Few migraine sufferers referred for behavioral treatments

For the study, researchers surveyed American Headache Society members to assess their knowledge and beliefs about the use of behavioral treatments, including biofeedback and relaxation training for migraine.

Behavioral treatments have "Grade A" evidence of effectiveness, according to the study scheduled to be presented Wednesday at an American Headache Society meeting in Los Angeles. The U.S. Preventive Services Task Force says that "Grade A" means there is "high certainty" the benefits of a treatment outweigh the risks.

And yet, "we found low rates of referrals among migraine treatment specialists for behavioral treatments for their patients," lead author Robert Nicholson, of Mercy Health Research in St. Louis, said in a headache society news release. "Reasons may include both a lack of knowledge about the value of such treatment as much as a lack of available referral services in local communities."

Two-thirds of migraine specialists said they routinely assess patients for depression and more than half assess patients for anxiety. Only 30 percent assess patients for abuse and post-traumatic stress disorder, both of which are associated with migraine.

Overall, about 25 percent of headache specialists referred patients to non-drug treatments. Stress management, relaxation training and psychotherapy were the most common, Nicholson reported.

American Headache Society president Dr. Elizabeth Loder noted in the news release: "Behavioral therapies are often helpful for conditions other than migraine, such as anxiety or depression, and they are typically well-tolerated. They offer a broad range of benefits and a narrower range of harms than most drug treatments for headache."

Migraine affects about 36 million Americans. An additional 6 million suffer from chronic migraine, where patients have at least 15 headache days a month along with other disabling neurological symptoms.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information: The U.S. National Institute of Neurological Disorders and Stroke has more about migraine.

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