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Worsening Trends in Headache Treatment Among Physicians – Finds Study

Headache TreatmentHeadache refers to chronic pain or a throbbing sensation occurring in any region of the head. The pain may occur on one or both sides of the head, radiate across the head from one point or isolated to a certain location. This condition can be triggered by a wide range of factors such as depression, over stress, lack of sleep, sinus infections, minor head injury, vision problems, viral infections and many more. Headaches caused due to depression or overstress may not be dangerous to your health but those caused due to migraine or sinus infections can be a symptom of a serious condition resulting in severe and debilitating pain.

Reports show that an estimated 12 percent or 36 million Americans revisit their physicians each year for headache complaints resulting in an economic loss of $31 billion each year due to lost productivity, medical expenses and absenteeism. Making significant lifestyle changes such as regular exercise, adequate sleep and dietary changes can help to manage migraine symptoms effectively. However, a new study reports that physicians are increasingly ordering advanced medical tests and providing referrals to specialists instead of focusing on offering counseling to patients on how changing their behavior could relieve their pain.

The study was conducted by researchers from Beth Israel Deaconess Medical Center (BIDMC) and results were published online by the Journal of General Internal Medicine. As part of the study, researchers evaluated more than 9000 physician visits for headaches between the years 1999 – 2000. It was found that physicians rather than identifying the potential causes and sources of relief from pain are increasingly suggesting advanced imaging tests and specialist referrals both of which provide little value in a diagnosis for this condition. An increased trend for imaging tests, medications and referrals was found along with less counseling. The highlights of the study include:

  • An analysis of 144 million patient visits found a persistent overuse of low value and high cost services (such as advanced imaging, as well as prescriptions of opioids and barbiturates).
  • A significant increase was registered in advanced imaging such as CT scans and MRIs, from 6.7 percent of visits in 1999 to 13.9 percent in 2010.
  • Clinician counseling reported a reduction from 23.5 percent to 18.5 percent between 1999 and 2010.
  • The use of acetaminophen and non-steroidal anti-inflammatory drugs remained stable at 16% of the medications. On the other hand, anti-migraine medications such as triptans and ergot alkaloids usage increased from 9.8 percent to 15.4 percent.
  • The use of preventive therapies such as anti-convulsants, anti-depressants, calcium channel blockers and beta blockers increased from 8.5 percent to 15.9 percent.

The study results signify that physicians are increasingly ordering advanced imaging techniques and making specialist referrals for headaches rather than suggesting significant lifestyle modifications to patients.

Following a healthy lifestyle integrated with regular exercise and a healthy diet may help patients to better manage their pain associated with migraine. At a multi-specialty healthcare center, patients can benefit from the services of pain management specialists. A detailed discussion with them regarding the actual nature of the problem will help them adopt a treatment modality on that basis. Established healthcare centers provide specialized and effective treatment modalities such as prolotherapy, radiofrequency radio ablation, physical therapy, Transcutaneous Electrical Nerve Stimulation (TENS), and administration of muscle relaxants for headache management.

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