Tension headaches

Migraine and Headache Symptoms

There are many different types of headaches. Although not all headaches are the same, they all share at least one thing in common -- they cause pain. But many headaches also cause other unwanted symptoms, including nausea and vomiting. This article addresses the most common headache symptoms associated with the different types of headaches.

Tension Headaches

People with tension headaches commonly report these symptoms:

Episodic Tension Headaches (occur less than 15 days per month)

Pain is mild to moderate, constant band-like pain, pressure or throbbing
Pain affects the front, top or sides of the head.
Pain usually begins gradually, and often occurs in the middle of the day
Pain may last from 30 minutes to several days

Chronic Tension Headaches (occur more than 15 days per month)

Pain may vary in intensity throughout the day, but the pain is almost always present
Pain affects the front, top or sides of the head
Pain comes and goes over a prolonged period of time

Associated Symptoms of Tension Headaches include:

Headache upon awakening
Difficulty falling asleep and staying asleep
Chronic fatigue
Irritability
Disturbed concentration
Mild sensitivity to light or noise
General muscle aching

Migraines

The symptoms of migraine headaches can occur in various combinations and include:

Moderate to severe pain (often described as pounding, throbbing pain) that can affect the whole head, or can shift from one side of the head to the other
Sensitivity to light, noise or odors
Blurred vision
Nausea or vomiting, stomach upset, abdominal pain
Loss of appetite
Sensations of being very warm or cold
Paleness
Fatigue
Dizziness
Fever (rare)
Bright flashing dots or lights, blind spots, wavy or jagged lines (aura)

Cluster Headaches

Intense one-sided pain described as having a burning or piercing quality that is throbbing or constant
Pain is located behind one eye or in the eye region, without changing sides.
Pain lasts a short time, generally 30 to 90 minutes (but can last for three hours); the headache will disappear, only to recur later that day (most sufferers get one to three headaches per day during a cluster period).
Headaches occur very regularly, generally at the same time each day, and they often awaken the person at the same time during the night.

Sinus Headaches

Deep and constant pain in the cheekbones, forehead or bridge of the nose
The pain usually intensifies with sudden head movement or straining and usually occurs with other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.

Who Gets Migraines?

The National Headache Foundation estimates that 28 million Americans suffer from migraines. More women than men get migraines and a quarter of all women with migraines suffer four or more attacks a month; 35% experience one to four severe attacks a month, and 40% experience one or less than one severe attack a month. Each migraine can last from four hours to three days. Occasionally, it will last longer.

What Causes Migraines?

The exact causes of migraines are unknown, although they are related to changes in the brain as well as to genetic causes. People with migraines may inherit the tendency to be affected by certain migraine triggers, such as fatigue, bright lights, weather changes, and others.

For many years, scientists believed that migraines were linked to expanding and constricting blood vessels on the brain's surface. However, it is now believed that migraines are caused by inherited abnormalities in certain areas of the brain.

There is a migraine "pain center" or generator in the brain. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels, causing them to clamp down or constrict, followed by dilation (expanding) and the release of prostaglandins, serotonin, and other inflammatory substances that cause the pulsation to be painful.

What Triggers a Migraine?

Many migraines seem to be triggered by external factors. Possible triggers include:

Emotional stress. This is one of the most common triggers of migraine headache. Migraine sufferers are generally highly affected by stressful events. During stressful events, certain chemicals in the brain are released to combat the situation (known as the "flight or fight" response). The release of these chemicals can provoke vascular changes that can cause a migraine. Repressed emotions surrounding stress, such as anxiety, worry, excitement, and fatigue can increase muscle tension and dilated blood vessels can intensify the severity of the migraine.
Sensitivity to specific chemicals and preservatives in foods. Certain foods and beverages, such as aged cheese, alcoholic beverages, and food additives such as nitrates (in pepperoni, hot dogs, luncheon meats) and monosodium glutamate (MSG, commonly found in Chinese food) may be responsible for triggering up to 30% of migraines.
Caffeine. Excessive caffeine consumption or withdrawal from caffeine can cause headaches when the caffeine level abruptly drops. The blood vessels seem to become sensitized to caffeine, and when caffeine is not ingested, a headache may occur. Caffeine itself is often helpful in treating acute migraine attacks.
Changing weather conditions. Storm fronts, changes in barometric pressure, strong winds, or changes in altitude can all trigger a migraine.
Menstrual periods
Excessive fatigue
Skipping meals
Changes in normal sleep pattern

