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Initial evaluations include:
Dr. Peters: A comprehensive history, physical examination, and review of medical records. Dr. Peters will order any needed diagnostic tests and begin a treatment program which may include preventive and headache relief medications and referral to Dr. Scopp, when appropriate.
Dr. Scopp: Lifestyle prevention strategies and identification of possible environmental, stress, and nutritional precipitants of your headaches. You will be given an introduction to strategies to stop headaches at onset such as biofeedback, home practice relaxation training, and shoulder-neck exercises.
Followup treatments:
Dr. Peters will monitor your treatment progress with the aid of the headache diary and adjust your treatment medications, coordinate treatment care with other health professionals and work with you to establish an optimal preventive and headache stopping medication program based upon your treatment response.
Dr. Scopp will help you prevent and stop headaches with research substantiated behavioral medicine treatments including biofeedback, headache trigger reduction, and improved stress management.
Integrative, coordinated treatment is indicated for patients who have not achieved satisfactory headache control with medication or other treatments. Over two-thirds of previously difficult to treat headache patients show at least 50% reduction in headache burden with more comprehensive treatment. In addition, published studies show comprehensive treatment results in decreased emergency room visits, decreased future headache related medical costs, and over 90% reporting subjective improvement. Comprehensive treatment may include research supported strategies such as appropriate preventive or headache control medications combined with behavioral medicine strategies such as identification and reduction of headache triggers, biofeedback and improved stress management.
Behavioral Medicine
Behavioral medicine has been shown to both prevent and stop headaches at onset among those patients who have not achieved satisfactory treatment with medications alone. Strategies may include:
1) Biofeedback: Biofeedback is rated as “Category A” by both the American Headache Society and the American Medical Association, meaning effectiveness has been demonstrated in a large amount (more than 500 studies) of convincing research. Biofeedback training teaches the headache patient to control or reverse headache physiology to both prevent future headaches and stop headaches at onset. Long term followup studies also demonstrate less medication usage, decreased anxiety and depression and improved self-efficacy as well. Read a patient’s description of her successful biofeedback experience in controlling headache.
2). Headache trigger identification and reduction. Your headache diary along with Dr. Scopp’s 30 years experience can help you identify and reduce some the causes of your headaches, thus decreasing total headache frequency. Lifestyle factors such as biorhythms, sleep, diet, proper exercise and improved stress management may be important in your long term headache control.
3). When relevant, improving management of stress or depression can be critical in a long term headache solution program. Studies show half of all migraine headaches are preceded by stress. Changing interpretation of everyday events (cognitive behavior therapy) to decrease stressful reactions is often an important part of a long term headache prevention.
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Biofeedback |
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Dr. Scopp on behavioral medicine
headache treatment (9 minutes) |
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Treatment Effectiveness
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Numerous studies have documented the effectiveness of a coordinated, simultaneous, comprehensive approach to the treatment of intractable headache. The following bar graph documents improvement over a ninety-day time period at our clinic.
(Reference hyperlink): Scopp A and Peters K., Comprehensive Headache Treatment Cost and Treatment Effectiveness, Headache 36: 277, 1996.-- cannot find hyperlink |
Approximately 25% of our patients have chronic daily rebound headache due to excessive use of prescription or over-the-counter
analgesics. These patients must be detoxified off of these offending agents either on an outpatient basis or as an
inpatient at El Camino Hospital in order to achieve therapeutic success.
Fibromyalgia
Fibromyalgia is a chronic pain disorder consisting of multiple body tender points, associated with headache, fatigue, sleep and mood disturbance. Recent research shows fibromyalgia responds to the combination of judicious medications and cognitive behavior therapy. We are available to treat fibromyalgia patients utilizing our integrative model..
Many private, PPO and HMO insurance programs accepted. Patients can be self-referred or referred by their physician.
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