.

Botox: If it can relax facial muscles to smooth wrinkles, scientists wondered, could Botox also dull migraine pain? Studies published in early 2010 reported that migraine sufferers who received Botox injections experienced a major decrease in the number of headache days; later that year, the FDA approved the drug as a treatment for chronic migraine. A tester for the magazine reported that not only did Botox help her headaches, but the effect lasted longer after successive treatments. Insurance should cover the costs, Patz says. Warning: Potential side effects include bruising and neck pain.

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Long-term treatment for headache sufferers

Electric stimulation of the peripheral nerve has shown long-term effectiveness for reducing the intensity of headaches for chronic headache sufferers.

For the more than 45 million Americans who suffer from chronic headaches, relief may be on the way in the form of an electric pulse, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting. Electric stimulation of the peripheral nerve reduced average headache intensity by more than 70 percent.

With electric stimulation of the peripheral nerve, a thin insulated wire is implanted in the back of the head (occipital nerve) or in the forehead above the eyebrow (supraorbital nerve) and delivers electric pulses to block pain. The study looked into the safety and long-term usefulness of this treatment.

"Despite advances in headache treatment over the past two decades, many people do not get adequate pain relief from current treatments, or they cannot tolerate the side effects of the medications," said Billy K. Huh, M.D., Ph.D., professor and medical director of the Department of Pain Medicine at The University of Texas MD Anderson Cancer Center, Houston, and adjunct professor of the Department of Anesthesiology at Duke University Medical Center, Durham, N.C. "This treatment offers hope to those patients and a chance for a major improvement in quality of life."

The study monitored 46 patients who received peripheral nerve stimulation between 2005 and 2012. Follow-up phone interviews were conducted to determine subsequent headache intensity, frequency of headaches per month, complications and overall satisfaction with the treatment.

The study found that both headache intensity and frequency decreased significantly. The average headache intensity was reduced by more than 70 percent. The average number of "headache days" decreased from 28 to 14 per month. Ninety percent of patients were satisfied with the treatment, with one reporting more than eight years of reduced headache intensity and frequency.

A drawback of the treatment is its relatively high level of complications, which include electrode migration, equipment problems and infection. The study authors state that as physicians gain experience with implantation techniques, complications will decrease.

"This is a real breakthrough for chronic headache sufferers," explained Dr. Huh. "For patients with no other options to relieve their pain and suffering, this treatment is a way for them to get their life back."

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