Headaches plague many people. Every year, more than 12 million Americans visit their doctors for help with headaches. These visits, combined with lost work time, cost the nation upward of $31 billion annually.
According to a new analysis by experts in the field, doctors and their patients may need to try a new — simpler — approach to combating the problem. The study examined the records of more than 9,000 doctors’ visits for headaches over an 11-year period. The researchers found that, instead of talking to patients about the possible causes of headaches and strategizing about things they could do to prevent headaches, the doctors tended to order advanced imaging tests, such as MRIs, or referred patients to specialists.
According to the study and evidence-based guidelines, imaging tests and referrals to specialists are “of little value” in the treatment of routine headaches. Doctors need to do a better job of identifying the relatively rare instances where a serious underlying cause of the headache is suspected, thus requiring imaging tests and a consultation with a neurologist, the authors said.
Other patients simply don’t need these extra services. The study also found that doctors may prescribe too many strong medications, such as opioids and barbiturates. In contrast, over the 11 years, the study revealed that counseling from doctors on identifying dietary or stress-related triggers of headaches, and preventing those triggers, declined from 23.5 percent of all patient visits to 18.5 percent.
According to the authors, the first line of treatment for routine headaches is for doctors to discuss lifestyle modifications with their patients. Doctors and patients need to focus on these simpler approaches. “The management of headache represents an area of particular concern for our health care system and stands out as an important opportunity to improve the value of health care in the United States,” said John N. Mafi, MD, a fellow in the division of general medicine and primary care at Beth Israel Deaconess Medical Center in Boston.
The most common type of headache is a called a tension headache. It’s most likely caused by the tightening of muscles in the shoulders, neck, scalp and jaw, according to experts with the National Institutes of Health. Tension headaches tend to be related to stress, depression or anxiety. They can also be caused by a head injury or holding your head or neck in an abnormal position. Tension headaches tend to occur on both sides of the head. This type of headache often starts at the back of the head and spreads forward. The pain can feel dull or like a squeezing sensation. Your shoulders, neck and jaw may even feel tight or sore.