Migraine is treatable, but…

Migraine is treatable, but…

There’s an effort within Migraine advocacy to promote the message that Migraine is treatable. Technically, this is true. In reality, the answer is much more complicated. Migraine is treatable just like heart disease, cancer, or diabetes are treatable. Most patients receiving first-line treatments respond well. They take the prescribed medications and adjust their lifestyle to accommodate their disease with minimal interruption to their daily lives. Yay for modern medicine!

Then there are smaller groups of patients that don’t fare so well. They simply don’t respond to the recommended treatments. It is tempting to blame the patient for not following through on the treatment plan. That may be true for some, but not all. Modern medicine isn’t perfect.

So yes, migraine is treatable

Those treatments work best under the following circumstances:

Researchers found that getting access to this kind of treatment is so difficult than only a fraction of those with Migraine can even get an accurate diagnosis.

Sure, there is a problem with public education

Less than half the people with Migraine ever talk to their doctor – not even once. These aren’t the patients who have “tried everything” and given up. These are people who self-medicate with OTC medicines and never ever mention the problem to a doctor.

YIKES.

But why should they? Their odds of getting a correct diagnosis is only about 25%. Most primary care physicians lack the skills to accurately diagnose any headache disorder. On the off chance the doctor gets it right, only 44% will walk out with an appropriate treatment plan. It’s simply not enough to write a script for Imitrex. That’s not good migraine management.1

It’s not the doctors’ fault either

How well do you think you would do with only 4 hours of training on headache disorders? Primary care physicians see a lot of patients with a lot of health problems. It’s not realistic to expect them to be experts on every single problem.

Enter, the specialist

In theory, that’s a great idea. Not knowing the difference between a headache specialist and a general neurologist, a doctor will likely refer patients to the closest neurologist. The time between identifying the problem and finally getting to a neurologist may take years. By that time, the patient could have developed Medication Overuse Headache, Chronic Migraine, or both.

The window of opportunity for early intervention is long gone. The patient had better hope that neurologist is a headache specialist. Otherwise, it could many more years of failed medication trials and a gradual worsening of the problem.

So yes, migraine IS treatable

  • If the patient knows to seek help when the attacks are mild and infrequent.
  • If the doctor knows how to diagnose it properly
  • If the patient is offered a multi-faceted treatment plan.

Even then, there are no guarantees for success

The problem of migraine treatment is much bigger than just creating public awareness with some purple ribbons and a Twitter feed. We need systemic change.

  • Medical schools that actually prepare doctors to treat this widespread disease
  • Lawmakers who are willing to make research funding for migraine a priority
  • Health care systems that routinely screen for migraine and direct patients to appropriate care
  • Insurance providers that will actually pay for the needed treatments
  • Labor laws that specifically include migraine as a protected disability
  • Public service campaigns to educate the general public
This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
Dodick, David W., MD; Loder, Elizabeth W., MD; Adams, Aubrey Manack, PhD; Buse, Dawn C., PhD; Fanning, Kristina M. Fanning, PhD; Reed, Michael L., PhD; Lipton, Richard B., MD. "Assessing Barriers to Chronic Migraine Consultation, Diagnosis, and Treatment: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study." Headache: The Journal of Head and Face Pain Volume 56, Issue 5, pages 821–834, May 2016.

Comments

View Comments (10)
  • Natalie D
    12 months ago

    After years and years of being shuffled around from neurologist(s) to family care docs to physical therapist, I FINALLY found a legitimate headache doctor. He sympathizes and empathizes with everything a migraineur goes through and tries every possible solution. But, by far the best thing he is doing is training about 5 family practitioners to recognize the signs of migraine and be able to treat it properly. Truly, had I been diagnosed 20 years earlier at my family doc, it would have saved years of time spent in bed, missing work, missing family events and missing out on life in general. I am by no means cured, but I am hopeful.

