Get relief from migraines

By Dr. Isadore Rosenfeld

About 10% of Americans -- some 30 million of us -- get migraines. These disabling headaches can develop at any age, and they strike three times as many women as men.

Doctors believe their migraines are due to a change in certain chemicals in the brain that regulate blood vessels and inflammation.

Beta-blocker drugs – effective in treating high blood pressure, angina and heart rhythm irregularities – are often prescribed to prevent these headaches.

But the most important advance for reducing pain is the triptan family of drugs, which inhibit the action of serotonin, the neurochemical involved in pain control. These medications come in tablets that you swallow or are dissolved under the tongue, injections and nasal sprays – but they probably should not be used by anyone with angina or other cardiac problems.

Studies now suggest that combining a triptan drug with a nonsteroidal anti-inflammatory agent can be even more effective than either one alone. A new medication with this formulation is under review by the Food and Drug Administration.

Source: Parade magazine, Oct. 7, 2007

Injury to the neck vertebrae can cause headaches

By Megan Rauscher

In rare cases, injury to the vertebral disc in the lower neck will not only lead to neck pain and pain radiating into the arm, but also to headaches, the results of a new study indicate.

Prolapse of a vertebral disc in the lower part of the neck (cervical spine), a condition sometimes referred to as a "slipped disc," is known to cause a variety of symptoms.

The cervical disc protrudes and compresses a portion of the spinal cord, causing pain that may limit neck movement. The pain radiates through the shoulder into the arm, and numbness or paralysis of the fingers may also occur. Now, investigators add headache to the list of possible symptoms.

Their report indicates that the headache, along with the other types of pain, "improves or resolves after successful surgery," Dr. Hans C. Diener of University Duisburg-Essen, Germany, told Reuters Health.

Therefore, patients with a headache that coincides with neck pain and pain radiating into one arm should undergo MRI of the cervical spine, Diener said.

In the journal Cephalagia this month, Diener and colleagues report that 12 of 50 (24 percent) patients with disc prolapse in one of the lower cervical discs complained of new-onset neck pain and headache, compared with 2 of 50 (4 percent) another group of patients with a disc injury in the lower back.S

Seven of the 12 (58 percent) patients with headache fulfilled 3 out of 4 International Headache Society criteria for cervicogenic headache (or headache emanating from the upper spine). The headaches in the two patients with the lower back injuries did not meet these criteria.

As mentioned, the physicians also found that removal of the prolapsed disc by surgery led to a significant reduction or disappearance of pain and headache in 80 percent of patients. The pain was relieved 1 week after surgery and was still gone after 3 months, they note.

Diener's team points out that cervicogenic headache caused by irritation or pressure to the upper cervical disc has been "well described." The current findings now suggest that pain in the lower cervical roots can converge with other nerves to cause pain extending through the arm and into the head, the researchers conclude.

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