What's New in Medicine - Treating Chronic Daily Headache

The treatment of chronic daily headaches needs to focus on establishing an effective plan for pain therapy; as well as, addressing factors that may diminish the disability associated with chronic daily headache and the potential development of co-morbid conditions ( Depression, Anxiety, Bipolar disorder).

These measures may translate into better treatment efficacy and satisfaction that result in a decrease in headache burden. Because episodic migraine progresses to chronic daily headache in some individuals, research is increasingly focusing on identifying factors associated with progression, such as specific genetic and environmental risk factors, including co-morbidities.

The assessment of the migraine patient is starting to include an evaluation of risk factors for progression. In addition to the symptom profile, evaluation will increasingly focus on co-morbidities, health-related quality of life, treatment needs, and treatment preferences. Estimation of the risk of progression is now starting to incorporate assessments of co-morbidity, exposures, and eventually biomarkers.

Those with high risk of progression ( four or more migraines per month in adults) will be more aggressively treated, not just to relieve current pain and disability but to prevent progression. Treatment will focus on decreasing current burden and preventing future burden.

References:

Treatment of comorbidities of chronic daily headache.
Ashina S; Lipton RB; Bigal ME. Current Treatment Options in Neurology 2008; 10 (1):36-43

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