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Medical Treatment of Refractory Daily Headaches, Including Interdisciplinary Management

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The Cleveland Clinic Manual of Headache Therapy

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Abstract

The treatment-resistant medication overuse headache (MOH), chronic migraine (CM), new daily persistent headache (NDPH), and chronic tension-type headache (CTTH) patients often need an intensive interdisciplinary program. Physical therapy, medical, and focused psychological therapy are combined to create a treatment plan for each patient over a period of several weeks. Utilizing the same abortive and preventive principles found to be successful for less resistant cases, the treatment plan adds paced physical rehabilitation and individually tailored stress reduction, psychotherapy, and biofeedback. It is necessary to include behavioral evaluation and treatment, because ignoring psychological ramifications of chronic pain states, including headaches, as well as the psychological comorbidity commonly seen in the patient population, is tantamount to ignoring intra-abdominal trauma as the cause of shock in the severe accident-related head trauma case! This chapter explores the medical treatment of chronic daily headache and suggests that successful treatment of refractory chronic headache patients is possible with an interdisciplinary approach.

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Authors and Affiliations

  1. Headache Center, Neurological Center for Pain, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, C21, 44195, Cleveland, OH, USA

    Mark J. Stillman MD

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  1. Mark J. Stillman MD
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Correspondence to Mark J. Stillman MD .

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Editors and Affiliations

  1. Cleveland Clinic Headache Center, Cleveland, Ohio, USA

    Stewart J. Tepper

  2. Cleveland Clinic Headache Center, Cleveland, Ohio, USA

    Deborah E. Tepper

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© 2014 Springer International Publishing Switzerland

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Stillman, M. (2014). Medical Treatment of Refractory Daily Headaches, Including Interdisciplinary Management. In: Tepper, S., Tepper, D. (eds) The Cleveland Clinic Manual of Headache Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-04072-1_14

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  • DOI: https://doi.org/10.1007/978-3-319-04072-1_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04071-4

  • Online ISBN: 978-3-319-04072-1

  • eBook Packages: MedicineMedicine (R0)

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