Headaches
are a very common health issue for patients. Here
are a few startling statistics: 76% of all women
in the United States report having a headache
at least once a month: 57% of all men report the
same (Porth). And that is just the number of people
reporting headaches!
Headaches are one of those conditions that most
people overlook by popping an aspirin and just
going about their day. And if they are mild or
you are so accustomed to having them, then you
may not even consider them to be a condition worth
treating. That is until they occur with some regularity
or, even worse, express themselves as incapacitating
migraines. If you or anyone you know suffers from
migraines, then you are well aware of the excruciating,
I-need-to-stop-everything-I-am-doing-and-crawl-into-a-dark-silent-room-for-a-few-hours
kind of pain. In this article, we will explore
the various types of headaches, their possible
triggers and causes, and ways to treat them and
prevent them from recurring all from both a Western
and Chinese Medicine perspective.
Types of Headaches
46 million Americans report getting migraines
with 75% of those being women (WebMD.com). Migraines
tend to be throbbing in nature, unilateral, generally
center around one eye, can last for 1-2 days,
and get worse with physical activity. They can
often be accompanied by nausea and vomiting, light
and sound sensitivity, and some may even get a
preceding aura, which can be visual disturbances
like double vision, flashes of light, sparks in
the visual field or neurological symptoms like
temporary transient muscle pains or unusual sensations.
There are no proven causes for migraines, but
some theories include decreased levels of serotonin
functioning, inflammation affecting nerve conduction
in the head, and hormonal variations especially
estrogen in a woman’s cycle, which can certainly
account for the frequency of migraines occurring
consistent with a woman’s cycle and the
predominance of women suffering from migraines
as compared to men (Porth).
Cluster headaches occur mostly
in men, can be severe and unrelenting, unilateral,
come on suddenly and in clusters over a period
of weeks or even months and then not occur again
for a long while. They tend to come on within
10 to 15 minutes and last up to 3 hours. They
may occur with red eyes and tearing, nasal congestion,
a runny nose and forehead sweating.
The most common type are tension
headaches, which tend to be dull and aching, diffuse
in location and often occur with stress, anxiety,
jaw tension and caffeine withdrawals. In fact,
jaw tension, often called Temporo-Mandibular Joint
disorder, or TMJ, can easily refer pain to other
parts of your head causing headaches.
The often-overlooked sinus headaches
occur around the nose, eyes and the forehead,
and occur most frequently with nasal and sinus
congestion consistent with sinus infections, whether
obvious or not. And the last headache I see quite
often is one that comes from fatigue, hunger,
or at the end of a woman’s cycle. In Chinese
Medicine, we refer to these as deficiency
headaches. Here, either we are so depleted that
we do not have enough energy to raise to our heads,
or as a woman loses menstrual blood without replenishing
it through sufficient land-based protein intake,
then there may not be enough blood to nourish
the vessels of the head.
It is important to recognize that if you do not
typically get headaches and all of a sudden you
begin getting severe intractable
ones that disturb your sleep and come along with
drowsiness, visual or limb disturbances, or altered
mental status, you need to notify your doctor
or go to the ER immediately as this may reflect
a much more serious condition that requires immediate
medical attention.
Causes & Triggers
Other than in the case of deficiency, headaches
and migraines are caused when blood vessels in
our head swell, creating pressure causing us pain.
Our Autonomic Nervous System (ANS) acts in part
to control the dilation and constriction of our
blood vessels to help us adapt to stress in our
daily lives. If we interfere with that functioning,
whether by choice through stimulant use like sugar,
nicotine, caffeine, and stress or our ANS is hyper-sensitive
to environmental factors like odors, then our
system cannot find its own balance and homeostasis.
Other triggers can include red wine, cold cuts
and aged cheese that contain the amino acid tyramine
which is known to trigger migraines in some individuals.
Another extremely common contributing factor
in our overly sedentary lifestyles is poor posture.
We were not designed to sit at a desk staring
all day at our computers. In doing so, we teach
our muscles to exist in a very limited range of
motion, tightening our shoulders and necks to
support this heavy head of ours. With the thousands
of people I have treated in the last 11 years
of working with patients, I’d be hard pressed
to find some without a tight neck and shoulders.
Tight muscles lead to poor circulation which allows
too much blood to pool in the head and not drain
from it.
The triggers for sinus headaches are quite different.
It is an unavoidable fact that we are surrounded
by toxic influences in the air we breathe, the
food we eat, the products we use on our bodies
and the very real adverse effects of stress on
our bodies. And the sinuses are one area that
such a confused immune system can communicate
with us.
Seldom will there be just one trigger; invariably
there are a few that you stack one on top of another,
until you start to notice the consistent presence
of headaches or you get leveled with a nasty migraine.
Treatments & Prevention
The obvious most common remedies for headaches
are to take over-the-counter (OTC) non-steroidal
anti-inflammatories (NSAIDs) like aspirin, Tylenol,
and Advil. Helpful in the moment, but by no means
do they actual address the underlying problem.
And long-term use can be quite damaging to your
digestive system, your liver and your kidney function.
For migraines, you may be prescribed a caffeine-based
medication to be taken at the onset of the migraine.
You may even be prescribed anti-depressants, sedatives,
anti-seizures medications, and the list goes on.
These can once again be helpful in the moment
or keep the headaches at bay, but are still not
addressing the real issues at play.
One of the most important things I ask my patients
to do, especially when they are unclear about
the when’s and how’s of their daily
chief complaints, is to do a Food Mood Journal.
Creating awareness around your patterns of eating
and emotional states is a powerful way to teach
yourself to fish. Here we may modify the journal
can call it a Food-Mood-Headache Journal. For
7 days, you write down what you eat, when you
eat, how you feel before and after, and the occurrence,
severity, and location of your headaches or migraines.
When we can identify your pattern, you can begin
to make changes.
Then there is stress.
Everyone who walks into my office can benefit
from learning how to handle stress better. The
goal is to handle stress early enough and well
enough so that it does not manifest in our bodies
in the form of things like headaches and migraines.
Are you tightening you shoulders and neck from
computer use, or is that “just where you
hold stress?” Do you cope by eating sugar
and sweets? Does stress interfere with your sleep
causing you to drink 4 cups of coffee a day to
stay awake? Welcome to the slippery slope of stacking
triggers.
Acupuncture
and Chinese
herbs are extremely effective in
dealing headaches and migraines. One of my greatest
pleasures is when a patient comes in with a headache
or migraine and within seconds of touching a point
in their foot, their pain eases. The look on their
face is priceless! Getting rid of the pain in
the moment is not that difficult. The real challenge
comes in identifying the patterns of imbalance
that contribute to the frequency and severity
of your headaches. It involves a lot of detective
work and a willingness to leave no stone left
unturned. And as we reveal your particular causes,
we can explore the various ways you can help yourself:
getting acupuncture and massage, exercising, better
food choices, meditation and lightening your daily
toxic load by, for example, getting an air filter
for your bedroom.
~~~~
Headaches and migraines can be very debilitating
and frustrating to deal with. Self-medicating
may get you through the day, but may not keep
tomorrow from being just as painful. There is
no reason to continue suffering. Sometimes, enough
is enough and it is time to do something about
it.
~~~~
Here is a list of informative websites on headaches
and migraines:
1. WebMD.com
2. Headaches.org
3. Migraines.org
4. Medlineplus.gov
5. AmericanHeadacheSociety.org
Sources:
1. Pathophysiology: Concepts of Altered Health
States, Carol Mattson Porth, Lippincott Publishing,
2002.
2. WebMD.com
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