Buchholz’s broad-based theory of migraines

Baltimore neurologist David W. Buchholz’s theories on head pain have made him sought after both on the witness stand and as a talk show guest. But some of his peers caution against applying those theories too broadly.

In a transcript of Dr. Buchholz’s 2004 appearance on Larry King Live, King discloses that Buchholz has treated his wife’s migraines.

Buchholz then explains his theory that migraine is not so much a specific type of headache as it is the underlying cause of nearly all headaches.

“The important message is that they’re not necessary,” Buchholz says of headaches in general. “They may be natural, but they’re not necessary. You can control them.”

In a video of his 2006 appearance on The 700 Club, Buchholz quotes scripture to emphasize to host Pat Robertson that painkillers are not the answer.

“Nowhere is Hosea 4:6, ‘My people are destroyed for lack of knowledge,’ more true than when it comes to this dependence on pain pills for headaches,” Buchholz says.

Shunning painkillers that lead to rebound headaches and controlling head pain through dietary changes are centerpieces of Buchholz’s book, “Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain.” The third step, if the other two fail, is preventative medication.

In a chapter titled “A Morass of Misdiagnoses,” Buchholz writes, “To a large extent, posttraumatic headache and postconcussive syndrome are migraine.” If those symptoms linger months after the trauma, he writes, “it’s likely that some other factor — such as rebound or psychological pressures of personal injury litigation — is perpetuating the problem.”

The 272-page book, published in 2002, includes a foreword by University of Maryland neurology professor Stephen G. Reich and a cover blurb by Dr. Robert B. Daroff, then-president of the American Headache Society, saying its wisdom would benefit “every headache sufferer.” It has garnered rave reviews on Amazon.com from hundreds of readers. But it has not gone through a formal peer-review process like articles in medical journals.

Randall R. Benson, a Wayne State University neurologist who has studied head injuries in NFL players, said via email that Buchholz’s three principles of treatment for migraine are “pretty standard.” But he added that several types of brain imaging studies “indicate that concussion is more than migraine.”

David W. Dodick, professor of neurology at the Mayo Clinic in Scottsdale, Ariz., and current president of the American Headache Society, agreed.

He had not read Buchholz’s book and would not comment on it specifically, but generally speaking, Dodick said, there is no cure-all when it comes to head pain.

“There’s 300 types of headache,” he said, “and each one is treated differently.”

Dodick also said that because migraine is not something that can be seen on an MRI or measured in the blood, it can be tricky to diagnose.

“Posttraumatic and postconcussive headaches look, sound, smell and feel like migraines,” he said. “The symptoms can be nearly identical to each other. Are they the same disorder? Probably not. Do they respond to the same medications? Probably not. To say that it’s all migraine is not correct.”