Essay Sample on Primary Headaches

Introduction

Presentation of primary headaches varies for the various types of conditions that most patients encounter. For a cluster headache, patients experience trouble that is frontal which is frequently associated with tearing. (3) For tension headaches, the distribution of pain is band-like covering the frontal, temporal and occipital areas. Patients often describe it as a headache that is associated with a feeling of pressure around the head (3). Migraine headaches are frequently unilateral but may occur bilaterally. They are throbbing in nature and may be associated with other symptoms such as nausea and photophobia. The pain may be very severe thus incapacitating the patient or interfering with their daily activities. (3)

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Primary headaches are managed using several classes of drugs but nonsteroidal anti-inflammatory drugs are the first line of treatment in most cases. If they do not control the symptoms, one may use tricyclic antidepressants, triptans, and dihydroergotamine. (3) In acute exacerbation of symptoms, use of opioid analgesics such as morphine is advisable. For migraines, a patient known to have the primary headache condition may be given prophylaxis when they are symptom-free to reduce the rate of recurrence of symptoms.(3) The agents used include tricyclic antidepressants, beta blockers and some anticonvulsants. (3) Most medics and other healthcare professionals prefer to use therapeutic agents in their practice. When one uses other modes of treatment, they serve as an adjunct therapy to the medicinal treatment that is often mainstream.

Complimentary medicine for headache may be in the form of nutritional intervention such as taking herbal extracts, manual therapy as in acupuncture, and traditional medicine from Chinese practice as well as strategies to improve mind and body awareness. (4) There are several documentations concerning the benefits of complementary medicine for the traditional Chinese therapies of acupuncture, meditation, biofeedback massage, and yoga. These forms of treatmentare helpful for migraine and tension headaches. (4) Some other types of therapy like manipulation of the spine, hydrotherapy, diet alteration, and chiropractic care also have good outcomes for migraine headaches. (4)

There are several benefits of using complementary medicine. The first advantage of using complementary medicine as outlined above is that they have an excellent safety profile, with few documented adverse effects. (5) The approach used is also holistic, and it promotes participation of the patient in their healthcare, and so it is a right approach for chronically ill patients. (6) Complementary medicine methods also have disadvantages. There is no standardized way of practicing therapies or dispensing medicine. (7) Therefore, patients who are seen by practitioners of this form of medication may end up receiving overdose or under-dose for whichever agents in use. Besides that, there is no formal training for individuals who practice alternative or complementary medicine. As such, there is no way of deciding who would be the best person from whom a patient will gain maximum benefit.

The evidence in support of using alternative medicine is very compelling. A meta-analysis of research on the effectiveness of using alternative extracts like coenzyme Q10, alpha-lipoic acid and riboflavin as a form of complementary medicine showed that the outcome was good for some specific types of headaches. Some of the forms of complementary medicine have an excellent scientific background and evidence that they are beneficial. (7), (8) Behavioral therapy and biofeedback is one of the most used adjunct treatment in hospital settings for patients suffering from migraines which are refractory to treatment (9).There is not much documentation of adverse effects associated with the complementary medicine for headaches.(10)

Conclusion

In conclusion, primary headaches are conditions characterized by pain or discomfort in the head, which are not attributable to any other pathology. Patients with these headache disorders are usually chronically ill. (10) The main points to be noted by pharmacists in the approach of such a patient are as follows:

• There is a significant role for pharmaceutical therapy among these patients
• Pharmaceutical therapy is used in conjunction with complementary medicine to elevate the quality of care for the patient. Complementary medicine has a documented advantage in the management of this condition.
• There is no cause for alarm in the use of complementary medicine currently as it has no documented adverse effects. The purpose of complementary medicine will therefore not interfere with any other pharmacological treatment.

References

1. Anderson, P. Migraine New headache classification system published. [Internet]. [Place unknown]: Medscape; 2013 [Updated 2013: Cited 2013] available from https://www.medscape.com/viewarticle/807334

2.Benoliel R. and Eliav, E. Primary headache disorders. Dent Clin North Am. 2013: 57(3): pp 513-539

3. Raval T. Facial pain and headache. [Internet]. [Place unknown]: Medscape; 2019 [Updated 2019 Jan, 11: Cited 2019] available from https://emedicine.medscape.com/article/1048596-overview

4. Millstine, D. Chen, C.Y. Bauer, B. Complementary and integrative medicine in the management of headache [Internet]. [Place unknown] : The BMJ; 2017[ updated 2017: cited 2017 May, 16]. Available from https://www.bmj.com/content/357/bmj.j1805.long

5. Chawla, J. Migraine headache treatment and management [Internet]. [Place unknown]: Medscape; 2019 [Updated 2019 Jan, 31: Cited 2019] available from https://emedicine.medscape.com/article/1142556-treatment#d14

6. Chawla, J. What are the advantages and disadvantages to complementary and alternative medicine (CAM) therapies for the prevention of migraine headaches? [Internet]. [Place unknown]: Medscape; 2019 [Updated 2019 Jan, 31: Cited 2019] available from https://www.medscape.com/answers/1142556-171309/what-are-the-advantages-and-disadvantages-to-complementary-and-alternative-medicine-cam-therapies-for-the-prevention-of-migraine-headaches

7. Lie, D.A. Chronic headache: Is a CAM therapy worth a try? [Internet]. [Place unknown]: Medscape; 2019 [Updated 2013 Aug 27: Cited 2013] available from https://www.medscape.com/viewarticle/809809

8. Blanda, M and Sargeant L.K. Tension headache. [Internet]. [Place unknown]: Medscape; 2017 [Updated 2017 Nov,21: Cited 2017]. Available from https://emedicine.medscape.com/article/792384-treatment

9. Lopez, J.I and Bechtel K.A. Pediatric headache [Internet]. [Place unknown]: Medscape; 2019 [Updated 2019 Jan,2: Cited 2019]. Available from https://emedicine.medscape.com/article/2110861-overview

10. Elmer, G.W. Lafferty, W.E. Tyree, P.T and Lind, B.K. Potential interactions between complementary/alternative products and conventional medicines in a medicare population. Ann Pharmacother. 2017: 41(10): 1617-1624