  • kimmersutphin
    1 year ago

    My katamine infusions have helped but out of pocket so…. wish I could get medical majawanna but that would be out of pocket too. Had to go on disability 4 years ago. Giving up my dream job.

  • wappaw
    1 year ago

    This article is pretty close to my life. I have had migraines since 1972. I originally associated them to weekends on the shores of Lake Michigan, playing and drinking. By the time I would get home my head was pounding and the ice pick was stabbing behind my right eye.
    I probably went 10 years with these conditions, with the 3 – 5 migraines every two months. Nothing ever confirmed by a doctor.
    Then I started having more frequent migraines, waking up with severe head pain. That started months, if not years, of different doctors and test, just ruling out some identifiable problem, all while the frequency and pain ramped up, and emergency room visits became more frequent. I lived on Vicodin and other pain killers. All I did was work and sleep

  • wappaw
    1 year ago

    Continuing on:
    I continue on until about 2008 before actually being diagnosed with migraines. It wasn’t until 2015 before I started receiving Botox injections, which helped reduce the frequency of headaches, and the level of pain.
    Now that I recently retired, the amount of Imitrex my insurance will cover has been reduced, and the cost of my Botox has tripled. Looking forward to my golden years with migraines…

  • RRMother
    1 year ago

    And even if the neurologist is a “headache specialist,” it still doesn’t mean they actually understand. I got a referral to one last week and was told that the doctor requires every patient to sit through a 2 hour class prior to making an appointment with her. I can barely get out of bed! You expect me to sit through a 2 hour class just to hear all the usual stuff about headaches, then wait three months to get an appointment with you??

  • SMRHoover
    1 year ago

    I have a very big problem with this article: it says nothing about the people who suffer from migraines that are simply not treatable – except to control the pain when one hits. I have had migraines for 45 years, have tried dozens of preventatives, lifestyle and diet changes, triptan rescue medications, Botox. Nothing works. I am left with narcotics and anti-nausea medications when a migraine hits. So why does this article leave people like me out? Most likely because the medical world doesn’t want to admit that there are people they simply can’t help. And that’s a pretty sad thing.

  • litoria76
    1 year ago

    I’m in the same boat – chronic migraine (25/30 days per month) and have tried every known treatment. My neurologist has given up on trying to determine what is causing them and new treatments. I get 30 Percocet per month to treat the pain, nothing for the nausea. I’ve been on Percocet for at least 4 years so I have a tolerance and need 2 for a few hours of relief. I’m also trying to get disability but have been denied twice, had my appeal denied, and am waiting for a hearing. It’s impossible for me to work with the frequency and nature of my migraines. I’m considering going to see a headache specialist but am afraid they won’t prescribe my Percocet and I’ll lose the one thing i know gives me some relief.

  • DonnaFA moderator
    1 year ago

    Hi SMRHoover. I’m so sorry to hear that you feel discounted by the article. We never hope to do that and want all of our members to feel supported and represented. Each article is written from the author’s perspective of their personal experience, and each of us likely has a slightly different take away from each, based on our own personal experience. Myself? I see the author’s frustration that people assume that just because there is treatment everyone experiences relief, and what we need to experience acceptance and advancement for all of us.

    We do have many articles that you might like to browse which discuss intractable migraine. I hope these help with the information you are seeking. If not, please feel free to share subjects or perspectives you would like to see covered and I’ll be happy to share with our creative team. We’re glad you’re here! -Warmly, Donna (Migraine.com team)

  • Luna
    2 years ago

    Funding for research to find out more about the mechanisms of how the migraine actually starts and progresses would help to create better treatment options. Too much of what passes for treatment is prescribing a mix of drugs until they hopefully find something that actually helps. There really aren’t that many migraine specific drugs and they only help a usually too small percentage and too often the side effects are difficult.

  • Luna
    2 years ago

    Just read this article at Headway. Very interesting.
    http://headacheandmigrainenews.com/migraine-genetics-what-if/

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