In this blog, we delve into the misclassification of migraines and how the current system, despite its international acceptance, is falling short in addressing the true nature of migraines, how to effectively treat migraine headaches and the challenges faced by those who suffer from them.
A Deeper Look At The Classification Of Migraines Over The Years
Over the last few decades, the way medical experts view migraines and headaches has changed significantly. In 1962, the Ad Hoc Committee introduced the first ever classification for headaches, they categorised migraines and headaches based on the anatomical structure from where the pain originates.
The primary headaches were classified based on the following sources of pain:
Vascular
Muscle Contraction
Muscular / Vascular
This meant that doctors had to examine the patient in order to determine where the pain originated and then direct the treatment towards that anatomical structure, being the arteries, muscles or both.
However, things changed in the 1980s. The International Headache Society decided try and improve on the 1962 classification and appointed a new classification committee in 1985. This committee created the International Classification of Headache Disorders (ICHD) and in 1988, they introduced a new classification for migraines.
With the new ICHD classification, migraine diagnosis is based solely on the symptoms experienced. Notably, this new classification removed any references to diagnosing headaches based on the origin of the pain. Therefore, doctors no longer needed to identify the source of the pain through a physical examination. Over the years, the ICHD has become the gold standard for headache research, with all research accepted by the Headache Journals being based on the ICHD classification criteria. However, though well-intentioned, this classification was not based on robust data or evidence, raising doubts about its effectiveness.
Spotting The Flaws In The Current ICHD Classification System
The 1988 classification system, while widely accepted, has sparked debate among experts, and Dr. Shevel is a prominent figure in this discussion.
One significant concern is the lack of solid scientific evidence supporting the migraine classification criteria. For instance, using the frequency of migraine attacks or the duration of migraines as diagnostic criteria to treat migraines lacks a strong scientific foundation.
Furthermore, the new classification increases the chances of misdiagnosis. Many symptoms listed in the classification can be shared with other medical conditions.
Thirdly, the treatments do not address the cause of the migraines. In a public debate on migraine classification in 2009, Dr. Shevel pointed out that there's no evidence to suggest that the current treatments and medications address the root cause of migraines. Instead, they primarily alleviate the symptoms. This superficial approach can result in recurring migraine episodes, trapping patients in a cycle of pain and temporary migraine relief.
The 1988 classification system, while widely accepted, has sparked debate among experts, and Dr. Shevel is a prominent figure in this discussion.
One significant concern is the lack of solid scientific evidence supporting the migraine classification criteria. For instance, using the frequency of migraine attacks or the duration of migraines as diagnostic criteria to treat migraines lacks a strong scientific foundation.
Furthermore, the new classification increases the chances of misdiagnosis. Many symptoms listed in the classification can be shared with other medical conditions.
Thirdly, the treatments do not address the cause of the migraines. In a public debate on migraine classification in 2009, Dr. Shevel pointed out that there's no evidence to suggest that the current treatments and medications address the root cause of migraines. Instead, they primarily alleviate the symptoms. This superficial approach can result in recurring migraine episodes, trapping patients in a cycle of pain and temporary migraine relief.
The Impact Of The 1988 Classification On Migraine Sufferers
For those living with chronic migraines, the implications of an incorrect classification system are intense. Imagine seeking help for a condition that cripples you, only to receive a treatment that doesn't truly address the source of your pain. This is the harsh reality for many migraine sufferers.
Due to the flawed classification, migraine sufferers are often faced with:
Generalised treatments: Instead of receiving personalised treatments for their specific type of migraine and the source of their pain, they often receive generalised treatment based on common symptoms.
Trial and error approach: This approach leads many to jump between treatments and medication, trying to find something that works, prolonging their pain and suffering.Emotional and financial strain: The ongoing search to prevent and treat the migraine pain not only causes feelings of frustration and hopelessness but also results in missed workdays and increasing healthcare expenses.Generalised treatments: Instead of receiving personalised treatments for their specific migraine type and the source of their pain, they often receive generalised treatment.
Trial and error approach: This approach leads many to jump between treatments and medications, trying to find something that works, prolonging their pain and suffering.Emotional and financial strain: The ongoing search not only causes feelings of frustration and hopelessness but also results in missed workdays and increasing healthcare expenses.When the migraine classification system isn't accurate, it affects people in many ways. It impacts their health, their emotions, and even their finances. This not only complicates their journey to migraine relief but also hinders their access to treatments that could truly address the root causes of their migraines and provide them with permanent pain relief.
Conclusion
