NHF Regional Conference - Part IV

Dr. Tim Clark

Dr. Tim Clark is the program director for interdisciplinary services for the Baylor Center for Pain Management in Dallas.


Migraine is a Chronic Disease

• Examples of other chronic diseases: diabetes, high blood pressure, high cholesterol, fibromyalgia, arthritis, asthma
• It's there even when you're not having a headache

Knowledge is power

• What you think (your perception) matters
• Identify, manage, avoid triggers
• Take medications as directed
• Talk with your doctor (it's important to establish empathy and trust between patient and healthcare provider)

Triggers - Being exposed to more at one time makes you more vulnerable for a "perfect storm" / migraine attack


Pain is the 5th vital sign

• There's no way to objectively measure pain
• You have to record it and communicate it with your doctor

Ways to Improve Chances for Successful Headache Management:

• Diaries
• Managing pain is the primary goal
• Discuss goals/expectations with doctor
• Find support
• Doing several positive things at a time often leads to greater effects
• 3 P's of long-term success -

• Persistence
• Patience
• Positive attitude

Physical Therapies

• Acupuncture
• Have to give it a fair chance - 2 x's per week for 10 sessions, 1 week off, then 10 more sessions (sessions ~30 minutes each)
• Exercise
• Massage
• Chiropractic

Cognitive-Behavioral Therapies

• Biofeedback
• Training body in relaxation techniques (must practice regularly)

Relaxation Therapies

• Progressive muscle relaxation
• Autogenics
• Meditation or passive relaxation
• Hypnosis
• Abdominal breathing
• Mindfulness meditation

Treat Comorbidities

• Anxiety
• Depression
• Sleep disorders
• Chronic dysfunctional coping skills
• etc...