Three weeks ago I attended the scientific meeting of the American Headache Society, as I have for each of the past twenty years. It is the most important headache research meeting in the world. There were several bits of research that caught my attention. One was the profound role that placebo treatment works and even the role of expectation has on success. If a patient has a high expectation that a treatment will work, then it has a much better chance of working. On the other hand, if they have apprehension and fear about a treatment, such as medications, then they are far more likely to experience side effects. These aren’t just imaginary side effects (or benefits in the case of the former) but real. The brain is a very powerful organ and can change us.
The other, and somewhat disturbing, statistic was that almost 45% of patients who were evaluated at a headache center never returned for a second visit. You can only speculate as to why but the study seemed to imply it was because they didn’t like what they heard.
I can imagine how much a patient hopes to find someone who can look at their headache problem and tell you it is a simple fix. You have an allergy to a certain food, you need glasses, you atlas bone is twisted or your saliva test says that you have adrenal insufficiency and some natural supplements will cure you.
Then you come to our evidence-based headache centers, where we base everything we know on what the research tells us. Our answer are very complex and inconclusive. The solutions are also complex with a long program of trial and error until you get well.
The sad thing is that more than 80% of headaches sufferers can be 80% better and the early quitters miss out on that. But they do have to be patient until we find what works safely for them. Maybe we can do a better job in encouraging patients to allow us the change to help them get well.