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Avoid chronification: what really helps against headaches

Avoid chronification: what really helps against headaches


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What is the best way to relieve headaches?

Headaches are an extremely common complaint that can have very different causes. Often, chronic pain develops from pain that initially appears for a short time, although the use of headache tablets can also play a role. To alleviate the pain, measures should therefore be used that do not pose a risk of headache chronification.

"What many do not know: The excessive use of painkillers can trigger independent headaches that can become chronic," reports the German Society for Clinical Neurophysiology and Functional Imaging. V. (DGKN) in a current release. Inadequate pain relief should also be assessed as a risk factor for chronic headaches. The correct approach to the headache is therefore required.

2.5 million Germans have chronic headaches

According to the DGKN, almost 2.5 million Germans suffer from chronic headaches. This means that they have symptoms on average every other day. It is a "headache that occurs on at least 15 days a month for at least three months", says the private lecturer Dr. med. Charly Gaul from the Migraine and Headache Clinic Koenigstein im Taunus in the DGKN press release. The suffering for those affected - for example due to inability to work and reduced social participation in life - is considerable.

Over the counter medicines are the first choice

People with headache often use over-the-counter medication that they take without consulting a doctor. However, the risk of unpleasant side effects is often underestimated. Many are not aware that the regular use of painkillers can trigger independent headaches that can become chronic, reports the DGKN.

Effectiveness must be checked

In addition, according to the society, in doubt, the effectiveness of the medication taken must always be checked by a doctor, since inadequate pain relief is also a risk factor for chronic headaches. "It is also often not adequately checked whether the prescribed or recommended acute medication is effective at all," said Dr. Gaul. Those affected who consider their acute medication to be effective are at lower risk of chronification than those who judge their acute medication to be insufficiently effective.

Possible risk factors for chronic headaches

“If simple painkillers or so-called non-steroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (aspirin), ibuprofen or diclofenac are taken on 15 or more days, or if opioids, triptans, ergotamines or painkiller preparations are used for more than ten days, the risk of headache chronification increases significantly "Explains Dr. Chronification is particularly common for people with concomitant mental illnesses, overweight and lack of exercise. Furthermore, taking other medications such as sedatives and the presence of other chronic pain disorders (e.g. chronic back pain) are also a risk factor. Last but not least, women suffer from chronic headaches more often than men.

Preventive measures are appropriate

For headaches that occur not only occasionally, but regularly or even frequently, Dr. advises Go for preventive measures. Measures that are proven to be effective include cognitive behavioral therapy, regular endurance sports and relaxation procedures such as progressive muscle relaxation according to Jacobson, yoga and meditation. A number of medications are also approved for preventive use.

Medicinal prevention options

According to Dr. This applies, for example, to beta blockers, tricyclic antidepressants and anticonvulsants (valproate, flunarizine and topiramate) in migraine prevention. Botulinum toxin is also used to treat chronic migraines and the so-called off-label use (without specific approval) of candesartan for migraine prophylaxis is also an option. Furthermore, the antibody erenumab has been available for the prophylaxis of migraines in adults with four or more migraine days per month since November 2018.

The best effect in the treatment of headaches shows a combination of behavior change, classic relaxation measures and the preventive use of medication, according to Dr. The specific options for the therapy and prevention of chronic headaches and migraine attacks will also be discussed at a press conference of the DGKN on Thursday, March 28 in Freiburg. (fp)

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