LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Migraines In Children

Migraines in Children: How Well Do Meds Work?

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Few things are as difficult as seeing your child in pain. I remember when Keegan broke his leg and how much it hurt me knowing he hurt.

Headaches in children can be just as unbearable for a parent, but with the added concern of whether something more ominous is causing the headaches. While misguided, most parents will present to his or her pediatrician for evaluation and some type of answer. This usually prompts imaging of the brain despite the absence of red flags.  MRI if you are lucky, CT scans if your pediatrician wouldn’t recommend a medical journal if he or she got whacked upside the head with it.

Side note: In the absence of red flags, advanced imaging is not recommended.  Even when imaging should be done, it should be an MRI (with the single exception of looking for a subarachnoid hemorrhage, which is much more likely to occur in the elderly population). The radiation exposure with a CT scan is extremely high and has been linked to some 29,000 cancers per year.

So everything comes back normal, but your little baby is still having nightmare headaches. It’s nice to know there is nothing “real” going on, but this doesn’t take care of the migraine headaches. Your pediatrician’s only answer at this point is medication.

It is unfortunate, but a referral to a chiropractor is rarely undertaken before the medication. Many of the kids who come into our office for treatment of his or her headaches have already tried everything including medications. Most often we are able to help in a very short period of time, although there have been cases over the years that treatment in our office was not able to help and we just became one more therapy in a long list of failed attempts.

Anecdotally, I can tell you that we do extremely well with headaches. However, our comprehensive approach (manipulation, soft tissue work, diet, stress management) to migraines in children has not been studied in any type of clinical trial that I’m aware of, so maybe I could understand a pediatrician’s reluctance to refer out to a chiropractor. After all, we don’t want to subject our children to anything that has no research to back it up, right?

Which, of course, brings us to this particular study.  Basically, researchers looked across multiple studies to see which medications have been shown to be effective for the treatment of migraines in children. Here’s what they found:

  • Topiramate (Topamax) led to 0.7 less headache days per month.
  • Trazodone was slightly less effective at 0.6 less headache days per month.
  • Drugs with no benefit included clonidine, flunarizine, pizotifen, propranolol, and valproate (Depakote).
  • A single trial of fluoxetine for chronic daily headaches found it ineffective.
  • However, kids given placebo experienced an almost 50% drop in headache days (down 2.7 days / month).

Basically, the evidence sucks for the use of most medications for treatment of migraines in children.

Placebo, on the other hand, plays a far, far stronger role in slashing headache frequency in the children in these studies. Something to consider strongly should your pediatrician recommend medications (with a long list of side effects) to help control migraines in children.

It also brings us back to the use of a comprehensive chiropractic approach to the treatment of headaches in children. Our care is extremely safe when compared to any medication, and, at least according to this review, it certainly couldn’t be any less effective!

Migraines in Children: Do Meds Work? Are They a Good Idea?

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When ANY child has headaches, something is wrong.  They don’t just happen and they darn sure aren’t because that child is deficient in some medication.  And yet, we seem to think this is the case because the administration of medication seems to be the treatment of choice in mainstream medicine.

Even if a medication controls the headache for that moment, it has in no way, shape or form fixed what was causing the headache.  As a parent, it is your job to NEVER accept anything less than an answer.

Most often, the answer is not immediate.  I find that stress in children is a major contributor to headaches.  Even if you initiate stress management approaches (meditation, biofeedback using the Resperate, relaxation CDs, massage) these will take some time for the benefits to be noticed.

If the problem is structural, very commonly from carrying backpacks that are too heavy for the child, then they need structural work from a chiropractor that focuses on this aspect of treatment.

I cannot begin to describe the frustration we’ve had with patients here in the office.  We recently had a cheerleader who had several falls and had high stress levels and a “challenging” diet.  Despite a year of headaches and seeing virtually every other type of provider (including a neurologist at Barrow’s) there was never a suggestion of seeing a chiropractor.  After the first first, she didn’t have a headache for a week and they have been getting better managed since.  The patient is, needless to say, very pleased after just 4 visits.

I have another patient that was recently put on a triptan medication to manage his headaches.  He’s a very intelligent 11 year old boy, but he clearly stresses heavily over school.  There has not been any discussion about managing his stress.  It’s all been about medication.  Our office is working with his mother to get something type of relaxation program for his iPod and I’m very confident this will help greatly with his headaches.

Since I brought up the triptan class of medications (nice, segue, huh?), we should look at this particular study.

Researchers looked at multiple studies on the use of triptans for migraine headaches in children.  Here’s the catch:

The children’s placebo response rate was incredibly strong, with pain relief at 2 hours ranging from 53% to 57.5%.

Basically, because of this, none of the medications were more powerful than placebo in these trials.

So what does this mean?  It means that the brain is a powerful tool in managing migraine headaches–at least as powerful as commonly used medications.  This all points back to the ability of mind based therapies like meditation or biofeedback to control or eliminate migraine headaches in adolescents.

If this type of approach is NOT recommended in the care of any child with migraine headaches, I would personally pack up and run the other way.  If stress is a major contributor to headaches and this aspect is not addressed, the long term health consequences are going to be grave.

Medicine is NOT supposed to be about controlling the symptoms.  Medicine is finding the cause of a problem and fixing that cause so that the long term health of the patient is preserved.  Anything less is deficient.

If your child experienced migraine headaches, what did you find was the best therapy for them?