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A new study has found that almost all blood-pressure-lowering medications reduce the number of headaches migraine sufferers have each month. Researchers say that these medications could be a more affordable and accessible alternative to migraine medications.
A throbbing headache with pulsing is a common migraine symptom. It’s more than just a bad headache. Migraines can cause debilitating symptoms, including sensitivity to sound, light or smells. This can make it difficult to function. The severity of pain and the symptoms can change. Around 15% of the population is believed to be affected by migraine.
Migraine medications can be expensive, but they are effective in preventing future attacks and reducing symptoms. In 2020, migraine treatment in the US cost between US$2,000 and over $9,000 per year per person. Insurance may not have covered this. Blood-pressure-lowering medications, known as antihypertensives, are sometimes prescribed as a preventative to reduce how often migraines occur and the length and severity of headaches. Current prescribing guidelines recommend a few classes of blood-pressure (BP) medications: beta-blockers and angiotensin II antagonist receptor blockers (ARB).
Researchers at The George Institute for Global Health, Sydney, Australia, have found that almost all antihypertensive classes can reduce headaches for migraine sufferers.
This study shows that GPs can prescribe common BP medications to patients with migraines or severe headache episodes.
Researchers performed a meta analysis of all randomized studies of antihypertensives for the prevention of episodic headaches, defined as fewer than 15 headache days in a month. The analysis included 50 studies and 4,310 participants. They looked at the effectiveness of BB and ARB in addition to alpha-blockers (AB), angiotensin-converting enzyme inhibitors (ACEi), and calcium channel blockers (CCB), compared to a placebo.
Before we dive into the study findings, let’s take a look at how each class of drugs reduces BP, without going into great detail about their physiological effects, and a few common brand names. Beta-blockers, such as Tenormin, Lopressor Toprol and Levatol, lower heart rate. ACEi (Capoten Monopril Accupril Lotensin) reduces the production of angiotensin which helps to relax and dilate the blood vessels. ARB (Atacand Micardis Avapro) blocks the angiotensin effect, producing a similar outcome to ACEi. CCB (Norvasc Plendil Adalat) prevents calcium from entering muscle cells in the heart and arteries. This results in dilated blood vessels, a reduced heart rate, and a dilation of narrowed arteries. AB reduces resistance to arteries by relaxing the muscle tone.
Researchers found that each class of drugs had a lower number headache days per month compared with a placebo. The exception was those taking ACEi, or a combination antihypertensives. CCB was the drug that reduced monthly headache days the most. Antihypertensives, on average, reduced the number headache days per month in addition to the placebo effect by one day.
Researchers say that their findings are “clinically important” due to the availability and lower cost of antihypertensives and health insurance coverage. Weight gain and drowsiness are two common side effects of migraine medication.
Faraidoon Haghdoost is one of the study co-authors. “Around 90 percent of migraine sufferers can be managed by general practitioners, with the goal of preventing as many episodes as they can because of their disabling effect on the patient’s life,” she said. The good news is that many blood pressure medications can be found at low prices, and some are available in generic form. They are a reliable treatment option, alongside other preventive measures like avoiding triggers or making lifestyle changes.
Researchers plan to conduct a second review to find out which antihypertensive medications work best in combating migraine headaches.
The study was published by the journal Cephalalgia.
Source: The George Institute for Global Health
Have you ever had a sore back from hunching your neck over your phone or computer screen?
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LOUISVILLE (WAVE) – June is National Migraine and Headache Month.
Norton Healthcare wants to raise awareness about headaches, their causes and symptoms.
Kevin Maynard describes his headaches as “crippling”, “debilitating” and “debilitating”. He began experiencing them 15 years ago. They would appear, stay for 72-hours and then disappear for several months. They became a regular monthly problem.
After being misdiagnosed for years with migraines, he met Dr. Mandy Whitt at Norton Healthcare. She diagnosed Maynard immediately with cluster headaches.
The correct diagnosis led to the proper treatment which has resulted in him being headache-free since 18 months.
Maynard said, “She found something that helped with the pain until therapy was found to prevent them.” “It was life-changing, because they would ruin my entire life for those periods.”
Whitt said that cluster headaches were not common but extremely painful. She took his concerns very seriously.
She advised people to take note if their headaches were becoming unbearable.
“Their details will help me figure out their plan of treatment. Would oxygen help them?” “Are they usually out and about when having them?” she asked.
