PHYSIOTHERAPY
INTERNATIONAL

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January - February, 1998

HEADACHE PAIN
IS NOT ALL IN YOUR HEAD
 

More than 70 percent of the population suffers from headaches. Until a few years ago, researchers thought that tensing your face or tightening your scalp and neck muscles caused headaches. Now they believe muscle tension may be a consequence of the headache.

If you're like most people, you don't go to the doctor when you have a headache. Usually a couple of aspirin, a few minutes to rest and a good night's sleep are enough to provide relief. Many people may hesitate to admit that they are bothered by headaches, especially to friends or family.
The old notion that headaches are purely psychological or due to emotional problems is a difficult one to put to rest.

But attitudes are changing. Headaches are now recognized biological disorder. At least one kind, migraine, is inherited. Headache pain is not "all in your head."

To effectively combat headaches, the first step is to identify the kind of headache that exists. Controversies exist about whether headache is one disorder or many. Tension headache and migraine may come from the same disorder. Tension headache may be the mild form and migraine the severe variety. The key to treatment is to find they type of headache that is occurring and then find the causes.

If you have chronic or recurrent headaches, your physician may try to pinpoint the type and cause of your headaches by listening to your description of your pain and using common tests such as the CAT scan or the MRI. Your doctor may also want to refer you to a physical therapist specializing in headache therapy.

Your doctor may identify your headache as the tension variety. Tension headaches are the most common and can be simply a feeling of pressure or severe enough to cause painful knots in tense neck and scalp muscles. Or after hearing your description, the doctor may believe your headache to be a migraine. A migraine will hold characteristics that include throbbing or pulsating pain, sometimes simply pressure.
Sensitivity to light and sound may exist and there may be nausea or vomiting.

If your doctor or physical therapist identifies a migraine, they may ask you to keep a headache calendar for at least two months. Each time you get a headache, jot down your description of the pain in terms of characteristics, severity, location and duration. A headache calendar can offer valuable clues to help with diagnosing your particular kind of headache. This kind of record-keeping can also help you discover your headache "triggers."
A trigger for headache pain may be almost anything in your style or environment.
Susceptibility to factors that bring on headaches varies and can change. Triggers don't cause the pain. Instead, they activate an already existing imbalance of chemicals in your brain.

Keeping a headache calendar is your best way of identifying a pattern in the things you do, eat or feel and the onset of a headache. In turn, a headache calendar can help you avoid those factors that seem to cause your headaches.

Maybe the most common headache triggers bother you. They include stress and the "letdown" after a stressful period; alcohol; some cheeses and wines; chocolate or a craving; caffeine; change in the weather or seasons, altitude, or time zones; change in sleep patterns and meal times; or polluted air and stuffy rooms.
Rest, exercise, heat or ice packs, or a long, hot shower may be all you need to relieve and occasional tension headache. If not, try aspirin acetaminophen or ibuprofen. But take the minimal dose needed to relieve your pain and only as often as necessary. Overuse can worsen your pain by causing chronic daily headaches.
If over-the-counter pain relievers fail to manage your headache, your doctor may prescribe other drugs. Try not to become discouraged, many times headache medication relies on trial and error.
Selection depends on your particular headache, how well the medication controls pain, and how you tolerate side effects. Take your medicine only as directed.

In addition to prescription medication, try heat or ice packs, a hot shower and rest. Take a break from a stressful situation. Nap in a dark, quiet room. Press an ice towel to the back of your neck and apply gentle pressure to painful scalp areas. This helps quiet muscle activity, thereby relieving tension. You may also want to attempt light exercises including nodding and gently stretching. If you smoke, you and your doctor may want to consider stopping smoking as a means of treatment. One or all of these may help.

Tension headaches also result from stress. Manage stress by exercising regularly. (Caution: If physical activity brings on a migraine, make sure you first warm up slowly.) Also practice good posture by raising your chest and keeping your cheekbone in line with your sternum. In this position, the muscles in the back and neck reduce activity by one-third. This allows the muscles time to relax, which in turn may keep headaches at bay.

Taming headache pain takes determination together with a well-rounded approach. It means balancing use of medications with exercise, regular and nutritious meals, and adequate rest. Your goal is to attack headache pain from all sides. And to control your pain; do not allow your pain to control you.

For additional information on this subject or for a consultation, please contact Hands-On Physical Therapy in one of our clinics.
 

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