Interdisciplinary Method for the Assessment and Treatment of Chronic Headache
If you suffer from chronic headaches, with severe headaches occurring several days per week or more, you need intensive therapy. Cleveland Clinic’s Center for Headache and Facial Pain Clinic offers a unique treatment program for chronic headaches called IMATCH (the Interdisciplinary Method for the Assessment and Treatment of Chronic Headache). The IMATCH program is designed for headache sufferers whose lives have been severely disrupted. The comprehensive nature of the program simultaneously addresses medical, physical and emotional needs, combining medical management, physical therapy, and group and individual psychotherapy.
A need for a new approach
Traditionally, headaches have been treated exclusively with medications. While this is often helpful, in some cases reliance on medication doesn’t resolve the headaches, and may even make them worse. Prolonged inactivity due to pain can also cause other pain problems and make it difficult for you to continue participating in work, social or recreational pursuits. You may find yourself feeling frightened by your headaches, or depressed because of all the disruptions they cause. A team approach – which includes physical therapy, pain and stress management techniques, and medication adjustments – can address all these issues.
Intensive, multidisciplinary care
IMATCH is a three-week, full-day program that begins with a half-day multidisciplinary evaluation by a neurologist, physical therapist and psychologist. The team then formulates a joint treatment plan with input from you, which is used to guide the remainder of treatment. While some reduction in pain is common, treatment focuses on improving your ability to function in the face of pain, rather than on completely eliminating pain. We also strive to convert your daily headache into a more episodic pattern. By encouraging the resumption of normal activities, the program places you in charge of your own recovery, and seeks to break the passive, crisis-and-rescue focus of prior care.
Infusions and medications
For the four days following the initial evaluation, most patients receive intravenous medication infusions aimed at quickly removing medications contributing to headaches and/or sedation in a controlled setting. The infusion procedure also allows establishment of appropriate headache preventive medications. Nurses will teach you how to use your preventive and headache-abortive medications properly to minimize headache without impairing function. Most patients report feeling considerably better mentally, and are less sedated following these infusions.
Beginning in the first week, the program also provides group and individual physical therapies. These emphasize improvement in strength, flexibility and endurance through structured exercise. As you see yourself becoming stronger, you will gradually regain confidence to increase your activities outside the program as well. Such activity improvements are encouraged, and patient groups frequently visit tourist attractions throughout Northeast Ohio in the evening and on weekends during treatment.
Psychological interventions begin in the first week as well, but become more intensive during the second and third weeks, after the intravenous infusions have been completed. Most of the psychological treatment is completed in groups, providing you with encouragement and mutual support from other patients. You will learn to reduce any depression and anxiety you may have been feeling, as well as to eliminate pain behavior and develop more assertive means of dealing with others. Multiple relaxation techniques are taught, both for pain control as well as to enable you to avoid panicking during a pain crisis. These skills are enhanced by weekly individual biofeedback sessions and individual psychotherapy. A weekly meeting is held for family members, in order to help you maintain your treatment gains in your home community.
Patients completing the program have reported significant decreases in the severity and frequency of their headaches, increases in daily function, and improvements in mood. The program staff plans follow-up visits to determine the stability of the changes you have made following discharge, and to promote further progress.
All IMATCH and Center for Headache and Facial Pain Clinic services are offered at:
Cleveland Clinic’s main campus
WO Walker Building, C Building, Desk C21
10524 Euclid Avenue
Cleveland, OH 44195
For an appointment or for more information, call us locally at 216.636.5860 or toll-free 866.588.2264.
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