Cure for Headaches

There is not a day that goes by that I don’t hear from a patient about an obscure new treatment . . .  or even cure for headaches.  These treatments or cures are nowhere on the worldwide headache research radar (which I follow very closely). These new cures are virtually always based on very simple concepts of what’s causing the headaches. Therefore the whole claim, regarding the cause and easy cure, is very attractive to patients. It is even more palatable if the “cure” is claimed to “natural.”

I understand why this would grab patients’ attention. I wish that headache disorders had a simple cause . . . with a simple remedy . . .  more than anyone.

I have to walk a delicate tightrope when I discuss these other treatments. I want to support what we call CAM (complementary and alternative medicine) the best I can.  There are studies that show the subtle benefit in headache treatment of 1) acupuncture, 2) a few specific supplements (riboflavin, magnesium, Co Enzyme Q 10 and butterbur), 3) aerobic exercise and 4) weight loss. But there are many people out there promoting headache cures that are not much more than scams or rumor mills. The Internet is notorious for this.

I would stay out of the discussion, but I’ve seen patient after patient losing money on miracle cure vitamins, “toxin-cleansing” treatments, magnets, electrical hats, devices for the mouth and the list goes on and on.  If prostitution is the world’s oldest profession then selling fake medical treatments must be the second oldest.  If the issue was simply the patients throwing their money away, I guess I would just leave it up to them. However, there is an even greater tragedy and that is what I would call therapeutic distractions.

Over the years I’ve seen countless patients who have terrible headaches and have pursued just about every “natural” treatment possible, and with no benefit. They come to see me, seeking a very simplistic explanation, such as something that could be tweaked, or an allergy to black mold, or something that they can visualize and change and then be cured forever.  When I try to explain what we do know about headache disorders and the treatments that have been proven to work, they simply don’t believe me.

While we don’t know everything about headaches, we certainly know a lot more than we did thirty years ago when I started in this field.  Most of what we know is from the results of really smart and sincere people, such Dr.  Michael Moskowitz and his team at Harvard.  However, the more we learn the more complex the disease seems to be. We have also learned a great deal about what works and what doesn’t work. But unlike asthma or diabetes, there isn’t one treatment that works for everyone.

In the situation of what I call “therapeutic distractions” the patient doesn’t want to do any of the things I suggest.  Instead, they jump from fad to fad in headache treatment, just like those wanting to lose weight follow fad diet after fad diet without lasting results.  It breaks my heart when these patients come back in a year, still with the same, intense headaches and I make recommendations, yet, once again they want to try some unproven cure that they read about on the Internet or a friend told them about. Then off they go again, maybe stopping by again in a year, still no better.

There are no headache cures. Many people simply get better over time, but there are no treatments that render someone headache free for life. The best treatments that we know work for about 65% of patients.  Anyone who states that they help more than that, it is simply not true.  Something that works for 70% of headache patients would be the major article in every headache journal in the world and a candidate for the Nobel Prize in Medicine. If someone makes the claim that a particular supplement, cleansing, manipulation, electrical device works for headaches and wants you to pay for that, demand to see the studies that prove that it works. A good study has at least 100 patients and a thousand are better. It must be “double blinded” meaning that neither the researcher nor the study subjects know who has the real treatment and it must be placebo-controlled, meaning that half of the test subjects were given a fake treatment for comparison.  Testimonials have very little scientific validity. Anyone who supports the claim of their treatment with testimonials alone, usually has something to hide.