Migraines and Associated Conditions

There are some medical conditions that are more commonly associated with migraines, including:

Asthma
Chronic fatigue syndrome
Hypertension
Raynaud's phenomenon (occurs when blood vessels narrow causing pain and discoloration usually in the fingers)
Stroke
Sleep Disorders

Treatment & Care

Read your options for pain relief when you suffer from a headache. Also, with new prevention medications, you now have many options that help you avoid migraine pain.

Alternative Treatments for Migraines and Headaches

Migraines and other types of headaches cause significant productive loss to employers. They are also one of the most common complaints seen in the doctor's office.
Although drug treatments are effective, people suffering from headaches often use a wide spectrum of complementary and alternative treatments.

Chronic stress may contribute to the development of the most common types of headaches, including migraines and tension-type headaches. So it's not surprising that alternative treatments aimed at stress reduction, such as biofeedback and relaxation, are well-studied and considered effective treatments for some patients with headaches. There are additional "nontraditional" headache treatments, including acupuncture, massage, herbs, and diets, for which there are varying degrees of effectiveness.

Biofeedback for Migraines and Headaches

Biofeedback is a technique that can help a headache sufferer learn stress-reduction skills by providing information (feedback) about muscle tension, skin temperature, brain waves, and other vital signs. Small metal sensors, called electrodes, are attached to the skin and measure the amount of muscle tension or the skin temperature. This information is displayed as numbers, electrical waves, or sounds on a screen. For example, a stress response reduces skin temperature because of constriction of blood vessels, while a relaxation response results in dilated blood vessels and warm skin.

The results of several studies show changes in the blood flow in the brain during migraine attacks and in the pain-free periods in between. Using biofeedback training, a person can influence the blood flow to the brain and better manage a headache.Most studies on biofeedback indicate that it reduces the frequency and duration of headaches, both in children and adults. In general, the effects of biofeedback appear to be comparable to many drugs used for chronic headaches, and can be recommended as early treatment for recurrent migraines.

Stress Management for Migraines and Headaches

Life events that increase stress, anxiety, and depression have been associated with chronic migraines and headaches. Certain antidepressant drugs are the primary therapy for some types of chronic headaches, such as a tension-type headache. The results of a large study indicate that stress management therapy reduced headache, headache-related disability, and use of pain medications to a similar degree as therapy with antidepressant drugs. However, the best results were obtained when stress management was combined with antidepressant medication.

It may be helpful to incorporate a regular practice of relaxation into a health-promoting lifestyle (getting enough sleep and eating a healthy diet, for example).
Biofeedback and relaxation training can be obtained at the psychology and psychiatry departments of many medical centers.

Acupuncture for Migraines and Headaches

Acupuncture is an ancient Chinese technique that involves the insertion of very fine, solid needles into certain points of the body. According to traditional Chinese medicine, acupuncture helps headaches by stimulating the body's ability to resist or overcome illnesses and conditions by correcting energy imbalances. The term "chi" (pronounced "chee") is used to describe the energy that circulates through meridians in the body. The belief is that migraine and headache pain develops when the natural flow of chi is disrupted, leading to an imbalance of energy, and that acupuncture can correct this energy disruption to restore physical, mental, and emotional health.

According to studies, acupuncture may cause the release of pain-reducing opioid chemicals, such as endorphins. In addition, acupuncture may stimulate the brain to release other types of body chemicals and hormones that transmit signals between different types of cells, including those of the immune system.

Acupuncture appears to be beneficial in treating a variety of health problems in addition to headaches. The World Health Organization currently recognizes more than 30 diseases or conditions, ranging from allergies to tennis elbow, that can be helped by acupuncture treatment. The Consensus Statement on Acupuncture by the National Institutes of Health, released in 1997, stated that for conditions including headache, low back pain, menstrual cramps, and carpal tunnel syndrome, acupuncture was useful as an additional treatment or an acceptable alternative to be included in a comprehensive pain management program.

