Ask Dr. Clary: What Are The Risks And Benefits Of Headache Treatments
Understand the risks and benefits of your headache treatment options.
Choosing the best medical treatment for headache begins with an evaluation of treatment risks and benefits. “It’s very satisfying to treat headache pain,” says pain specialist Dr. Andrew Clary. “No one wants to be in pain, and migraine pain can be particularly miserable. It is very gratifying to help my patients get relief from a migraine diagnosis.”
Evaluating treatment options means understanding risks and benefits
Of course, migraines aren’t the only headache culprit. “A throbbing head is sometimes accompanied by other telltale symptoms,” says Dr. Clary. “Our first job is to identify the cause of the pain. Sometimes, patients may think they have a migraine when they are really experiencing neck pain that radiates into the head. This is actually very common and treatable. Once we understand the source of the headache, we can consider appropriate treatments. I want my patients to understand the risks and benefits of each treatment option.”
Risks and benefits of headache medications
“A primary care physician will often be the first to have medication discussions with you; they often start patients with these medications,” explains Dr. Clary. “We’ve treated migraines with preventative and abortive medications for years. These medications do have side effects, though they are often mild. The side effects we normally see with headache medications include:
- Word-finding difficulties
- Changes in vision
- Tingling in the fingertips
- Dry mouth
- Sleepiness or fatigue
“Medication side effects are dose dependent,” notes Dr. Clary. “Some patients aren’t bothered by these symptoms, or accept them because they feel more comfortable with medication treatment. Other patients experience these side effects and don’t tolerate them well. In that case, we’ll either lower the dosage or change the medication altogether. It all depends on the patient.”
Risks and benefits of Botox injections
Botox injections are considered for chronic migraine patients suffering 14 or more migraine episodes a month. “Botox is a good treatment choice for patients who are intolerant of medications,” explains Dr. Clary. He also considers Botox for patients with significant migraine or tension headache pain—and for whom nothing else has worked.
“This is an injection treatment,” Dr. Clary continues. “That can be a deterrent for patients who really don’t like needles. But I think Botox is exciting because there are almost no side effects. The vision changes, tingling, and dry mouth patients experience with the other medications don’t exist with Botox. The most notable Botox side effect is that patients may lose a few forehead wrinkles. In my experience, most patients aren’t mad when their wrinkles vanish.”
Another advantage of Botox is that it can be combined with other medications. “If you’ve taken a medication in the past, you can continue to take it,” says Dr. Clary. “In fact, when we offer Botox, we don’t ask patients to stop all other medications. We are hopeful that they may come off some of them, though.”
Finding the treatment protocol that works for you
“When patients understand the risks and benefits of their treatment options, they make better-informed choices,” says Dr. Clary. “And that’s always a benefit. I want you to know the pros and cons of your treatment options. If you already have a treatment protocol—we’ll talk about whether injections or alternatives are right for you. If a current protocol isn’t fitting with your lifestyle, then we’ll consider other options. I will work with you to find the best treatment for you.”
More resources for you
- Learn more about the causes of neck pain
- Watch the video: Introducing Dr. Andrew Clary
- Check out tips to avoid neck pain that can contribute to headaches
Meet the Expert: Doctor Bio Video Series
Dr. Mundrati’s advice to help patients manage back pain—and keep it from recurring.
Dr. Choi helps chronic pain sufferers understand the link between stress and back pain.