Dr. Mauskop's Migralex™

Aspirin is First Line Treatment for Severe Headaches

Dr. Mauskop — Wed, 25 Jan 2012 18:32:15 +0000

According to a new report published in the journal Headache, aspirin should be used as the first line treatment before prescription drugs, even for severe headaches. Many doctors, including neurologists and headache specialists advocate the use of prescription drugs as the first line treatment if the pain is severe because of the assumption that over-the-counter medications (OTC) will not be effective in most patients. This is so-called stratified care – where milder headaches are treated with OTC drugs and if the pain is severe, a prescription drug is used right away. The three authors of the study (from Austria, Germany, and Norway) examined the results of clinical trials involving thousands of patients and concluded that even with severe headaches, there is never a need to start with a prescription medication because aspirin will work in a high percentage of patients. This finding is specific to aspirin and definitely does not apply to acetaminophen (Tylenol), which is the weakest (and not necessarily the safest) OTC medication.

Neck pain is best treated with exercise

Dr. Mauskop — Wed, 04 Jan 2012 04:29:13 +0000

About three out of four people have neck pain at some time in their lives. A large study funded by the National Institutes of Health compared chiropractic manipulation, neck exercise, and medications in the treatment of 272 people with neck pain. The duration of neck pain was between 2 and 12 weeks prior to the start of the study. A third of patients was given spinal manipulation by chiropractors, a third was given instructions on daily neck exercises and another third was given pain and muscle relaxing drugs. The first two groups did equally well, while the outcome in the drug group was worse. After 12 weeks of treatment 30% of manipulation and exercise group were completely pain free, while only 13% of the medication group was pain free. Even a year later the first two groups continued to do better than the group that took medications. Clearly, exercise is a safer, cheaper, and less time-consuming option compared with chiropractic manipulation. Unlike manipulation of the lower back, manipulation of the neck carries a very small but not negligible risk of complications, such as strokes. One of the exercises used in the study is described as moving your head back while tucking in your chin (resembling what a chicken does while walking) and repeating this exercise several times every day. Stretching and circular movements by each shoulder, and particularly strengthening isometric neck exercise are very useful. Isometric neck exercise consist of pressing with your own hand against the head on either side above the ear, then pressing against the forehead and then with clasped hands against the back of the head, while the head remains stationary. The pressure is exerted for ten seconds in each direction, but the exercise needs to be repeated as many times every day as possible. Improvement usually occurs within two weeks. If you stop exercising, neck muscles weaken and the pain may return, especially if you are under stress, hold the phone on your shoulder, or carry a heavy bag on the shoulder.

Massage relieves cancer pain

Dr. Mauskop — Wed, 09 Nov 2011 03:47:58 +0000

A scientific study by Taiwanese and American researchers published in the journal Pain examined the effect of massage on metastatic bone pain. They compared 36 patients who received a standardized form of massage for 45 minutes with 36 patients who were given social attention also for 45 minutes. Treatment sessions were given on three consecutive days to patients admitted to the hospital. Patients who received massage had significantly less pain than those who were given only attention. The relaxing effect of massage lasted for at least 16 – 18 hours and their sleep also improved. Intuitively, we all suspect that massage must be good for a variety of medical conditions, but this is the best study that shows pain-relieving properties of massage in cancer patients.
Massage is probably also effective for headaches, although definitive proof is lacking. The other drawbacks of massage are its cost and availability. While occasional massage is a wonderful thing, regular aerobic exercise is something that can be done daily with excellent relief of headaches and other pains (but not metastatic bone pain), unless the person is unable to do it.

More aspirin benefits

Dr. Mauskop — Sat, 29 Oct 2011 03:03:41 +0000

Aspirin prevents colorectal cancer, according to a study by a group of European researchers published in the Lancet. Participants who took 600 mg of aspirin for an average of two years had a 63% reduction in the risk of colon or rectal cancer. Surprisingly, aspirin did not reduce the risk of developing polyps which are considered to be a precursor of cancer. Five people in the aspirin group developed endometrial cancer, a malignancy in the lining of the womb, compared with 13 in the placebo group. The drug has also been shown to reduce the risk of strokes and heart attacks. Side effects of taking aspirin include ulcers and internal bleeding in the stomach. “I’d rather have that than cancer or a heart attack,” said the lead author of the study, British professor John Burn.

Naproxen, ibuprofen, and other NSAIDs, but not aspirin are dangerous for heart patients

Dr. Mauskop — Mon, 03 Oct 2011 01:46:58 +0000

COX-2 inhibitors, such as Celebrex, Vioxx and Bextra were introduced with the promise of being as effective as ibuprofen (Advil), naproxen (Aleve), and other NSAIDs, but with a much lower risk of stomach ulcers and bleeding. However, Vioxx and Bextra were taken off the market because they increased the risk of heart disease. This has led researchers to also look at the traditional NSAIDs, such as diclofenac, ibuprofen, naproxen, meloxicam, and other. According to a new study recently published in Circulation, even short-term use of these drugs in people with preexisting heart disease significantly increased the risk of a heart attack and death. For some time now doctors have been warned that using NSAIDs in patients with heart disease and hypertension is dangerous, but they continue to prescribe them anyway, according to Danish researchers who conducted this study. They looked at the data from more than 83 thousand patients older than 30 and discovered that there is a 45% increase in risk of having a second heart attack within as little as one week of taking an NSAID. This percentage increased to 55% after 3 months on an NSAID. The highest risk was found with diclofenac (sold under brand names of Voltaren, Cataflam, and Cambia). At the same time one NSAID which is not only safe but is beneficial for heart patients is aspirin. It is given to all heart attack victims as soon as they enter the emergency room.

