The Triptans, Migraine and Sinus Headache

August 7, 2009 by dean · Leave a Comment 

It has been claimed that the effectiveness of the triptans in someone experiencing facial pain does not exclude a diagnosis of ‘sinus’ headache because it has been shown that the ‘triptans’ do relieve the pain of sinusitis. Whilst this is true (because abnormal information from a diseased, infected sinus will sensitise the brainstem and the ‘triptans’ desensitise the brainstem), the relief from pain will not continue once the effect of the ‘triptans’ has worn off if the facial pain were coming from an infectious condition – the triptans are not an antibiotic.

But why take a ‘triptan’ when an examination of the neck will confirm in most cases, in my clinical experience of over 13000 hours, a neck disorder as the sensitising source in the headache and migraine process?

Cheers

Dean

(Hoskin KL, Kaube H, Goadsby PJ. Sumatriptan can inhibit trigeminal afferents by an exclusively neural mechanism. Brain1996; 119:1419-28

Kari E, DelGaudio JM. Treatment of sinus headache as migraine: the diagnostic utility of triptans. Laryngoscope 2008 Dec;118(12) :2235-9

Kim H. The characteristics of sinus headache resembling the primary headaches. Nippon Rinsho 2005 Oct;63(10):1771-6)

About dean
Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally. For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.

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