Behavioral Therapy May Ease Teen Migraines

Does your teenager get migraines? Before you reach for the medication, you might want to consider therapy, according to a new study.

Ohio University researchers found that behavioral therapy -- not medication -- may be the most effective weapon against migraine pain for teenagers.

Researchers studied 30 teens ages 12 to 17 with migraines. Half received triptans, a class of drugs widely used by adults with migraines, and half received a phone-administered behavioral therapy program that included instruction in biofeedback and a variety of relaxation exercises.

Eighty percent of the kids receiving behavioral therapy recorded a decrease of more than half of their migraines per month, according to Connie Cottrell, who will present the findings at the American Headache Society's annual meeting June 21 in Seattle.

Teens in this group also recorded an 80 percent reduction in the hours of activities missed due to migraine pain.

Migraines affect some 8 million children and adolescents, resulting in more than 1 million lost school days each year, according to the Journal of the American Medical Association Migraine Information Center.

"Some of these kids were in so much pain, they were just tearful," Cottrell said. "There was one boy whose parent told me would just lie on the bed, hold his head and cry because the pain was so bad."

Studies over the years have revealed a lot of information about the prevention, onset and treatment of migraines in adults. But even though the peak onset for migraine headaches is around 15 years of age, there is less research on migraines in children and teens.

"Triptans are promising treatments for teens," said Ken Holroyd, a professor of health psychology at Ohio University. "However, if teens can learn to control migraines without medication, this could save decades of medication consumption."

The teenagers in the behavioral therapy group were given a manual written by Cottrell called "STOP" (Strategies to Take Out the Pain), which included information on ways to identify early signs of migraine and how to manage the triggers that bring on the pain. The book also offered training in relaxation, biofeedback and stress management.

Teens read a chapter each week and discussed what they learned during a 20- to 30-minute phone conversation with project leaders.

"Most people who have headaches want to talk about them because they're used to no one listening to them," Cottrell said. "I didn't have any problems getting them to talk about their headaches. Some of the teenagers didn't do all the reading they were supposed to and in those cases, we talked about what they should have read over the phone so they were exposed to the information."

But for the most part, teens in the study were eager to learn to control their headaches, Cottrell said. The teens also responded favorably to biofeedback therapy, which, in this project, involved a small electronic thermometer that attached to a teen's finger to measure body temperature. Kids were taught how to increase the temperature in their fingers, a process that triggers blood vessels in the head to relax, lessening headache pain.

"Interestingly enough, it was a lot easier for the teenagers to do the biofeedback than for adults," Cottrell said. "Maybe it was because it uses a computer and kids thought it was cool or maybe kids are more open-minded."