Melissa returns to the clinic today for a 2-month follow-up appointment. She followed the recommendations that were made during the last appointment. She is extremely happy to report that she is down from 30 days to only 2 days with headache each month. She has found tremendous benefit particularly from the biofeedback techniques that she has learned. Biofeedback allowed her to become more aware of stress levels as trigger for migraine. Please listen to the following video to hear the patient’s perspective regarding biofeedback.
Melissa Discusses What Worked Best
Discussion and Review
This case is representative of the patients commonly seen in the primary care clinic or specialty headache clinic. After completing this module, you have the tools and capability to identify and manage patients that suffer from MOH. Many patients with chronic headache will respond well to these interventions without the need for specialty referral.
The three most important steps to remember are to:
- Rule out a secondary headache using SNOOP
- Identify risk factors for medication overuse
- Develop a multimodal treatment plan which addresses the patient’s needs.