From diagnosis to treatment, how to cope with the chronic nature of migraine headaches

Migraines are unpredictable. They can be triggered by bright and flashing lights, strong odors or scents, heat, extreme cold, poorly ventilated rooms, and noise.

Anyone who suffers from migraine headaches will agree that this type of head pain is not like a typical headache. A migraine can stop ones daily routine for a day or more when the pain strikes, despite medication or natural remedies administered to the patient.

Migraines are one of the most diagnosed illnesses associated with pain. But how do you know you suffer from a migraine and not just an ordinary headache? It would help if you understood the stages of a migraine and the various treatments available for you at Jaffe Sports Medicine.

Types of Headaches

Chronic headaches are not always considered migraines. Instead, the type of headache you have is determined by the associated symptoms and where the pain is located. Types of headaches range from a migraine headache, cluster headaches, tension headaches, and common cold or sinus headaches.

If you have widespread head pain, some neck pain, and the pain is considered a 5-6/10 on a rating scale, the headache is likely associated with tension. If you have not experienced visual disturbance, nausea, vomiting, or light sensitivity, the headache is probably a tension headache and will go away in an hour or two.

If your eyes are red and watery, or you’re experiencing facial pain, you could be having a typical sinus headache. The sinus headache symptoms can often mirror a cluster headache; however, with a cluster headache the pain is moderate to severe and lasts longer.

Head pain caused by a sinus headaches tension headache  is annoying and feels dreadful, but often, the pain is quickly relieved with an over-the-counter headache remedy. However, if you experience the stages below, it’s safe to assume you have a migraine headache.

Stages of a Migraine

Migraines are often associated with warning symptoms leading up to the attack. With a migraine, the nature of the headache will include stages. These stages may or may not produce pain. The symptoms are varied and can range from mild mood swings to severe and debilitating pain, which almost always lasts from 24 to 72 hours.

Prodrome: Migraine symptoms may begin suddenly or over one or two days leading up to the headache. The symptoms of onset in the prodrome stage will include changes in mood, fatigue, neck pain, and sometimes food cravings.

Aura: The aura stage will include tingling sensations in the arms and legs and sometimes facial areas, as well as the inability to gather thoughts or speak in complete sentences.

You may also notice visual disturbances called “floaters,” which can severely affect the ability to see for a long time. Just know these floaters will subside, and you will have no problems with vision once the migraine has run its course. We understand that there may or may not be head pain associated with the aura stage, depending on how quickly the migraine progresses.

Attack: The attack stage is when the actual pain occurs. Along with pain, you can expect nausea, vomiting, possible fainting, and throbbing head pain. Our patients often describe that they will need to lie down in a dark room with no sounds or light until the pain subsides once the headache begins. The pain/attack phase can last several hours but the duration is often reliant on if you have taken medication to relieve pain.

Recovery: Once the pain subsides, you will likely feel fatigued, despite the numerous hours you may have slept. The recovery stage can last up to 48 hours. After that, you will slowly regain strength, and your functions will feel more restored.

Treatment Options

There are many treatment options available for those who suffer from diagnosed chronic migraines.

Medications are available to treat migraines once they occur, and some are even available to prevent migraines from occurring. In addition to these medications, Botox injections have been helpful for patients and some antipsychotic medications.

For those who prefer a more holistic approach, supplements such as magnesium, Butterbur, CoQ10, and Feverfew have been noted to help prevent migraines. In addition to supplements, practicing the methods of stress management, better dietary choices, and yoga are effective treatment options.

Other options include acupuncture and physical therapy that promotes progressive muscle relaxation techniques that Jaffee Sports Medicine can prescribe for you.

At Jaffe Sports Medicine, our physicians will perform an initial evaluation before beginning treatment for your chronic headaches to determine what methods to use for your headache relief. Our multidisciplinary medical center is comprised of experienced and caring doctors that provide the best care in head pain relief. With the most advanced diagnostic and therapeutic tools currently available, our medical professionals can analyze your headache and find the best course of action to improve and relieve your pain and discomfort.

