NONPHARMACOLOGICAL MANAGEMENT OF HEADACHES DURING PREGNANCY

Concerns about the effects of maternal medications on the growing baby limit the use of medication treatment for benign conditions, such as recurring headaches, during pregnancy and lactation. Nonpharmacologica l therapies hold particular promise for pregnant women due to the limi ted medication options. No controlled studies, however, have reported on the efficacy of nonpharmacological treatments for pregnant women. T he first study evaluated the effectiveness of a combined nonpharmacolo gical treatment (CT) consisting of relaxation, skin-warming biofeedbac k, and physical therapy for pregnant women with chronic headaches. In a second study, the CT protocol was compared with an attention control (AC) that received headache education and skin-cooling biofeedback. T he first study resulted in significant symptom improvement in 79% of s ubjects, with an overall 72.9% reduction in headaches. In the second s tudy, both groups improved with treatment; however the CT group was mo re likely to experience significant headache relief (72.7%) than the A C group (28.6%, chi(2)(1) = 4.97, p < .03). Significant improvement wa s maintained at a 6-month follow-up for over 50% of patients, It is co ncluded that the combined nonpharmacological treatment was more effect ive than an attention control in reducing headaches during pregnancy. This treatment was effective regardless of predisposing variables.