Maynard is headache-free now for more than one year. He said that he was able to pursue hobbies such as woodworking. He made a rocking pony for Dr. Whitt’s children as a way to say “thanks”.
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A young woman who had life-saving surgery performed at Beaumont Hospital in January has pledged to raise funds for research to help doctors and other patients in similar situations.
Clare Kavanagh, from Wexford, was living a normal life in January 2023 when a persistent neck pain began to bother her.
“I was living my life as normal, working, planning the future, spending time with family and friends, and looking forward,” she said.
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She says that in “what appeared to be a blink of an eye, everything changed” when she began experiencing health problems which she had at first attributed to a previous injury or sleeping a certain way.
“I was experiencing persistent neck pain for several months. I went to physiotherapy, and put it down to a previous injury or sleeping a certain way,” explained the woman.
Clare, when physio failed to resolve the issue, sought a referral for a MRI scan. We assumed that it was a recurrence of an old injury because nothing else had been on our radar.
She said, “The results of my MRI were shocking.”
“It showed that a large tumor was growing inside my spine cord. This tumour was at the top of my spinal cord, just below my cerebral stem. This is a rare type of tumor, located in a dangerous location for surgery or treatment.
The tumour was located in the “prime real estate” of the spine, and surgery was the only way to remove it. I would have ended up in a wheelchair and suffered further degenerative effects if this surgery had not been performed.
Clare, a young and fit woman, found it difficult to comprehend the life-altering scenarios and risks that doctors described in the event of a failed surgery.
“I was referred by Beaumont Hospital to the best neurosurgical team in the nation. This team was the only one that could handle the risks of the surgery. Clare explained that she was “my only hope”.
“Within five-weeks of my diagnosis, I underwent an arduous, 12-hour surgery that was highly precise. The outcome was nothing less than a miracle. “I attribute this miracle to the skills, dedication, and experience of my medical team, as well as the prayers of many!”
Clare’s team of Beaumont surgeons was able to remove the entire tumour. She still has a long recovery road ahead of her, but she achieved the result she wanted.
She said that due to the invasiveness of the surgery she had to relearn to walk and regain use of her arms and hands. The Wexford woman, however, is determined to not only rebuild herself but to raise money to help others.
“I promised before I went to hospital that if it could be removed by a miracle, I would do everything I could to raise money for the people who saved my life. My surgeon, Professor Bolger, asked that the money be donated to the Beaumont Neurosurgery Research and Development Fund.
“I will be organizing a fundraising concert once I am physically recovered, but I wanted to start the ball rolling by creating a GoFundMe account. This money will go towards the incredible work of this team and department who literally save lives every day. These funds are needed because we all know that the health care system is broken.
“I’ll never be in a position to repay them in full, but I can at least contribute in a small way to the amazing work that they do in Beaumont.”
Clare raised EUR6,000 in less than 24 hours. Donations came from all over. Clare thanked her family and friends, as well as all those who contributed to the fundraising. She told people to keep their eyes open for concert details coming in the new year.
Clare’s GoFundMe Page can be found HERE.
A federal jury, despite the defendant’s admission of negligence, awarded no damages to the woman who claimed neck injury following a rear-end accident on Interstate 64.
The big question was whether she was injured, and if so, how much of her injuries were related to the accident, said Brian McChesney, an attorney with Rynearson, Suess, Schnurbusch & Champion.
McChesney represented Jeffrey Gershman for his February 2019 traffic accident in St. Clair County in Illinois with plaintiff Teresa Neville. Neville claimed that she would require a cervical fusion in order to relieve the neck pain caused by her accident.
McChesney said that Neville’s problems requiring hydrocodone and chiropractic treatment dated back nearly two decades. McChesney said the crash was not the cause of the problems.
“When we looked back at the six-month period before the accident, her terms used in speaking to her doctors were almost the same as those she used after the accident,” he said.
McChesney stated that there was little dispute about the facts of the crash and his client admitted fault.
Emery Reusch, of Brown & Crouppen who represented the plaintiff did not respond to a comment request.