TEXT BY M. HIATT

With every strain and sprain is a recovery period, and physical therapy is often the pathway to recovery.

If your strain or sprain is not a persistent problem or a possible reinjured impairment, healing can be achieved with at-home therapy and rest. However, if you are experiencing constant pain, swelling, immobility in the affected area, you will need to be evaluated for a possible deeper problem.

In a situation of injury or post-surgery, physical therapy is the prescribed method for regaining your motion and restoring balance to your body. These are the four most significant benefits of physical therapy.

No Pain No Gain

Did you know that by performing physical motions that you can prevent the need for surgery at times? We know the old saying “no pain no gain” is a cliché, but sometimes surgical intervention can be avoided by going through the painful motion of physical therapy first.

You may hear your doctor mention the term “conservative treatment,” which means your doctor wants to try the first option, physical therapy, to help reduce pain and regain the affected region’s mobility. Perhaps there will be no need for surgery.

Of course, we understand there are circumstances when conservative treatment will not work, and you will need surgery regardless. We will be here for you when you are ready to start the process of physical therapy.

Practicing Stretching Techniques

We know it is not easy stretching the pain away, but we also know that stretching is the best medicine to restore motion to your joints and muscles in small doses. These small doses will ultimately become motions that build strength and endurance.

Consider this—after surgery or an injury, rest is necessary. However, if you continue to rest the injury, scar tissue begins to form like cobwebs and soft tissue contracts.

Stretching regularity will knock down the cobwebs and get you back in action. So, if you want to restore the range of motion or maintain a good range of motion, you must make a regular habit of keeping your muscles and tissues loose.

When you make good habits of stretching, you ensure that scar formations do not hold you back. Practice makes perfect, so be sure to practice the stretching technique at home that one of our PT specialists or doctors has prescribed for you.

Training for Strength

To strengthen your beautiful bones, you must strengthen the muscle and tissues around the bone, which is especially true as you age.

Strength exercises will help improve your muscle’s function and improve strength, endurance, and help you achieve a better range of motion.

We will work together to strengthen your core, which is essential for building strength in the back and pelvis. The core is also the heartbeat of balance.

If you have had surgery or are working with an injury, our doctors work with the physical therapy team to create a physical therapy program for you. Each program assesses your current ability and sets an ultimate end goal for you.

Improve Balance and Prevent Falls

Several injuries can prevent good balance, including leg, hips, pelvis, back, knees, ankles, and feet. Poor balance and fall risk can also occur from muscle weakness, sedentary lifestyle, sitting at a desk working all day, aging, and joint stiffness.

Good posture is paramount in keeping good balance; however, maintaining a stable and upright position when standing, walking, and even sitting can be problematic for older people or people with injuries.

We will assess your posture and teach you exercises to improve your ability to maintain proper posture.

Our physical therapist will prescribe active movement techniques and exercises to help your affected body system. We will also discuss hazards in your home that increase your risk of balance problems are falling, such as a throw rug, poor lighting, or an unrestrained pet, or other possible objects.

By learning the technique and importance of good posture and strengthening the appropriate muscles, we can help you achieve better balance and prevent falls.

Our physical therapists work individually with each patient to ensure that your health and wellness goals are met. At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery.

To schedule an appointment with our physical therapists or sport medicine therapists, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT

Jaffe Sports Medicine is pleased to offer a minimally invasive procedure for our patients who experience severe back pain or spinal deformities. Pain and deformities can occur due to a number of possible diagnoses, including cancer or osteoporosis. With imaging and further testing, we can begin to evaluate your condition and determine if you are a possible candidate for kyphoplasty.

Diagnosis and Surgical Factors

Before learning more about kyphoplasty, it is important to know what conditions and diagnoses are associated with this type of surgery. Most common are diagnoses such as osteoporosis and spinal tumors associated with certain cancers.

