Efficacy of an individualized outpatient program in the treatment of chronic post-traumatic headache.

Abstract

Twenty patients disabled for work because of chronic post-traumatic headaches were treated: 13 men, and seven women. Their ages ranged between 26 and 69 years (mean = 40.3). Their accidents occurred three months to eight years prior to the initial visit (mean = 1.5 yrs). Thirteen patients had concurrent spinal injuries. They were assigned to an individualized program with emphasis on doctor-patient relationship. All patients received medications, biofeedback, and educational sessions. Thirteen patients with concurrent spinal injuries received additionally therapeutic exercises and transcutaneous nerve stimulation. Five patients needed neuromuscular re-education, and three, stress management. All sessions were individualized. Patients attended the Center one to three times a week for three to 12 weeks (average = 9 weeks). The number of treatment days ranged from six to 37 (average = 18.8 days). The average cost of the program for patients with headache alone was $3849.00; and for those with additional spinal injuries, $7030.00. All patients improved: markedly, 14; moderately, four; and slightly, two patients. The improvement occurred within seven to 150 days (average = 48.7 days). Seventeen out of the 20 patients, (85%) returned to work within 21-224 days (average = 111 days). An individualized outpatient program is very successful in the treatment of post-traumatic headache.