RELATED Click to search and submit your Verdicts and Settlements
Defense verdict for out-of-state
Motor vehicle collision
Venue: U.S. District Court, Southern District of Illinois
Case Number/Date 3:21-cv-131/March 9 2023
Judge: Reona Dally
Plaintiffs’ Experts : Eric Sincoff (neurosurgery), St. Louis
Experts for the Defendants: Donald deGrange (St. Louis)
Last Pretrial Demand : $150,000
Last Pretrial Offer: $100
State Farm Insurance
Caption: Teresa Neville v. Jeffrey Gershman
Plaintiffs’ attorneys: Emery Reusch Brown & Crouppen St. Louis
Defendants’ Attorneys: Brian McChesney, Rynearson, Suess, Schnurbusch & Champion, St. Louis
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This is part 1 of a detailed look at the labor shortages and hiring issues in the equestrian sector that was first published in the Chronicle of the Horse issue of June 12 & 19 2023. Tomorrow, we will be addressing the challenges of retaining staff once they are hired.
The equestrian sector is likely to continue to face labor shortages in the near future, especially with the U.S. unemployment hovering at around 3.4 percent. Some equine owners and consultants say that it is time to rethink the labor situation.
“The issue of employment and retention is a concern for the equine sector in the U.S. and it’s a major concern when we consider our sustainability as an equine-related industry,” says Karin Bump. She is the founder of the National Association of Equine Affiliated Academics in Madison County, New York, and of Saddle Up NY.
Since months, the U.S. labor force participation rate has struggled to rise above 62 percent, despite efforts to attract more Americans to the workforce. There are many stories in the news about businesses that struggle to find enough support to stay afloat, and equine operation is no exception.
Margie Hutchison is the owner of Larkin Hill Farm in North Chatham. The farm offers boarding and training for horses. “Every restaurant, store, and everyone is crying out for help.”
She said that everyone has the same story.
Hutchison says, “It is hard to find people and even when they respond and say they’ll come in for an appointment, they often don’t show.” “I hear this from many businesses, not only those in the horse industry.”
Elizabeth David-Zoerhof of Zoerhof Classical Horsemanship, Boyne City Michigan, says it is harder to find experienced people. “It has been difficult for me and my friends in this area,” she says. It doesn’t matter which discipline you are in, the problem is the exact same.
Laws and Logistics
Elisabeth McMillan, an industry consultant with EquestrianProfessional.com, says that, based on surveys she has conducted, the severity of the labor problem varies among equestrian businesses depending on such things as the size of operation, location, types of employees, and how employees are managed and treated.
She says that businesses and barns who are trying to expand their equine business are finding it difficult to find enough grooms at home and to help out at shows. She says that there aren’t enough grooms available. “It’s highly competitive and the cost per day help can be prohibitive.”
McMillan explains that there are also differences in the way employees are classified. She says that “most horse business owners don’t classify their employees” as employees. “They incorrectly classify them private contractors. This exposes them multiple risks.
These risks include an Internal Revenue Service Audit and uninsured workers. McMillan says that the reason for the misclassifications in the horse industry is that even when employees are classified correctly, the costs associated with payroll taxes and workers’ compensation insurance can be so high that the business may end up operating at a loss.
Lois New, the owner of Bon Accord Lusitanos, in Ballston Lake New York, found out that truth when she decided to hire full-time employees. She says, “It is a big decision for a business owner to hire full-time staff because it involves so many responsibilities including employment regulations and costs.”
It can be more difficult for equestrian operations who can’t afford full-time staff or don’t require it. “Part of the issue is that I don’t have enough full-time staff. Hutchison explains that she doesn’t need someone to work all day. “I also need someone local, because no one will drive an hour to do a few hours’ work.”
McMillan says that skirting labor laws is a challenge when using part-time workers, or what some barns refer to as contract work. When it comes to hiring private contractors, some horse show grooms might be an exception – if they’re hired at the show and use their own tools. They can also set their own working hours. But it’s a grey area where penalties and mistakes are high.
Equine industry consultants state that while the ability to offer full-time positions and a good salary may be attractive to some applicants, it is not attractive to all.
David-Zoerhof aims to reach out to retired workers. “I target retired workers who want to remain active, but don’t need a full-time job and prefer a few hours of work here and there,” says David-Zoerhof. Like many barn owners she also relies heavily on her family. “My mother helps as much as she is able to,” she says.
Bump says that barns of all sizes will need to implement staff development programs to attract qualified employees. “When new employees arrive, you should make them feel valued and give them the opportunity to grow, even if that means starting their own business from the stable.”
McMillan concurs: “The horse professionals who report success in hiring and keeping good employees report similar protocols about the way they treat their employees. They onboard their employee. They encourage and educate their employees to keep them engaged. They give feedback. They value the employees as important members of the barn. They pay fairly, but not excessively. Average of $15.00 an hour for work at home, more at horse show. Employee turnover is the worst for those who complain about their workers. They hire them, expect that they will do the job, then punish them if they don’t.”
