Non-pharmacological and pharmacological prevention of episodic migraine and chronic daily headache

Episodic Migraine and Chronic Daily Headache are common disorders affecting millions of Americans, with a significantly disproportionate affect on women. West Virginia, due to its high obesity rates and lower socioeconomic status, is likely more heavily affected by these conditions. Prevention of episodic migraine goes well beyond the limited scope of medications and includes many areas which physicians need to be knowledgeable, including lifestyle modifications, trigger avoidance, and relaxation therapies. The prevention of progression of episodic headaches to chronic headaches includes a number of options, possibly most importantly the prevention of medication overuse from either over-the-counter or prescription medications. Despite limited evidence based pharmacologic options for the prevention of headaches, there are many safe and effective mechanisms in which physicians can help their patients limit the burden of migraine and prevent the progression toward chronic daily headache.