Vitamin B12 deficiency can cause brain shrinkage

Dr. Mauskop — Wed, 28 Sep 2011 02:54:43 +0000

Vitamin B12 deficiency is very common and unfortunately is difficult to diagnose. A study published in the leading neurology journal, Neurology showed that the standard test is unreliable and using a more sensitive test is critical. Researchers from the Rush University Medical Center in Chicago measured both vitamin B12 levels and several other indirect markers of vitamin B12 deficiency. They discovered that in the elderly there was a strong correlation between vitamin B12 deficiency and loss of brain volume and cognitive decline. However, this correlation was present only with methylmalonic acid level, which goes up when there is a deficiency of vitamin B12, but not with the vitamin B12 level itself. This happens because even if normal amounts of vitamin B12 are circulating in the blood, this vitamin is unable to get inside the cells to perform its crucial functions. This is not really a new discovery. There have been several reports of patients with life-threatening neurological disorders due to vitamin B12 deficiency and very normal blood lees of this vitamin. The regular, “serum” level of vitamin B12 is useful only when it shows a deficiency. The accepted normal range is from 200 to 1,100, but in fact, if it is below 400 it is very likely that a deficiency is present. Vitamin B12 deficiency can worsen headaches and cause many neurological symptoms, as well pernicious anemia. Vitamin B12 is very poorly absorbed in the stomach, so taking it by an injection is preferred in patients with documented deficiency. Sublingual (under the tongue) tablets get absorbed better than tablets that are swallowed. Vitamin B12 is also available by prescription in a nasal spray form, but it is fairly expensive. Some of my patients are happy to inject themselves with vitamin B12 monthly and at times even weekly since the injection is given with a small needle under the skin.

Aspirin is the first-line drug for moderate or severe headaches. A new report.

Dr. Mauskop — Tue, 30 Aug 2011 17:40:27 +0000

Aspirin should be used first, before prescription drugs for the treatment of headaches, regardless of their severityaccording to a new study published in the journal Headache. The report was entitled, Aspirin is First-Line Treatment for Migraine and Episodic Tension-Type Headache Regardless of Headache Intensity. Many neurologists will start with a prescription drug when the patient reports having a severe headache, assuming that drugs like aspirin will be ineffective. Three prominent headache researchers (from Austria, Germany, and Norway) reviewed the data from 6 large trials of aspirin for migraines and one trial of aspirin for tension-type headaches. Migraine trials included 1165 patients with attacks of moderate severity and 914 with severe. The tension-type headache trial had 180 patients with moderate pain and 145 with severe. Surprisingly, aspirin was equally effective for both moderate and severe attacks in both types of headaches.

Narcotics cause sustained changes in your brain

Dr. Mauskop — Mon, 15 Aug 2011 03:29:10 +0000

One of the most commonly prescribed drugs for treatment of headaches is Vicodin (hydrocodone with Tylenol) and other similar narcotic (opioid) drugs. A study just published in the journal Pain entitled “Prescription opioid analgesics rapidly change the human brain” indicates that narcotic drugs actually change the way brain looks on a high resolution MRI scan. Ten patients with chronic low back pain were given morphine daily and had scans before and after the treatment, as well as 4 – 5 months after morphine was stopped. Thirteen different brain areas were changed by morphine and the higher was the dose of morphine the bigger was the change. Even more disturbingly, 4 – 5 months after morphine was stopped these brain changes persisted. When researchers looked at people taking a placebo pill for 6 weeks, they did not find any changes on the MRI scans.
We also know that as few as 5 doses of a narcotic pain killer taken monthly significantly increases the risk of intermittent headaches becoming chronic.

Olive oil consumption reduces the risk of strokes by 41%.

Dr. Mauskop — Mon, 15 Aug 2011 01:48:31 +0000

A recent article published in the journal Neurology reports on the results of the Three-City Study. French researchers discovered that people with high intake of olive oil had a 41% reduction in the risk of strokes compared to those who never used olive oil. The authors meticulously controlled for other variables, such as sociodemographic and other dietary factors, physical activity, body mass index, smoking, and other factors. They also measured blood levels of oleic acid (an omega-9 fatty acid), which is the main ingredient of olive oil, and these measurements confirmed that those with high blood levels of oleic acid had a lower risk for strokes.

Sublingual feverfew and ginger relieve acute headaches

Dr. Mauskop — Sat, 13 Aug 2011 03:00:44 +0000

A new study in the journal Headache tested the efficacy of a homeopathic remedy which contained a small amount of feverfew and ginger for the treatment of migraine headaches. This remedy (called Gelstat) was found to be more effective than placebo in relieving migraine attacks. Ginger is known to be effective for the treatment of nausea, while daily intake of feverfew has been reported to prevent migraine attacks. However, in this study the amounts of both ingredients were very small, which is typical for homeopathic remedies. This is a first well controlled study which suggests that homeopathic remedies may in fact be effective. Homeopathy is based on the idea that very small amounts of herbal extracts can be curative. The modern science has no explanation about how it possible could work. This, along with the lack of convincing studies is the reason for great skepticism about homeopathy. The main advantages of homeopathy are its safety and relatively low cost.