Chronic migraine: a case of successful treatment without medication

Chronic migraine: a case of successful treatment without medication

Introduction
A young man visited the clinic complaining of frequent headaches (more than 15 days per month).


Complaints
The patient reported experiencing symptoms approximately 3-4 times a week, with pain predominantly affecting the entire head, occasionally just one side. The dull, pressing pain reached 7-8 out of 10 on the pain scale (severe), sometimes accompanied by pulsating sensations. Nausea, sensitivity to noise and light were also present. He also felt pressure behind the eyes.

The pain would often occur after stress, prolonged computer work, hunger, and excessive sleep. Physical exertion would exacerbate it.

The painful sensations were more frequent during weekdays in the second half of the day, interfering with work. The man took various pain relievers (Baralgin, Spasmalgon, Pentalgin) to continue his tasks but they only slightly dulled the pain.

Sleep would improve his condition, relieving the headache.

Medical History

The patient is 31 years old. He first experienced headaches in high school, attributing them to stress and strain. Initially, the symptoms were rare, and medications effectively managed them. In 2019, he underwent an MRI of the brain, which showed no abnormalities.

However, over the past year, the episodes became more frequent, prompting him to seek medical help.

The patient recently transitioned to a managerial position. Due to work changes, he frequently encountered stressful situations and had little time for rest.
His mother also suffered from headaches, attributing them to hypertension. No other family members experienced similar symptoms.

Examination

No abnormalities were observed during the examination. Blood pressure was 120/80 mmHg. Tension and tenderness were detected in the paravertebral muscles along the spine, trapezius, chewing, and temporal muscles, but there were no clear focal symptoms.

According to clinical recommendations for managing migraine patients, no laboratory or instrumental investigations were conducted as they do not reveal specific changes.

Diagnosis

Chronic migraine without aura. Medication-induced headache.

Treatment

The patient was prescribed preventive treatment for chronic migraine and advised to discontinue analgesics, which only exacerbated the headaches.

The possibility of using monoclonal antibodies and normalizing lifestyle was considered: the man needed to adhere to a work-rest schedule, get enough sleep, exercise, eat properly, and identify triggers for headaches and try to eliminate them.

Nine months later, the man returned for a follow-up appointment. He chose a non-medication route of treatment: he stopped taking tablets, adjusted his routine, and started exercising. The number of episodes decreased to 1-2 times per month, which he managed on his own.

Given the positive outcome, the young man continued with the chosen strategy and kept a headache diary for observation.


Conclusion

Migraine is a chronic, genetically predisposed disease. Severe headaches are usually poorly tolerated by patients, often leading to overuse of painkillers. People often use analgesics daily, sometimes several tablets a day.

Patients devoutly believe in the “magic pill” and are reluctant to change anything in their lives. However, lifestyle transformation often yields better results. Honestly, this case is the first of its kind in my practice. But it proves that non-medication methods can also alleviate pain.