What makes acupuncture a unique antipain approach is the suggestion that its effects may be long-lasting. In one recent study, acupuncture treatment reduced chronic pain in the neck and shoulder areas and associated headache, with the effects lasting for months.

Massage for Migraines and Headaches

The value of massage in treating headaches has not been demonstrated convincingly through clinical trials. Nevertheless, massage is a great way to reduce stress and relieve tension. It is especially effective in reducing tightness of tender muscles, such as those in the back of the head, neck, and shoulders, and increasing blood flow in those areas. For some people, massage may provide relief from headaches caused by muscle tension.

Herbs for Migraines and Headaches

Among herbs used for migraine and headache treatment and prevention, only the effectiveness and safety of feverfew has been examined in clinical trials. Feverfew is the most popular herbal remedy for prevention of migraine headache, and studies have shown that it is helpful and well-tolerated, with only mild side effects. However, the evidence is not convincing that this herb is more effective than a placebo (inactive pill). More rigorous and larger clinical trials are required.

Essential Oils for Migraines and Headaches

Another approach that has origins in herbal medicine is aromatherapy. In many traditional medical practices, the use of essential oil, simply by smelling it or by applying it to the skin, is thought to encourage relaxation and alter pain perception. Anecdotal evidence suggests that the use of lavender, ginger, or peppermint oils may help relieve tension-type headaches. More research has to be done to determine the effectiveness of this therapy.

Dietary Changes for Migraines and Headaches

Certain foods, such as chocolate, aged cheese, citrus fruits, red wine, and others, may cause headaches in susceptible people. For long-lasting management of headaches, it is important to identify and reduce food-related headache triggers (along with others, including stress, sleep deprivation, and fatigue). This can be done by maintaining a careful diary of headaches and eating habits. To date, only a few dietary intervention trials have been conducted to determine if dietary changes can reduce headache pain.

However, a significant decrease in migraine headache has been observed when dietary fat consumption is reduced. Other studies suggest that supplementing the diet with omega-3 fatty acids may be beneficial. Other potentially helpful supplements include coenzyme Q10 and melatonin. Again, more research is needed on these supplements to determine their safety and effectiveness.
Considering the lack of reliable data on the benefits of dietary approaches to headache management, it's best to eat a well-balanced diet and avoid skipping meals or fasting, as this may trigger a migraine attack. Also, be sure to talk to your doctor before starting a new diet or taking any new medications, including vitamins, herbs, and supplements.

Tips for When You Have a Migraine

1. Be prepared.

By planning, you may be able to reduce the intensity and frequency of your migraines.
For example, because skipping meals can trigger migraines, Halpern suggests packing a healthy snack in your bag for yourself -- just as you do for your kids -- when you head out the door. If you have trouble remembering to take your medication or eat a snack, Halpern recommends setting an alarm on your watch or cell phone as a reminder.

It's especially important, parents say, to make sure that you always have your migraine medication on hand in case you need it. Some find that if they take their medication as soon as they notice the first symptoms of a migraine, they can reduce its severity.

Erika Bowles, a mother of a 2-and-a-half-year-old daughter in Falls Church, Va., once got a migraine during a friend's baby shower. "My daughter was with me at the shower and I realized that I didn't have my medication with me and didn't feel well enough to drive us home," she says. Although Bowles' mother was able to pick them up, she notes, "I have never left the house without my meds since then."

2. Identify and avoid your migraine triggers.

If you're not sure of your migraine triggers, Halpern advises tracking your headaches on a calendar for a few months.
Record when you have a headache, your pain level on a scale of 1-10, what medications you took, and other factors that stand out, such as if you didn't get enough sleep. Women should track their menstrual cycle on the calendar as well."A lot of people with migraines can identify at least some of their triggers and then they can avoid those triggers or plan around them," Halpern tells WebMD.
Some common migraine triggers include lack of sleep, dehydration, stress, changes in weather or barometric pressure, bright lights, certain foods or alcohol -- and, for women, hormonal changes during menstrual cycles.

