Practical Pain Management: What’s Old, What’s New in Migraine Treatment

Migraine headaches are a common cause of disability in the United States, affecting approximately 27 million American adults, or 17.1% of women and 5.6% of men.1 To help better define migraines, the term classical migraine has been replaced with migraine with aura, and non-classical migraine is now referred to as migraine without aura. Chronic migraine, which affects 3.2 million Americans (2%), is defined as having migraine symptoms for at least 15 days per month, lasting at least 4 hours, and for longer than 3 months in duration. This is in contrast to episodic migraine, which causes symptoms on fewer than 15 days per month.2 Current treatment for chronic migraine is divided into acute, abortive agents (analgesics, triptans, ergots, etc.), and medications that will prevent migraine onset.

This review written by Lawrence Robbins, MD for Practical Pain Management highlights the current definitions of migraines, as well as treatment options. To read the full article, visit

  1. Lipton RB. Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):342-349.
  2. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders. 2nd ed. Oxford, England: Blackwell Publishing; 2003.

Board of Directors – Sarah Rahal, M.D.

Dr. Rahal is an Assistant Professor of Neurology and Pediatrics at the Icahn School of Medicine at Mount Sinai. She is a board-certified pediatric neurologist, also specializing in headache medicine with an interest in integrative medicine. She obtained her medical doctorate from New York Medical College in Valhalla, NY, and then went on to a Pediatrics residency at Westchester Medical Center. She completed her Child Neurology residency at Columbia University Medical Center-NYP, and following this, a Headache Medicine fellowship at the Icahn School of Medicine at Mount Sinai. Dr. Rahal is a member of the American Academy of Neurology, the American Headache Society, and the Child Neurology Society.

Stigma of Migraine Has Impact on Outcomes

The symptoms of migraine can be difficult for anyone, but the stigma associated with the disease may also be negatively affecting their health. According to a presentation at the 27th Annual Stowe Headache Symposium sponsored by the Headache Cooperative of New England, individuals are more likely to hide their disease and not seek treatment due to the stigma.

The stigma of the disease also has an impact on providers. Continue Reading