A team of Dutch researchers has debunked previous theories about the cause of migraine pain, and proven that this pain does not originate inside the brain. Specialists and doctors can read this breakthrough article published by Schoonman et al (Brain 2008). There is also an interesting television interview and informative newspaper coverage on the subject.
This proves the assertions of Dr Elliot Shevel of The Headache Clinic in South Africa, who in his pioneering work has firmly maintained that migraine pain is not caused by the blood vessels in the brain. Although sufferers feel as though the pain is originating inside their skull, it is in fact caused by those parts of the face, head and neck that lie outside the skull. Fortunately for headache and migraine sufferers, this means that the structures that cause this pain are easily accessed and can be treated successfully and often cured without medication.
Essential principles of headache and migraine diagnosis and treatment
The first step in determining the best treatment is to diagnose where the pain is coming from. The structure or structures that are causing the pain signals must be correctly identified. This is why a "multidisciplinary assessment" is necessary: A neurologist, for example, would examine the nervous system and brain, a maxillo-facial specialist the facial structures, a physiotherapist the muscles, a dentist the occlusion, an ENT the sinuses, etc. A "multidisciplinary assessment" draws upon and integrates the expertise of an array of specialists. While normally, an individual doctor or specialist would try to treat a headache patient within a specific discipline, The Headache Clinic combines their expertise into a single comprehensive body of knowledge.
This assessment includes a comprehensive examination of the structures usually involved in this pain, namely:
- The head and neck muscles to ascertain whether there is abnormal tension present
- The external carotid vasculature to determine if an arterial element is causing the pain
- The nerves of the scalp
- The patient’s specific history and diagnosis will determine the development of an individual treatment programme. Using the techniques developed at The Headache Clinic, most patients can be treated successfully without the need for medication.
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