3. Choose quiet places and activities.

Some parents say that they can continue to spend time with their children when they have a migraine if they can find quiet, calm activities to do together. They caution that you should avoid places that are likely to aggravate your symptoms, such as a playground with bright sunlight and screaming kids.

"There are days when the slightest noise hurts me, but I still want to engage with my 2-year-old daughter in a quiet activity like reading a book," says Mark Tippett of Herndon, Va. He has chronic migraines due to a traumatic brain injury he sustained while serving in the Army in Iraq. "We'll make shapes with Play-Doh together at the dinner table and it takes my mind off the pain."
Katie Biggs, a mother of two in Naperville, Ill., sometimes has a movie night with her kids when she has a migraine. Biggs makes popcorn and ice cream sundaes with her 18-year-old daughter and 12-year-old son and turns the living room into a movie theater. "We turn off the lights and have a movie marathon. I can stay with them, even if I'm laying on the couch with ice on my head," she says.

Rebeccah Graves, who has a 4-year-old and a 15-month-old, has her kids play with their toys in a childproofed playroom when she has a migraine. "I'll bring a pillow and lay on the floor as they play quietly around me," says Graves, who lives in Vienna, Va. "It's great to set up a safe space where your young kids can be entertained and you can be nearby if you're needed."

4. Talk to your kids about your migraines.

Whether your kids are toddlers or teens, parents say it's best to talk openly with them about your migraines. You can help calm any fears they may have when they see you having an attack and understand why your usual routine may change on those days.
"I think it really helps to explain your migraines to your kids," Graves says. If your kids are young, you could compare how you feel when you get a migraine to a time that they didn't feel well, she says.

When her children were younger, Biggs explained her migraines to them by saying they felt like getting an ice cream headache or "brain freeze" that doesn't go away for a really long time. "Kids understand that because it's something they've experienced," she says. "The key is to explain it very simply."

5. Find support.

For the times when a migraine makes it difficult for you to function, it helps to line up adults you trust who can potentially assist with childcare. Talk with them in advance about your migraines and the kinds of support you might need.

"Choose someone who is really reliable, has some flexibility, and has a connection with your kid," says Terri Miller Burchfield, a mom in Washington, D.C. and co-founder of MAGNUM: The National Migraine Association. In her own case, Burchfield talked with her daughter's nanny so she understood what to do. "If I came home from work with a migraine, she could stay later than usual and keep my daughter occupied," Burchfield says.

Biggs found that she can rely on her friends to help when her migraines are at their worst. "It's important to have people you can call for back-up and they know what to do," she says.
When Biggs returned from a hospital visit and was groggy from her migraine medication, for example, her friends came over to make dinner for her children. Another time, a friend took her children to the movies when she had a migraine. "Over time, I've been amazed by how many people were willing to help me when I just asked," she says.

6. Explore all your migraine treatment options.

If you don't feel like your current medication or other migraine treatments are easing your symptoms, don't give up on exploring other options. "If you can find the right physician and get on the right medication, it's often possible to significantly improve your quality of life," Halpern says.
Tippet also believes you should stay optimistic that your migraine symptoms can improve once you've found the right treatments. "Learn about all your options and find out what works for you," he says. "It will make life better for you and your children."

How to Relieve a Tension Headache

Relax Your Eyes

1
Rest your eyes periodically. Tension headaches are often caused by eye fatigue.
2
Close your eyes, cup them with the palms of your hands, and apply light pressure for 2 minutes. Don’t be alarmed if your vision is blurry for a few seconds when you finish.
3
Place wet peppermint teabags on your eyelids for 5 minutes. Closing your eyes will rest them as the peppermint soothes them.
4
If you work on the computer, take a 10-minute screen break every hour. This is also a good idea if you’re in a movie theater or watching television.
5
If the problem is chronic, visit your optician. You may need glasses.

