A new, relatively simple treatment has been developed to ease the pain experienced by those who suffer from migraines. The procedure delivers anesthetic lidocaine directly to the nerves in the back of the nasal cavity, and preliminary research indicates it could offer significant pain relief to migraine sufferers.
According to the small, but ongoing study, the early findings suggest that a single outpatient treatment could reduce the pain associated with migraines by about 35 percent for up to a month after the procedure.
The technique is "a minimally invasive treatment option," said the study's lead author Dr. Kenneth Mandato, a vascular and interventional radiologist at Albany Medical Center in Albany, N.Y. He added that he views the new procedure as "a clear simple alternative" to standard migraine treatments.
"This nasal spray option is safe, convenient and innovative," Mandato says.
For the study, researchers focused on 112 patients averaging approximately 45 years of age that suffer from frequent migraines or cluster headaches. Before beginning the study, patients were asked to rate their pain levels from 1 to 10, with pre-treatment scores averaging more than an 8. The participants then underwent a therapy session during which a spaghetti-sized catheter was inserted through the nostril into the nasal passage, to deliver the dose of lidocaine directly to the nerve center known as the sphenopalatine ganglion.
The target nerve bundle, explains Mandato, "resembles a complex highway crossing with many [nerve] signals and exits going in all directions." And, he said, the hope was that lidocaine would essentially short-circuit that bundle's headache-causing pathway.
The day after the procedure average migraine pain levels had dropped from over 8 to just over 4, with pain scores only rising marginally a week after the procedure and reaching an average of 5 a month after the treatment.
The procedure didn't help everyone, however, with seven of the patients failing to receive any benefit from the treatment. But 88 percent of those in the study did report needing less standard pain medicine after undergoing the procedure.
Researchers have acknowledged that the procedure is only temporary and would have to be repeated to keep pain levels in check. Currently, the team is monitoring patients to determine how the nasal spray treatment holds up six months after being administered.
Dr. Richard Lipton, director of the Montefiore Headache Center in New York City, described the findings as "very dramatic."
"Unmet treatment needs in chronic migraine are huge, as is the overuse of medications," Lipton says. "When a body gets used to having a chronic headache suppressor, the patient can experience a rebound in the absence of that suppressor. So developing an effective treatment that can reduce the need for acute medicine would be very valuable."
"These results sound very promising. Of course, it remains to be seen if the demonstrated benefit already seen holds up over a longer period of time, and with a bigger group of patients."
