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Managing headache triggers: think 'coping' not 'avoidance'.

Abstract

The standard clinical advice for individuals who suffer from recurrent headaches is that the best way to prevent headaches is to avoid the triggers. This editorial challenges that advice from a number of perspectives. First, there is little empirical support for such advice. Second, cognate literatures in the fields of chronic pain, stress and anxiety raise concerns about avoidance as a strategy. Third, studies have demonstrated that short exposure to a headache trigger results in increased sensitivity and prolonged exposure results in decreased sensitivity. Conclusions include that one aetiological pathway to developing a primary headache disorder may be via attempts to avoid triggers resulting in increased sensitivity to triggers. Also, clinicians need to become more flexible in the advice they give pertaining to triggers, namely they should think 'coping with triggers' rather than avoiding all triggers, as avoidance will sometimes be the preferred strategy, but often it will not be.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Division of Psychological Medicine, Monash University, Melbourne, Vic, Australia.

    Source

    MeSH

    Adaptation, Psychological
    Headache
    Humans

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19673895

    Citation

    Martin, P R.. "Managing Headache Triggers: Think 'coping' Not 'avoidance'." Cephalalgia : an International Journal of Headache, vol. 30, no. 5, 2010, pp. 634-7.
    Martin PR. Managing headache triggers: think 'coping' not 'avoidance'. Cephalalgia. 2010;30(5):634-7.
    Martin, P. R. (2010). Managing headache triggers: think 'coping' not 'avoidance'. Cephalalgia : an International Journal of Headache, 30(5), pp. 634-7. doi:10.1111/j.1468-2982.2009.01989.x.
    Martin PR. Managing Headache Triggers: Think 'coping' Not 'avoidance'. Cephalalgia. 2010;30(5):634-7. PubMed PMID: 19673895.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Managing headache triggers: think 'coping' not 'avoidance'. A1 - Martin,P R, Y1 - 2010/02/11/ PY - 2009/8/14/entrez PY - 2009/8/14/pubmed PY - 2011/1/28/medline SP - 634 EP - 7 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 30 IS - 5 N2 - The standard clinical advice for individuals who suffer from recurrent headaches is that the best way to prevent headaches is to avoid the triggers. This editorial challenges that advice from a number of perspectives. First, there is little empirical support for such advice. Second, cognate literatures in the fields of chronic pain, stress and anxiety raise concerns about avoidance as a strategy. Third, studies have demonstrated that short exposure to a headache trigger results in increased sensitivity and prolonged exposure results in decreased sensitivity. Conclusions include that one aetiological pathway to developing a primary headache disorder may be via attempts to avoid triggers resulting in increased sensitivity to triggers. Also, clinicians need to become more flexible in the advice they give pertaining to triggers, namely they should think 'coping with triggers' rather than avoiding all triggers, as avoidance will sometimes be the preferred strategy, but often it will not be. SN - 1468-2982 UR - https://www.unboundmedicine.com/medline/citation/19673895/full_citation L2 - http://journals.sagepub.com/doi/full/10.1111/j.1468-2982.2009.01989.x?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -