Headache clinic to open at Stanford

A new clinic dedicated to arguably one of the most common human ailments — the headache — will open on July 28 at Stanford Hospital and Clinics, officials have announced.

The clinic will be headed by Dr. Rob Cowan, chairman of complementary and alternative medicine for the American Headache Society and a board-certified specialist in psychiatry, neurology and pain medicine.

Often a chronic condition, headaches affect 60 million Americans and cost $30 billion annually in lost productivity, Cowan said.

“In many cases, patients have searched for help without result. You’ll go to an emergency room; it’s maybe the third or fourth time you’ve been in. You’re labeled a drug seeker. You’ll be given a narcotic, which isn’t really effective. It’s a horrible situation,” he said.

Headache management has improved in the last decade, according to Meredith Barad, M.D., who is also joining the clinic.

“We are no longer throwing opiates at the pain; studies show they don’t work,” she said.

Cowan said the clinic will offer an integrated approach that focuses on prevention, lifestyle changes, physical therapy, stress management, nutritional counseling and planning for an immediate response with medication when a headache occurs.

Craniosacral work, massage and yoga with Stanford’s Center for Integrative Medicine will also be part of the program, he said.

Migraine is a complex condition that requires complex care, he said.

“We don’t have a cure, so the goal is to manage it as a chronic condition. It can become a footnote or it can ruin your life,” he said.

Stanford will also add a fellowship in headache, a rarity, said Frank Longo, M.D., chair of neurology and neurosciences. Most medical training does not include substantive teaching about migraine and other forms of chronic headache, he said.

“That’s especially remarkable, proportionately. It’s one of the most common chief complaints in medicine, and it might be the most common in the neurosciences. Unless one has specialized training, it’s a very intimidating area,” he said.