Suggest treatment for migraine headaches with history of cervical spine fusion surgery

Posted on Tue, 25 Nov 2014 in Back Pain
Question: I had cervical spine fusion surgery in 2009. I've always had migraines but it was the worst ever for a solid week after the C5-C6 Fusion. It seems like my migraines are getting worse. I'm 58 years old and a very active golfer. I've had spinal injections since for pain management. I do have spinal degeneration. I recently started a detox cleanse about 4 days ago. I haven't had caffeine for the last 4 days. Ive had two migraines a day since. I currently take Imitrex which I've taken for nearly 20 years. It definitely makes my headache go away. But from what I understand it constricts the blood vessels whereas caffeine expands them. Im very confused on how to attack the migraines. I hate taking that many Imitrex (2 a day for the last 4 days).
Answered by Dr. Suresh Heijebu 2 hours later
Brief Answer:
Combine naproxen for excellent relief

Detailed Answer:
Hi Sir.

I have read your query and understand your concern.

Migraine is caused by cerebral vasodilation and is relieved with vasoconstriction.Imitrex will certainly cause cerebral vasodilatation and abort the acute attacks of migraine.

The severity of migraine attacks in your case can be linked to post cervical fusion surgery as the aggravating cause.

Coming to coffee intake and migraine ,the relationship is complex.

Caffeine relieves headache if taken occasionally(by increasing the availability of imitrex to brain)and will cause headache if taken continuously in migrainous patients.

These mechanisms are unclear and are supposed to be due to the development of tolerance on long term coffee ingestion which leads to rebound headache.

To conclude its always advisable to avoid coffee in patients with chronic migraine.

In case of severe frequent attacks of migraine,its advised to take tab Naproxen 500 mg initially followed by 250 mg 8th hourly with or without sumatriptan for excellent relief of symptoms.

This drug can help to substitute Imitrex on long term use.
Also avoid migraine triggers.

This drug should be taken only under strict medical prescription.

Hope i have answered your query,
post further queries if any.
Thank you.
Above answer was peer-reviewed by : Dr. Raju A.T
Answered by
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3657 Questions


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