Patient education
・To make patients understand the basic medical knowledge of headache and the treatment process, to relieve unnecessary worries, and to improve treatment compliance.
-Establishing correct expectations of prevention can help improve treatment compliance.
・Tell patients that some medications may also trigger drug-dependent headache, such as overdose of antipyretics and other medications used in the acute phase.
-If treating acute headache more than twice a week, consider giving preventive treatment to prevent drug-induced headache.
・When developing a treatment plan, involve the patient in the process of determining the plan, including making the patient aware of the advantages and disadvantages of treatment and the characteristics of drug-induced headache.
-Teach patients about acute attack control and preventive treatment.
・Encourage patients to keep a headache diary, including the frequency, duration, and severity of headache attacks, the use of medications and the effectiveness of treatment, and the side effects of medications.
Lifestyle adjustment
・Avoid migraine triggers: Make patients aware of the many factors that may cause migraine attacks.
-Environmental factors include: physical overwork, weather changes, bright light, noise, high altitude areas, etc.
-Lifestyle factors include: changes in sleep patterns, irregular diet, smoking, excessive mental stress, etc.
-Hormonal changes in the body include: menopause, puberty, menstruation, etc.
-Emotional factors include: anger, worry, depression, excitement, etc.
-Drug factors include: nitroglycerin, oral contraceptives or hormone replacement therapy (HRT), etc.
-Dietary factors include: high intake of caffeine, chocolate, alcohol, monosodium glutamate, etc.
・Patients should maintain a regular diet, sleep, and exercise, and pay attention to relaxation and relief of mental stress.
Psychological and behavioral treatment
・Applicable to: willingness to try non-pharmacological prophylaxis; non-response to prophylactic drugs; intolerance of adverse drug reactions or contraindications to drug use.
-Can be used in combination with drug therapy when needed.
・Treatment goals.
-Reduce the frequency of headache attacks and reduce the degree of pain.
-Reduce dependence on medication.
-Reducing the functional impairment and pain caused by headache.
・Relaxation exercises: To train patients to control muscle tension, thought relaxation and/or visual imagery can be used.
-Can prevent migraine attacks to some extent.
・Biofeedback training: Standard temperature and electromyography biofeedback training is commonly used.
-Temperature feedback combined with relaxation training can have some effect.
-It should be guided by trained medical personnel, takes time, and requires the patient’s cooperation.
Cognitive-behavioral therapy: Teach techniques to perceive and control stress.
-Sometimes hypnotherapy is also used.
Acupuncture
Acupuncture: Acupuncture needles are applied to specific “pressure points” to cause the release of endorphins, thereby reducing pain.