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II. Treatment

Joel R. Saper, MD

JAMA. 1978;239(23):2480-2484.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THE MOST useful therapeutic tool in the treatment of a patient with chronic headache is the establishment of a trusting relationship between physician and patient. The physician must convey a genuine interest in the patient's distress, giving the patient ample time to discuss his symptoms and the social and emotional disruptions that either promote the symptoms or arise as a result of them. Because the headache sufferer is often anxious and frightened, a full explanation of the diagnostic and treatment approach can help allay inappropriate fear. Unfounded or premature emphasis on emotional factors as a cause of the headaches must be avoided, lest it encourage a defensive posture toward the physician and prevent the development of the confidence necessary for successful treatment.

NONMEDICAL TREATMENT

Isolating Triggering Factors

Migraine can be viewed as a genetically determined physiologic predisposition that is influenced by a wide variety of emotional, biological, and constitutional factors, . . . [Full Text PDF of this Article]

Footnotes
This is part 2 of two parts. Part 1 appeared in the June 2 issue of The Journal, pages 2380 to 2383.

Parts 1 and 2 are available as a combined reprint. Address requests to Department of Neurology, University of Michigan Medical Center, Ann Arbor, MI 48109 (Dr Saper).

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