Osteoporosis is the loss of calcium from bones, which results in weakened bone structures throughout the body. In some patients, osteoporosis increases the risk of fractures of the vertebra.

When the vertebral body is fractured, there will be a noticeable collapse occurring at the Thoracic Spine, thus producing a wedge; more familiarly known as a “hunch-back” appearance. What is happening here is the vertebral body is shortened in height and spinal alignment is then shifted.

There are additional serious health problems that are associated with this type of curvature, including chronic and severe pain, reduced mobility, and reduced lung capacity. Osteo fractures such as this make it five times more likely further fractures will occur.

Though osteoporosis is the most common cause in fractured vertebral bodies, cancer with associated spinal tumors can also cause fractures that lead to the need for corrective measures.

As the tumor(s) grow, the fractures occur. The tumor will of course require treatment and/or removal, however, Kyphoplasty is a viable option for treating the fracture and preventing further injury to the vertebral body.

Understanding the Kyphoplasty procedure and the benefits.

Kyphoplasty, also known as vertebral augmentation, is a minimally invasive surgical procedure for treating osteoporosis fractures. As discussed, these fractures may occur because of conditions such as osteoporosis or trauma.

Kyphoplasty is a minimally invasive procedure that includes injecting acrylic bone cement into the spinal fracture through a hole in the skin. The cement-like materials are injected directly into the fractured bone with a needle or thin tube. The cement works to stabilize the fracture, which provides immediate pain relief in many cases.

To be more specific, the needle or thin tube, once inserted into the damaged vertebrae, is tipped with a balloon. The balloon is inflated to create a cavity in which bone cement will be injected.

The balloon is deflated and removed, and the bone cement is then injected into the cavity. The cement mixture hardens in about 10 minutes. The entire procedure will probably take less than an hour, though it may be longer if more vertebrae are treated. Your doctor will use your X-ray as guidance while performing the procedure to ensure accuracy.

You will be under general anesthesia throughout this minimally invasive procedure.

Afterward, you may experience soreness in the area for a few days, but you will likely be symptom-free and will not need to do physical therapy or rehabilitation. You will spend some time in recovery after the surgery, however, you will likely go home the same day, but will need someone to drive you home. The risks of kyphoplasty are exceptionally low.

Who is a candidate for Kyphoplasty?

To be a candidate for kyphoplasty, your pain must be related to the vertebral fracture, and must not be due to any other problems such as disc herniation, arthritis, or stenosis, which is narrowing of the spinal cord.

We feel the best candidates are generally reserved for people with painful, progressive, and increasing back pain caused by osteoporosis, or pathologic vertebral compression fractures. These candidates will also have a reduced ability to move and function because of the fractures. Limitations can include the inability to drive, perform daily tasks such as household chores and cooking, caring for yourself, or your family members.

Like any surgery, there are associated risks, such as infection, bleeding, increased back pain, tingling, numbness or weakness because of nerve damage, allergic reactions to the chemicals used with X Rays to help guide the doctor, cement leaking out of position.

Pre and Post Operative Procedures 

Before the day of your surgery, your physician will perform an exam and will obtain current imaging of the spinal column. You will discuss any recent illnesses and talk about any allergies you may have.

Do not forget to bring with you a list of the medications you are currently taking and discuss with your doctor in the weeks before surgery if you are taking blood thinners or aspirin for a directive, as you will need to stop taking these before the surgery. Do not eat or drink anything up to 8 hours before surgery.

Following the successful kyphoplasty procedure, you can return home to normal activities. Please try to avoid heavy lifting for up to six weeks following the surgery. As previously mentioned, any pain caused by the procedure itself should be gone within two to three days.

Kyphoplasty helps correct bone deformities and relieves pain that comes with spinal compression fractures. kyphoplasty can restore damaged vertebrae and may also relieve pain by injecting a special cement into your vertebrae to provide our patients with relief.

Call us today to make an appointment and let’s begin your evaluation to resolve your back pain.

TEXT BY M. HIATT