Holly Fisher, Hilltop Farm Inc.’s operations director in Colora, Maryland, says that part-time work can be more attractive than full-time work in some cases.
She says, “In our recent job searches, we found that we needed to broaden our scope, which also meant adapting our position.” In the past, we looked for full-time employees with some working student/intern roles. We’re now finding that part-time jobs with increased flexibility in scheduling are more successful.
This is part 1 of an article which appeared in the issue of The Chronicle of the Horse, June 12 & 19 2023. Subscribe to the digital version of The Chronicle of the Horse, and enjoy an entire year of the publication. You’re missing out on so much unique content if you only follow COTH online. Each print edition of the Chronicle is packed with in-depth competition information, fascinating features, probing look at issues within the sports hunter/jumper eventing and dressage and stunning photography.
NSW will look to restore pride in their jerseys when they return to Sydney for the State of Origin dead-rubber match next month.
The Blues’ attack has been criticized for its inability, in the first two matches, to break through the Queensland defensive line. Only four tries were scored in 160 minutes.
Brad Fittler will have a lot on his mind for the third game.
Credit: Stephen Kiprillis
NSW’s defensive structure was thrown into chaos by the early injury of Tom Trbojevic during game two. The Maroons, led by captain Daly Cherry Evans and fullback Reece Walsh’s blistering pace, took advantage of every opportunity to score 32 points.
Would a change in personnel lead to a change in fortune for the Blues? Michael Chammas looks at the biggest selection conundrums ahead of game three on Saturday, July 12.
After two poor performances by his lofty standards in the Blues’ first two games, there have been calls to remove Blues skipper James Tedesco from the team.
Brad Fittler is unlikely to drop his captain. Tedesco, who will be remembered as one of NSW’s greatest players ever, has earned the right to bow out at his home instead of being a mid-series injury.
If Fittler decides to axe his captain for the third game, South Sydney’s Latrell Mitchel, if he is fit, would be an obvious replacement. The only question mark about Mitchell is his fitness.
He hasn’t been able to play for a month due to a calf problem, and isn’t known for his constant efforts. He is a dynamic player who can make an impact, but the intensity and pressure of Origin will test him.
Dylan Edwards is the other option. He is arguably the best fullback in the competition, and would look great in a Blues jersey. Fittler’s loyalty to Penrith players may deter some.
Nicho Hynes during his Adelaide Origin cameo.
Credit: Getty
Fittler must decide whether to keep the incumbent Mitchell Moses, or recall Nicho Hynes, who was dumped by the Sharks.
Moses was solid for the losing side, but his team’s inability convert pressure into points is a reflection of the Eels halfback.
Hynes was also dropped from the team for his brief cameo in game one.
Adam Reynolds, who is in great form, would be a good option for a left-field solution, even if it was a short-term fix without a long-term view. Reynolds was seen as the better option by many heading into the second game. You could pair him with his former South Sydney teammate Cody Walker and have a Rabbitohs-dominated side.
In a dead rubber it would be difficult to justify selecting a 33-year old Walker alongside Reynolds who turns 33 two days before the last game of the series in Accor Stadium.
Isaah Yeo tackles Xavier Coates in game two.
Credit: Getty
Isaah Yao was arguably the best lock forward during the last few seasons. But he looked predictable and half a step slower than the Queensland forwards in this year’s Origin Series.
Cameron Murray deserves to be in the team. However, NSW looked like a much better team when Murray was on the field. Murray played only 33 mins in game two, which is not enough time for a player with his caliber.
Murray should start game three and add some spark to a team that has been largely unsuccessful. Yeo has played all 160 minutes in the series. Murray has only played 82 minutes.
Manly’s Tom Trbojevic will miss the rest of the year after tearing his pectoral muscles in the first minutes of game two. The Blues are forced to make a change.
Latrell Mitchell had been scheduled to play in both of the first two matches, but he opted out due to injury. If he is fit, he can return to the team. Stephen Crichton is still a question mark.
He was one of NSW’s best players, but in a losing team, he may be replaced by fresh blood.
Crichton was initially selected ahead of South Sydney’s Campbell Graham for the first game, but a serious injury ended his stay at camp.
If Graham joins the team, it’s not surprising to see the Blues considering Crichton as a wing. This would put enormous pressure on Canterbury’s Josh AddoCarr to keep his position.
