P05.06. Treating Chronic Daily Headache Without Giving Yourself One: A Rational Integrative Algorithm of Care

Focus Areas: Integrative Approaches to Care, Alleviating Pain Chronic daily headache (CDH) is a descriptive term that encompasses multiple headache diagnoses and effects. It refers to a group of headache disorders characterized by a headache occurring on 15 or more days per month for more than 3 months. CDH affects 4% of the adult population in the United States, with similar figures around the world. The burden of CDH is extremely high, with considerable financial impact as well as impact on quality of life. The diagnosis and integrative management of CDH require a knowledge of distinct CDH subcategories and familiarity with conventional treatment regimens. Approximately one third of patients seeking integrative care do so because of pain. Overall, 49.5% of US adults with severe headache, 13.5 million adults, reported using at least one complementary and alternative medicine (CAM) therapy within 12 months. However, integrative therapies offered at various centers around the United States do not offer a uniform approach to pain. Sometimes the disconnect between plausible, scientific explanations and efficacy of treatment has resulted in the dismissal of integrative care. Even within the integrative medicine community, a tension exists between applying ideal-world evidence-based outcomes and real-world patient-centered care. The complex, personalized interventions required in integrative medicine lack the rigor of standardized protocols. Practitioners often struggle with when and how to use integrative approaches that may lack the scientific rationale clinicians are accustomed to when employing conventional medical options. This presentation will provide a review of a successful five-pronged, integrative medicine treatment approach for CDH. The presenters are the medical directors of Alliance Institute for Integrative Medicine (AIIM), overseeing 20 000 patient visits each year, the majority of which deal with pain.