Research has shown that surgical treatment for migraine helps reduce headache frequency and severity and also leads to improvements in everyday functioning and coping ability. Migraine headache patients are known to experience disability and often have difficulty performing at work and/or school. Surgery can be an effective treatment option for patients with chronic, severe migraine headaches who do not respond to other treatments. Migraine surgery procedures target trigger sites linked to headache patterns.
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Questionnaires are often used to help better understand treatments in the medical realm. Such questionnaires, while they have been used for other pain syndromes, have not been applied to migraine surgery. The study evaluated the performance of the Pain Self Efficacy Questionnaire (PSEQ) in those who had migraine surgery. The PSEQ has been used in patients with a wide range of pain conditions to study treatment outcomes. The PSEQ provides information on pain scores and on functional disability and ability to cope with pain when performing normal daily activities. A total of 90 patients who had migraine surgery between 2013 and 2015 filled out a questionnaire. Before and after surgery, patients were evaluated on a standard migraine questionnaire (the Migraine Headache Inventory – MHI) and on the PSEQ. The final analysis included a total of 74 patients who completed both questionnaires at one-year follow-up after migraine surgery.
Before migraine surgery, all of the patients had “extremely poor” PSEQ scores which indicated a high level of disability. Preoperative pain coping scores in migraine patients were substantially lower than has been reported for patients with other types of chronic pain such as neuropathic pain or lower back pain. One year after migraine surgery, the patients had a very large percent improvement (112%) in their average PSEQ score. This was much higher than in prior studies of patients with other types of chronic pain. Migraine surgery was found to improve functioning and coping in patients with very low PSEQ scores. This result was different than in patients with low back pain where if they have a low PSEQ scores to start they often have a poor treatment outcome.
Migraine surgery patients were able to recover function and ability to cope with pain well after surgery. The researchers note that surgery led to an average 76% improvement in the migraine-specific MHI score, which measures outcomes like headache duration, frequency, and severity. The research showed continued positive outcomes after migraine surgery in appropriately selected patients. The researchers feel that chronic pain questionnaires such as the PSEQ improve the knowledge of how outcomes happen after surgery and also allow for comparison with other treatments in pain conditions. It is of course worthwhile to emphasize here that the patients who had migraine surgery had first tried more convention treatments before resorting to a surgical approach.
Reference: Lisa Gfrerer, and et al., Ability to Cope with Pain Puts Migraine Surgery Patients in Perspective, Plastic and Reconstructive Surgery, vol. 141, issue 1, 2018.