NEW YORK (Reuters Health) - Injection of a local anesthetic into active trigger points in the lower part of the neck -- the cervical spine -- ameliorates migraine symptoms, Italian investigators report.
The local treatment of trigger points can reduce the use of migraine drugs, and thus help prevent headaches caused by medication overuse, Dr. Maria Adele Giamberardino from "G. D'Annunzio" University, Chieti, told Reuters Health.
Drug overuse headaches are a "huge problem" and are becoming more frequent in migraine patients and are "extremely difficult to treat," the study investigator added.
Giamberardino and colleagues evaluated the effects of treating specific trigger points in the lower neck in 78 migraine patients. Fifty-four patients were assigned to active treatment and 24 to inactive placebo.
Active treatment consisted of intramuscular injection of the pain-killer bupivacaine at key trigger points on days 3, 10, 30, and 60 following an initial evaluation.
The researchers report in The Journal of Pain that trigger point injection was associated with significant decreases in the number and maximal intensity of migraine attacks, whereas migraine number and maximal intensity did not change significantly in the untreated patients.
"I expect the benefits will persist as long as the trigger points remain inactivated," Giamberardino told Reuters Health. "This can vary among patients. In our experience, more than 50 percent of treated patients have had stable results after 2 years, while in the remaining patients the benefits have declined over time."
Summing up, Giamberardino said this study shows that migraine can be successfully treated by local injection of trigger points, "substantially reducing the burden" of a heavy drug treatment regimen.
SOURCE: The Journal of Pain, November 2007.
