July 9, 2005
Q: I suffer from severe backpain and headaches and have tried all conventional and nonconventional (alternative) therapies I could find. Although many gave relief to some degree, none were permanent. Is there anything new out there? - Layperson
A: Headaches have many causes but generally fall under the following categories (probably not all-inclusive):
Tension Type Headache
Tension type headache is the commonest form of headache with up to two thirds of people experiencing it at some stage in their lives.
Symptoms: Tension headaches are usually felt on both sides of the head. The pain is dull and persistent, varying in intensity. It is often described as a feeling of pressure, heaviness or tightness in a band around the head.
Frequency & Duration: Episodic tension type headaches can last from 30 minutes up to a week. They usually occur infrequently, but can progress to what is known as a chronic condition, where headaches occur all the time, with sufferers enduring headaches of varying intensity all day, every day, and can be woken by them at night.
Generally, tension type headaches are diagnosed as being chronic when they are present for more than 15 days per month. In this case, a sufferer will notice the headache at the start of the day, and it will remain as a dull ache throughout the course of the day.
Possible Causes: Tension type headaches may be triggered by emotional or physical stress (eg. an argument, fatigue, prolonged reading, dehydration or sitting for a long time with bad posture), or by environmental factors such as loud music.
Treatment: Lifestyle - Combat stress by keeping fit, getting regular sleep and exercise and eating a balanced diet. Some people find that learning specific relaxation techniques or posture improvement techniques such as yoga or meditation are effective because they tech you to relax your mind and your body, particularly during time of stress.
If your headaches occur daily and are diagnosed as being chronic tension type headache, your doctor may prescribe tricyclic antidepressants which have been shown to be useful in this condition and which may also be useful for any associated depression.
Some migraine sufferers (about 10%) also sufferer from tension headaches. It is important to keep an accurate record of the exact symptoms and triggers for all your headaches so that your doctor can see if you fall into this category and treat you accordingly. See you doctor if
Symptoms: A sinus headache usually occurs as a gnawing pain over or under both eyes. It usually accompanies blocked sinuses caused by bad cold, flu or allergies and can be associated with a rise in temperature. The affected area may be painful when touched. The headache gets worse as the day goes on and increases in intensity if you bend forward.
Frequency: Sinus headaches can occur at any time.
Possible Causes: Sinuses are air-filled spaces in the facial bones around the nose, which are part of the respiratory system. Sinus headaches are one symptom of sinusitis, where your sinuses become infected and inflamed.
Treatment: Lifestyle: If possible stay indoors in a room with an even temperature, as a dry overheated environment could make your high temperature and nasal congestion symptoms worse. Steam inhalation may be useful to try and clear the sinuses.
See your doctor if - Your symptoms last for more than a
couple of days.
Migraine (Vascular) Headache
Migraines affect one in eight adults in the developed world. People of any age can suffer, although adults aged 25-34 are most commonly affected, and women two or three times as frequently as men.
Symptoms: The main migraine symptom is a moderate to severe throbbing pain, usually on just one side of the head. This is often accompanied by nausea (feeling sick), cold hands, vomiting and sensitivity to light and sound.
A migraine where people suffer an 'aura' or warning, 10 to 30 minutes before the migraine begins, only occurs in one in five cases. The aura may take many forms: lines or spots before the eyes, total darkness, tingling or numbness in the limbs and speech impairment. This can be a frightening experience.
Eighty percent of migraines have no aura, although a few days beforehand you may feel irritable, lethargic and experience food cravings.
Frequency & Duration: A migraine attack occurs on average once a month and usually lasts between 4 and 72 hours.
Possible Causes: There is a wide range of possible triggers associated with migraine.
Women may find fluctuating hormone levels (due to ovulation, menstruation, or birth control pills) are a contributing factor.
Your diet can also make you vulnerable to migraines> red wine, cheese, chocolate, nuts, soy sauce, citrus fruit, alcohol, excess caffeine (eg. cola, tea, coffee) and some food additives (monosodium, glutamate, sodium nitrate) are all possible triggers.
Treatment: Lifestyle - One way to manage headaches is to learn to recognise if there are 'triggers', so they can be avoided. Keeping a diary (included in this booklet) will help by highlighting suspect events, moods or foods. Given that stress is one of the most common triggers for migraines, relaxation such as yoga or meditation may be helpful.
However, only a minority of people with migraine can clearly identify what triggers their attacks and even if triggers can be identified, they can not always be avoided. Support organisations such as the Migraine Foundation of Australia that will provide further information about lifestyle changes you can make to help manage migraine.