Crichton’s height and size will help the Blues come out of their half and also combat aerial threat from Queensland winger Xavier Coates.
The most heated debate in game two was probably the selection and use the interchange. The decision to not pick a back from the bench backfired when the replacement hooker Damian Cook was thrown in the centres to cover for Trbojevic.
NSW was lacking the speed and spark of Cook in the middle. Hooker Reece Robson had a great debut, but was exhausted and unable to run.
Hynes is likely to be considered, but there are some forwards who may sneak into the team. Spencer Leniu of Penrith is in the mix for selection. He could beat out Stefano Utoikamanu. South Sydney’s Keaon Kooamatangi, a wrecking ball, is also being considered.
Liam Martin was one of NSW’s top players in the first two matches and is likely to be pushing hard for a starting position.
State of Origin is exclusively available on Channel 9 and9Now .
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WEDNESDAY June 21, 2023, (HealthDay News). The phrase “pain-in-the-neck” is used to describe annoying people or situations that test our patience. But for those with neck pain, the situation is not funny.
Neck pain can be debilitating and affect daily life. It is a condition that leaves sufferers desperate for relief. This article will provide some helpful tips to relieve neck pain, including neck pain exercises, self-care strategies and other useful treatments.
A study led by VA Puget Sound Health Care System researchers has shown that prazosin, a drug used to treat high blood pressure, can prevent posttraumatic headaches.
Senior study author Dr. Murray Raskind, director of the VA Northwest Mental Illness Research, Education and Clinical Center in Seattle, Washington, explained that few treatment options exist for this type of headache.
Persistent posttraumatic headaches are the most common long-term consequence of mild traumatic brain injuries (concussions) in Veterans and active-duty service members, causing substantial distress and disability at home and work. Although these headaches usually resemble migraine headaches symptomatically, they often fail to respond to the prevention treatments useful for migraines.”
Dr. Murray Raskind, Director of the VA Northwest Mental Illness Research, Education and Clinical Center in Seattle, Washington
The FDA approved prazosin to treat hypertension in 1976. It has been widely used “off-label” to treat conditions such as PTSD-associated nightmares and enlarged prostate. An earlier study by members of the research group suggested that prazosin could reduce the frequency and severity of headaches caused by traumatic brain injury (TBI).
To test this effect, the researchers conducted a pilot study with 48 Veterans and service members with headaches caused by mild TBI, also known as a concussion. Participants took gradually increasing doses of prazosin for five weeks before receiving the maximum dose for 12 weeks. The study showed that the drug was well-tolerated, and researchers reported that morning drowsiness was the only adverse effect.
Before the trial began, study participants had an average of 18 headache days each month. By the end of the 12-week period, those taking prazosin only had headaches for an average of six days a month. Participants receiving a placebo reported some reduction in headaches, but still had headaches about 12 days a month. Significantly more participants in the prazosin group had at least 50% fewer headaches during the 12 weeks of taking a full dose of medication.
Participants taking prazosin also saw significant decreases in how much headaches impacted their quality of life. By the end of the trial, those taking prazosin reported that headaches had “some impact” on their daily ability to function, while participants given a placebo continued to report “severe impact” of headaches.
Larger clinical trials are needed to confirm the extent of these promising results, according to the researchers, but these initial findings offer a potential relief for a common ailment faced by many Veterans.
“This study is the only clinical trial of an oral medication to demonstrate efficacy for posttraumatic headache. Because prazosin is widely used across VA and the Department of Defense to treat PTSD trauma nightmares and sleep disruption, many VA and DOD prescribers are familiar with prescribing this generically available, inexpensive medication,” said Raskind. “Prazosin now offers an evidence-based approach to alleviate the suffering of Veterans and service members who have struggled for years with frequent posttraumatic headaches.”
TBI has been called the “signature injury” of the recent wars in Iraq and Afghanistan. Since 2000, more than 460,000 service members have sustained a TBI, most of which were mild TBIs. Headaches are common following a mild TBI, and they often become chronic and cause substantial disability and distress.
The study results appeared in the June 14, 2023, issue of Headache, the Journal of Head and Face Pain.
Veterans Affairs Research Communications
Mayer, C. L., et al. (2023) Randomized controlled pilot trial of prazosin for prophylaxis of posttraumatic headaches in active-duty service members and veterans. Headache The Journal of Head and Face Pain. doi.org/10.1111/head.14529.