A new letter published in the Journal of the American Medical Association Internal Medicine shows that doctors often recommend unnecessary and expensive brain scans for headaches.
Rising Numbers of Brain Scans and Costs
Doctors writing into the journal presented their research, which showed that brain scans for simple headaches had increased threefold since 1995. In 1995, only 5% of people who went to their doctor with a headache were recommended for a brain scan, but by 2010, that number had increased to 15%. About three-quarters of those sent for brain scans were women, and most of them were under the age of 65.
Researchers cited multiple potential causes for the increase. Most doctors will say they do it to reassure patients when asked, but it’s also likely that defensive medicine plays a role. Doctors might recommend brain scans just in case they are afraid they might later face a lawsuit for missing a serious condition. Doctors may also recommend a brain scan because they have a profit motive. Many doctors invest in outpatient centers where brain scans are done, and want their investment to pay off in the form of increased fees.
In total, researchers noted that the cost of brain scans comes to about $1 billion a year.
Part of the problem is that doctors don’t have good guidelines for recommending brain scans.The US Headache Consortium developed brain imaging guidelines for nonacute headache, but these guidelines aren’t especially helpful.
There are only two recommendations that are made with a “B” grade of confidence:
Patients with an abnormal finding on a neurologic exam should be referred to a brain scan
Without abnormal findings on a neurologic exam, people with migraines shouldn’t be referred for a brain scan
All other recommendations aren’t made with a very high level of confidence. There isn’t much evidence to support them.
Talk to your doctor about your risks, but be wary of a referral for a brain scan if you don’t have abnormal neurologic findings.
TMJ Treatment for Headaches
There are many potential causes of headaches, and often doctors are just guessing at what might be responsible. This makes it hard for them to give you a successful treatment.
If your current headache treatment isn’t working to prevent headaches, you should be tested to learn whether TMJ might be responsible.
If TMJ is the cause of your headaches, we can recommend safe, non-drug treatment that can reduce or eliminate them. To learn more about TMJ headache treatment, please call