Mild migraine pain can be treated with analgesics (eg. aspirin, paracetamol), antihistamines and anti-emetics (to combat nausea).
If you suffer two or more migraines a month, your doctor may prescribe preventative medication., which is used when migraines are severe or frequent enough to disrupt your life. This continuous, daily medication should help you to reduce the number of migraines and may eliminate them altogether.
For moderate or severe attacks which are not too frequent, you may prefer effective, on the spot acute treatment rather than daily preventatives. In this case, medications such as sumatriptan (Imigran) or ergotamine can effectively reduce the severity and the duration of migraine pain and its associated symptoms.
See your doctor if - You think you might be suffering form migraine or if you are not satisfied with your current migraine treatment. If you have been suffering from migraine for years, there may now be more effective treatments available.
Temporal arteritis is not common, and often affects people over the age of 55.
Symptoms: Head pain is described as persistent, waxing and waning throughout the day, and may occur anywhere on the head, although it is often over the temples. It may be severe, burning and throbbing in the early course of the disease and non-throbbing later. Other symptoms are eyesight problems, mild fever, weight loss and jaw pain when chewing.
Frequency & Duration: Once diagnosed long term management can prevent recurrences.
Possible Causes: Temporal arteritis is caused by inflammation of the arteries which supply your head with blood.
See your doctor if - You have these symptoms, or if you are over 50 years of age and develop a new, persistent headache as serious complications may develop and these can be avoided by prompt treatment.
Cluster Headaches Cluster headaches are rare, severe and mainly affect men.
Symptoms: Severe pain developing around or behind one eye, which usually occurs at nights and wakes the sufferer from sleep. Congestion of the eye and nose on the affected side produces tears and nasal blockage and discharge on that side.
Frequency & Duration: Cluster Headache usually lasts between 15 and 90 minutes and can occur almost daily in groups or "clusters" for days or weeks at a time. Then they may disappear for a year or more.
Possible Causes: There is some evidence that excessive smoking and /or alcohol consumption can trigger an attack.
It has been estimated that 70% of migraine sufferers are female. Of these female migraine sufferers, 60%-70% report a menstrual relationship to their migraine attacks.
Headaches in women, particularly migraines, have been related to changes in the levels of the female hormone estrogen during a woman's menstrual cycle. Estrogen levels drop immediately before the start of the menstrual flow.
Premenstrual migraines regularly occur during or after the time when the female hormones, estrogen and progesterone, decrease to their lowest levels.
Migraine attacks typically disappear during pregnancy. In one study, 64% of women who described a menstrual link to their headaches noted that their headaches disappeared during pregnancy. However, some women have reported the initial onset of migraines during the first trimester of pregnancy, with disappearance of their headaches after the third month of pregnancy.
Birth control pills as well as hormone replacement therapy during menopause have been recognized as migraine triggers in some women. As early as 1966, investigators noted that migraines can become more severe in women taking birth control pills, especially those containing high doses of estrogen.
The frequency of side effects, such as headache, decreased in those who took birth control pills containing lower doses of estrogen and did not occur in those who took birth control pills containing progesterone.
The medications of choice to stop a menstrual migraine are non-steroidal anti-inflammatory medications (NSAIDs).
The NSAIDs most often used for menstrual migraines include:
NSAID treatment should be started two to three days before the menstrual period starts and continue til the period ends. Because the therapy is of short duration, the risk of gastrointestinal side effects is limited.
For people who have severe menstrual migraines or who want to continue taking their birth control pills, doctors recommend taking a NSAID, starting on the l9th day of the cycle and continuing through the second day of the next cycle.
Other medications that may be used are given by prescription only. They include:
These drugs should also be started two to three days pre-menses, and continued throughout the menstrual flow.
Because fluid retention is often associated with menses, diuretics have been used to prevent menstrual migraine. Some doctors may recommend limiting salt-intake immediately before the start of menses.
Lupron is a medication that affects hormone levels and is used only when all other treatment methods have been tried and have been unsuccessful.
Transformed migraines are chronic, daily headaches with a vascular quality (meaning that they are throbbing in nature.) Most people who experience transformed migraines have a history of migraines, usually beginning in childhood or early adolescence. The onset of daily transformed migraine headaches generally occurs in people during their 20's and 30's.
Many people with a previous history of migraine will suddenly report the headaches are less severe but are more frequent, until they begin occurring daily. This change may be caused by the daily use of pain-relievers. Some people with transformed migraines report having severe episodes accompanied by nausea and vomiting, much like migraines. Often, it is difficult to differentiate between tension headaches and transformed migraines.
