Delayed Diagnosis, Treatment and Chronic Migraine

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December 16, 2014

Lack of uniform guidelines for applying peripheral nerve stimulation (PNS) to various pain conditions, including chronic migraines, may be the reason many patients don’t receive this proven migraine treatment when it is most needed. According to a recent report on Medscape medical news, the International Neuromodulation Society (INS) enlisted global pain experts to review medical literature with the objective of determining how widely neurostimulation is being offered to treat people with chronic pain.

The medical experts concluded that even though neurostimulation is safe, cost effective and successful for treating pain conditions like chronic migraine, practitioners are still hesitant to recommend this treatment. Migraines and headaches should first be treated conservatively before considering neurostimulators. The president of the INS said “we don’t want people with a few headaches who have not been tried on a triptan or another simple therapy to be implanted.”

He further emphasized, “There is good evidence and proof that this (extracranial stimulation) is helpful in chronic migraine. We want to see it positioned firmly within treatment algorithms.” Practitioners currently wait too long before adding neurostimulators to the treatment strategy and patients suffer needlessly with chronic pain. The INS president added that it should be used prior to using long-term opioid therapy.

In a separate but related research news story, published on Painmedicinenews.com, headache experts presented some interesting, but certainly not groundbreaking, findings about chronic migraines at the 2014 annual meeting of the American Academy of Neurology. They re-confirmed the importance of diagnosing episodic migraines and treating them appropriately, since failure to do so could lead to transformation into chronic migraines.

The presenters noted that for people suffering with the chronic condition, barriers to receiving effective treatment and socioeconomic advancement continue to be significant challenges. For example only about one half of sufferers know that preventative medication is available and chronic migraineurs on average earned less than their episodic counterparts.

It’s clear that getting the right information and best treatment will lead to optimal pain management, without needless suffering and delay that might potentially worsen your condition.

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