Journal Critique on Headache 1

Running Head: JOURNAL CRITIQUE ON HEADACHE

Journal Critique on Headache

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Journal Critique on Headache

What a Nurse Can Do without Doctor’s Help for a Patient Experiencing Headache

Health Care has witnessed a considerable shift in the previous millennium due to

breakthroughs and commendable achievements. Similarly the Nursing profession has a

tremendous chance to stand up to the challenges of the 21st century. These involve coming to

the fore and assuming a responsible position in the Medical profession especially as compare

to doctors. Nursing education has to be enhanced in order to enable them to stand shoulder to

shoulder with doctors while carrying on their regular tasks- an event that we may soon see

enfolding in the future.

Summary of the Article - Sierpina, V.; Astin, J.; Giordano, J. (2007). Mind-Body Therapies

for Headache. American Family Physician. Volume 76, Number 10, p. 1518-22.

Headache is one of the most frequent yet most bizarre problems tackled by any healthcare

provider. Headache is not a single disease, and different pathologic systems are involved in

unique kinds of headache. Mind-body therapies like cognitive behavior therapy, biofeedback,

hypnosis, relaxation and meditation training can influence neural substrates and arguably are

effective interventions for different kinds of headache. Studies of randomized controlled trials

have revealed that the utilization of mind-body therapies, alone or as a complement,

considerably decreases symptoms of tension, migraine, and mixed-type headaches. Side

effects normally are negligible and ephemeral.

For the purpose 39 trials studying behavioral approaches to migraine were selected.

Treatments included relaxation training, thermal and electromyographic (EMG) biofeedback,

stress management training, and cognitive behavior therapy, alone or in combination. The

meta-analysis showed that these treatments reduced migraine symptoms by 32 to 49 percent

compared with no treatment. A meta-analysis of 35 trials on behavioral treatments for

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tension-type headache showed a 37 to 50 percent reduction of symptoms in treated patients

compared with a 2 to 9 percent reduction in control patients. Therapies included relaxation

training, EMG biofeedback, EMG biofeedback plus relaxation training, cognitive behavior

therapy, and stress management training. The effect size was larger than those in earlier meta-

analyses, with a 35 to 55 percent reduction in headache frequency and pain; however, patient

variables may have significantly affected the treatment effects. A meta-analysis of seven

trials found that cognitive behavior therapy improves headache activity by 49 percent. This

treatment can be combined with relaxation training and group therapy.

Personal Views about the Article

Physicians have a wide range of well evidenced behavioral and mind-body therapies

available for the treatment of headache in children and adults. Despite evidence from many

studies, mind-body therapies are an underused treatment modality in medical practice,

possibly because of lack of training, insufficient time, or lack of awareness of the evidence

base supporting these therapies. Many therapies, such as the relaxation response, progressive

muscle relaxation, and simple diaphragmatic breathing, can be taught quickly in the

physician’s office and can be practiced by the patient at home. Muscle relaxation methods are

simple and effective, and they can mitigate centrally mediated pain patterns.

It is an excellent study on the subject keeping in mind the constraints inherent to it. More

studies are needed on the topic and especially on the efficacy of the techniques and the

possibility of their use domestically by housewives or parents. Further research for the

benefits of nurses is also highly advised.

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Reference

Sierpina, V.; Astin, J.; Giordano, J. (2007). Mind-Body Therapies for Headache. American

Family Physician. Volume 76, Number 10, p. 1518-22.