Because transformed migraines are difficult to diagnose, many people may be treated inappropriately. Treatment is further complicated because of the chronic nature of headache. Many people with transformed headaches have the tendency to overuse pain-relievers, both prescription and over-the-counter, using these drugs daily with or without having a headache. This puts the person at risk for building up a tolerance to the drugs. Additionally, taking large amounts of pain-relievers containing caffeine can experience withdrawal headaches.
In many cases, people suffering from transformed migraines have other health problems such as hypertension and depression which complicate treatment. Seeking care by an experienced, multidisciplinary health care team to coordinate treatment is essential to finding relief
When the occasional headache strikes, most of us head for the medicine cabinet or local pharmacy and take an over-the-counter pain medication, such as acetaminophen (Tylenol), ibuprofen (Motrin), aspirin, or pain-relieving medications containing caffeine.
While over-the-counter pain-relievers are helpful in improving headache pain, they must be taken with caution because they could actually make your headaches worse if they aren't taken correctly. The overuse or misuse of pain relievers -- exceeding labeling instructions (such as taking the medications 3 or more days per week) or not following your doctor's advice -- can cause you to "rebound" into another headache.
When the pain medication wears off, you may experience a withdrawal reaction, prompting you to take more medication, which only leads to another headache and the desire to take more medication. And so the cycle continues until you start to suffer from chronic daily headaches with more severe headache pain and more frequent headaches.
Pain-reliever overuse appears to interfere with the brain centers that regulate the flow of pain messages to the nerves, worsening headache pain.
This rebound syndrome is especially dangerous if your medication contains caffeine, which is often included in many pain-relievers to speed up the action of the other ingredients. While it can be beneficial, caffeine in medications, combined with consuming caffeine (coffee, tea, soft drinks or chocolate) from other sources, makes you more vulnerable to a rebound headache.
In addition to the rebound headache, over-use of pain-relievers can lead to addiction, more intense pain when the medication wears off, and possible serious side-effects.
Any person with a history of tension headaches, migraines, or transformed migraines can be affected by rebound headaches if he or she overuses certain medications.
Many commonly used immediate relief medications, when taken in large enough amounts, can cause rebound headaches. Medications once thought of as "safe" are turning up as the likeliest culprits. These include:
While small amounts of these medications per week may be safe (and effective) -- at some point, the continued medication use can lead to the development of low grade headaches that just will not go away.
Taking larger or more frequent doses of the offending immediate relief medication is not recommended. This not only exposes the person to a higher level of the medication's harmful ingredients, but it can make the headache worse and continue indefinitely.
You can prevent rebound headaches by using pain-relieving medications on a limited basis, only when necessary. Do not use them more than once or twice a week, unless instructed otherwise by your doctor.
Also, avoid caffeine-containing products while taking a pain-relieving medication, especially medication that already contains caffeine.
There are three types of new therapies based on ancient principles - mind-body-energy patterns:
1. CST was pioneered and developed by osteopathic physician John E. Upledger following extensive scientific studies from 1975 to 1983 at Michigan State University, where he served as a clinical researcher and Professor of Biomechanics.
CST is a gentle, hands-on method of evaluating and enhancing the functioning of a physiological body system called the craniosacral system - comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord.
Using a soft touch generally no greater than 5 grams, or about the weight of a nickel, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system.
By complementing the body's natural healing processes, CST is increasingly used as a preventive health measure for its ability to bolster resistance to disease, and is effective for a wide range of medical problems associated with pain and dysfunction, including:
2. SER (Somato Emotional Release) is a therapeutic process that uses and expands on the principles of CranioSacral Therapy to help rid the mind and body of the residual effects of trauma. SER offers applications designed to enhance results using CST and other complementary therapies.
3. DNA Activation - Since 1997, Dr. Robert Gerard has been pioneering the psychological effects augmented by a technique he calls DNA Activation. Basically, our DNA changes according to our thought patterns, consciously and unconsciously, producing negative or positive results mentally, physically, or spiritually. By properly reshaping your DNA with positive thinking, you get positive results, especially in health.
These therapies have shown results where all others have failed, and are noninvasive.
DISCLAIMER: The information in this column, is NOT intended to diagnose and/or treat any health related issues and is provided solely for informational purposes only. Consult the appropriate healthcare professional before making any changes to your healthcare regime. Even what may seem like simple changes in the diet for example, can interact with, and alter, the efficiency of medications and/or the body's response to the medications. Many herbs and supplements exert powerful medicinal effects. Neither the author, nor the website designers, assume any responsibility for the reader's use or misuse of this information.