Give Yourself a Mini-Massage

1
Massage the temples, shoulders, neck or any other area where you feel tension. Tense areas are easy to recognize because they feel tight and hard.
- Tension in the head, neck, and shoulders can often be the cause of headaches.
- Essential oils can be incorporated into massage to aid relaxation.
2
Massage your face. In particular, rubbing the temples, forehead, and area between the eyebrows can relieve tension. The fact that the face is so rarely pampered in this way will make it feel extra good.
- If you clench your jaw or grit your teeth, make an effort to relax your face. Try yawning to reduce facial tension.
3
Massage your hands. If you’re at a busy office or in public, massaging your hands can be a discrete way to relieve stress. Squeezing the pads of your palms and rubbing your fingers are especially effective.

Apply Heat or Cold

1
Place a hot compress on your fore-head or the back of your neck. The heat will help to relax knotted up muscles in this area.
2
Take a hot shower. If you don't have cardiovascular problems and can stand it, a steaming hot shower for 20 minutes can bring you fast relief.
3
Apply an ice pack to your neck for 10 minutes. If the cold is too direct, wrap the icepack in paper towels or a moist facecloth.

Drink Something Calming

1
Drink herbal tea. Many herbs, such as peppermint and chamomile, are said to have calming properties. Of course, the simple act of sipping a hot beverage from a mug is also psychologically calming, so be sure to go by whatever feels best.
2
Have a cup of caffeinated coffee or tea. Caffeine reduces blood-vessel swelling, and thus can help to relieve a headache. This is why caffeine is an ingredient in some extra-strength painkillers like Anadin Extra.
- If you enjoy and are used to energy drinks, they might be an acceptable substitute; however, the sugar might aggravate your headache, so use discretion.
- If you are already a heavy coffee/tea drinker, don't try this. Caffeine withdrawal can cause headaches, creating a vicious cycle.
3
Drink a glass of water. Headaches are often caused by dehydration, so try to increase your water intake to between 6 and 8 glasses a day. Even if you’re not dehydrated, the water might help flush out something that is stressing your body.

Inhale Soothing Scents

1
Sprinkle a few drops of essential oil onto a tissue and inhale deeply several times. The cooling effect of peppermint is said to fight headaches and nausea while the soothing scent of lavender is said to relieve stress.
2
Add herbs or essential oil to simmering water and let the scented steam fill the room. This is a great way to calm your mind while you attend to other tasks.

Calm Your Mind

1
Spend some time relaxing your mind. Visualize yourself in a calm scene, such as a green forest or blue ocean, and enjoy your surroundings. How does the sunlight feel on your skin? How do the crashing waves sound?
2
Listen to calming sounds. If you have a recording of natural sounds or a great rainy-day mix you can put on in the background, use it to mellow yourself out.
3
Breathe slowly and deeply. Inhale slowly over 8 counts, pause, and then exhale over 8 counts; repeat for at least a minute.
- In times of stress, the human body will default to breathing very shallowly; conversely, it is very difficult to remain stressed while breathing slowly and deeply.
4
Use the restroom. Going to the bathroom can definitely provide physical relief, but if nothing else, having a quiet moment to yourself might be just what the doctor ordered.

Take a Painkiller

Take an over-the-counter painkiller. If your relaxation techniques don’t work, aspirin, ibuprofen, or acetaminophen may help.

- Remember that the relief provided by painkillers is only temporary; addressing the root of the problem is your ultimate goal.
- Don’t overuse painkillers. Taking over-the-counter pain killers more than nine days a month can actually give you rebound headaches, a.k.a. medication overuse headaches.
  
  Tips
  - Avoid bright light, as this affects behind your eyes and makes your headache worse.
  - Try sipping a can of cola from a straw: there is a theory that the caffeine interacting with the aluminum in the can will relieve headaches. Though the jury is still out on this cure, some people swear by it.
  - Massage your pressure points which are at your temples, douse, eye brows, top of had and nape of your neck where your skull connects to your spine. Hold pressure to them about 30 seconds each.
  - Get sleep when you sleep you are closing your eyes which relaxes you so that you feel better.
  - Take a day off ... too much stress in office, papers work,computer all day,phone calls everyday.
  Sleep all day Hiking and laying outside, relax thinking.
  Can help a lot !
  
  ...

Wednesday, May 15, 2013

Headache