Headache affects virtually every aspect of life, from employment to social and personal relationships. Severe headache also disproportionately affects women, which means that management of headache through the childbearing years poses a particular set of problems. Overuse of medication in well-meaning but unsuccessful attempts to control frequent headaches is common in both sexes and can lead to conflicts between the sufferers, their families, and their physicians. Headache sufferers often feel as if they have simply lost all control over their medical condition and their lives.

Although recent advances in medications for migraine have greatly helped countless headache patients, many others still have problems finding effective diagnosis and treatment. The University of Iowa Health Care's Headache Clinic is dedicated to quality diagnosis and comprehensive, individualized management, in close cooperation with the patient's personal physician.

Clinic Procedures
The initial evaluation of every patient at the Headache Clinic has two goals: making certain the diagnosis is accurate, and developing a personalized, effective treatment plan.

Patients who have unusual or concerning headaches have access to some of the finest facilities in the country for such procedures as head scans (MRI or CT) and laboratory studies. Specialists in all fields are available at University of Iowa Hospitals and Clinics for consultation as needed. Fortunately, most headaches are benign, that is, not due to dangerous or worrisome conditions, and do not require extensive testing.

Once diagnosis is complete, we can choose among a large and constantly expanding menu of treatment options to put together an individualized program. Although medications can dramatically improve the lives of many headache sufferers, others find themselves in never-ending cycles of headache and medication use, with a once-helpful drug actually causing chronic headaches by a "rebound" effect. For those who have particular difficulty with never-ending headaches or use of pain medications, inpatient treatment can often lead to a significant turnaround in pain control and medication use.

In addition, a number of complementary and alternative treatments are available by referral for appropriate individuals:

• Physical therapy
• Injection evaluation by anesthesia pain clinic
• Relaxation training
• Biofeedback
• Pain psychology or psychiatry evaluation
• Acupuncture
• Nutritional counseling
• Referral to appropriate specialists in other fields

Following the initial evaluation, the patient may be followed either at the Headache Clinic or through his or her personal physician, as appropriate and desired. Close communication with referring physicians is a strong goal of the Headache Clinic, as we understand that headache is a chronic disease requiring ongoing treatment in the home community setting. The eventual aim is always to put the patient in control of headaches, and in so doing, of his or her life.