Answer #11 - Patients now are tending to certainly look to alternative treatments for any medical problem and I encourage them to do so as long as it doesn’t interfere with their medication if they have to be on medication for other reasons. Patients want to try treatments such as acupuncture, they want to try bio-feedback, relaxation exercises, etc., and if it works for them I certainly encourage that.

There have been no trials examining these things, that have been placebo controlled trials, so I cannot tell patients these treatments are effective. There has been nothing to prove these treatments are effective, but I certainly encourage patients if they wish to go that route, to try these things. In patients that cannot take medications for example pregnant woman I certainly go to these non pharmacological approaches because they simply can't take many medications and in a small population of pregnant women their headaches do get worse, so we do look in the direction of non pharmacological treatment; in which case I will often prescribe relaxation therapy, massage therapy, certain ointments like tiger balm for example.

The other non pharmacological approach is that patients will ask about herbal remedies, vitamin therapies and so on. Most recently the two vitamins that have been suggested are B12 and Magnesium. Now there are a couple of small studies that have looked at B12 and Magnesium, again I stress they are small , the evidence is poor, but I often encourage my patients if they want vitamin therapy B12 and Magnesium replacement may be something that they can think about.