In this episode of CME on the Go, our hosts discuss the complexities of diagnosing and treating headaches in primary care. They cover common challenges faced by family physicians, such as differentiating between primary and secondary headaches, the importance of taking thorough patient histories, and the appropriate use of diagnostic tests like MRI and CT scans. The episode offers a deep dive into treatment options for headaches, including pharmacologic and non-pharmacologic methods, with a special focus on managing chronic daily headaches, migraine disorders, and medication overuse headaches. The discussion also touches on the role of cognitive behavioral therapy, osteopathic manipulation, and the efficacy of various medications like NSAIDs, triptans, and beta blockers.

After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link.

https://www.aafp.org/assessment/take/19579/e

Learning Objectives

1. Apply a standardized, evidence-informed diagnostic and treatment algorithm for evaluating patients with headache, while acknowledging alternative approaches.

1. Differentiate between appropriate and potentially problematic interventions, including the use of narcotics, in-office procedures, and newer pharmacologic therapies.

1. Reflect on provider discomfort and fatigue in managing headache complaints, and develop strategies to maintain empathy, clinical consistency, and patient rapport.

References and Resources

• Bahra, A., & Evans, R. W. (2021). The secondary headaches. Cephalalgia, 41(4), 427-430.

• Jairo Hernandez, Eduardo Molina, Ashley Rodriguez, Samuel Woodford, Andrew Nguyen, Grace Parker, Brandon Lucke-Wold. Headache Disorders: Differentiating Primary and Secondary Etiologies. J. Integr. Neurosci. 2024, 23(2), 43. https://doi.org/10.31083/j.jin2302043

• https://www.sciencedirect.com/science/article/pii/S1470211823000052#bib0003 Novel screening tool for secondary headache in acute care—A pilot study.

• https://doi.org/10.1016/j.clinme.2023.100005

• https://ichd-3.org/

Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose.

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