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Doctor Recommended Alternative and Holistic Medicine for Headache Tension/Cluster/Migraine There are 7 types of headaches. Ongoing scientific investigations into effective medications, natural medicines and the cause of headaches offer hope to those who suffer. Studies are highlighting the role of nutrition, genetics, the role of sleep, mental and physical stress, hormones, and the environment on headache occurrence and severity. Research is focusing on the neurotransmitters, blood vessels and nerves of the brain and spinal chord. Below is a brief look at the 7 headache types, current research and a Table targeting key nutritional therapies. AWW will help customize medications and therapies that may help you manage headache.
HEADACHES A medical term used for headache is cephalgia: a diffuse pain located in one or more areas of the head where the pain is not limited to a location affected by the distribution of a specific nerve. It is estimated that as many as 28 million Americans suffer from migraines alone. Headaches are both physically and mentally disabling. “Effective management of migraines must include proper diagnosis, effective communication between patient and physician, and appropriate, individualized behavioral therapy and pharmacotherapy. When all of these components of treatment come together, migraine patients will experience considerable improvement.” “Healthy lifestyle changes should also be promoted and should include a focus on diet, exercise, and sleep patterns. “ CNS News. May 2001. Practical Strategies for Headache Management. 7 TYPES OF HEADACHES 1. Tension type headache: Episodic (comes and goes). Chronic (all the time) 2. Migraine (sick headache) Click on Migraine for extensive information and natural supplements. 3. Trigeminal neuralgia 4. Chronic paroxysmal hemicrania (dictionary: relating to the fifth cranial or trigeminus nerve) 5. TMJ (temporomandibular joint dysfunction) 6. Cluster type headache 7. Chronic daily headaches Resources used to categorize headaches include Cephalalgia. 1992 April:12(2):68., Medical World News, Stedmens Medical Dictionary December 1993, etc. Discussion 1. TENSION-TYPE HEADACHES International Headache Society Criteria for Episodic Tension-Type Headache. Following is a summary of the criteria from Neurology Reviews. April 2006. A. At least 10 episodes fulfilling criteria B to E. Number of days with such headache: 1 day per month and 15 days per month for at least three months (more than or equal to 12 days and less than 180 days per year). B. Headache lasting from 30 minutes to 7 days. C. At least two of the following pain characteristics: 1. Pressing/tightening (nonpulsating quality). 2. Mild or moderate intensity (may inhibit, but does not prohibit activities). 3. Bilateral location. 4. No aggravation by walking stairs or similar routine physical activity). D. Both of the following: 1. no nausea or vomiting (anorexia may occur). 2. Photophobia and phonophobia absent, or one but not the other may be present. Classic form of tension headache=pain in back of the head and is thought to be brought on at least in part by mental stress. E. Not attributed to another disorder. CNS NEWS. July 2001. Reduction of tension-type headache symptoms was seen with over-the-counter aspirin and prescription acetaminophen in a 2001 new placebo-controlled study by Dr. MacEachern presented at the annual American Pain Society meeting. Neurology Reviews April 2006. A randomized clinical trail showed that pure tension type headaches do not respond well to sumatriptan. Journal of Family Practice. December 2006. Vol. 55, No. 12. "Tension-type headache, also known as tension headache or muscle contraction headache, is the most commonly experienced type of headache. Population-based studies suggest prevalence rates of 35% to 40% in adults. Though all non-narcotic analgesics have equivalent efficacy against tension-type headache, ibuprofen’s generally favorable side-effect profile makes it a reasonable first choice.” 2. MIGRAINE Click on our category MIGRAINE for an extensive work up which includes information on the Causes/Diagnostic Criteria/Occurrence/Symptoms/ Triggers/ Therapies/Related Disorders. Migraines appear to be hereditary. If one parent has them, the person has a 50% chance of experiencing migraine. “The specific cause of migraine is unknown, although genetic factors now appear to be important and discrete loci of brain activation can be seen with PET studies. Considerably more is known about the pathophysiology of the pain”. “Current theories on the etiology of migraine headache suggest that it is a neurovascular disorder (i.e., vascular change secondary to neural activation), with a primary CNS dysfunction (central nervous system) giving rise to headache pain as a result of local cranial vasodilatation and release of sensory neuropeptides from nerve endings.” Neurology. November 2000. Volume 55, Number 9 (Supplement 2). The International Headache Society Criteria for Migraine without Aura include: At least 5 attacks in which the following criteria are met and which can not be attributed to another disorder. 1. Headache lasting 4 to 72 hours and occur <15 days per month (untreated or unsuccessfully treated). 2. Headache has at least two of the following characteristics: a. Unilateral location. b. Pulsating quality. c. Moderate or severe pain intensity. d. Aggration by or causing avoidance of routine physical activity (ie, walking or climbing stairs.) 3. During headache at least one of the following: 1. Nausea and/or vomiting. 2. Photophobia and phonophobia. Summary of Table from Neurology Reviews. April 2006. Click on Migraine for in-depth information. 3. TRIGEMINAL NEURALGIA Patient Care. August 30, 2001. Effective Options To Treat Cluster Headaches.” “Trigeminal Neuralgia differs from cluster headache, as it causes unilateral pain that lasts only a few seconds and is precipitated by touching facial trigger points. 4. CHRONIC PAROXYSMAL HEMICRANIA (CPH) Chronic paroxysmal hemicrania, a related condition (to cluster headaches) that affects one side of the head, may be differentiated from cluster headaches on the basis of the large number of headaches per day and the shorter duration. Patients with CPH experience 10 to 30 headaches daily, each lasting about 5 to 20 minutes. In women, cluster headaches may evolve into CPH, which is sometimes considered a variant or subtype of cluster headache. Patient Care. August 30, 2001. 5. TMJ TMJ (temporomandibular joint dysfunction) vs chronic daily headache and facial pain disorder Results of a study of personality characteristics and accompanying symptoms in temporomandibular joint dysfunction, headache, and facial pain by Mongini, Ciccone, Ibertis and Negro in 2000 reported: The TMJ group had: (1) Lower prevalence of almost all symptoms; (2) significantly lower scores of several personality profiles and of anxiety... Conclusion: It is concluded that some types of headache and facial pain seem to correlate with the presence of a number of accompanying symptoms and with some changes in personality. These changes are particularly relevant in patients with chronic daily headache and facial pain disorder. In contrast, patients with TMJ intracapsular disorders tended to show a low prevalence of accompanying symptoms and a normal personality profile.” J Orofacial Pain. 2000 Winter:14(1):52-8. 6. CLUSTER HEADACHES Patient Care. August 30, 2001. Effective options To Treat Cluster Headaches. "…cluster headache is marked by the occurrence of painful attacks in clusters lasting weeks or months, usually followed by relatively long remissions… Although cluster headache and migraine appear to share a common neurovascular pain pathway, the basic pathogenesis of each is significantly different resulting in unique symptoms and responses to therapies... The pain of cluster headache is unilateral, usually effecting one eye, either in, above, on either side, or below the eye. It also may be located in and around the forehead or temple and can extend to the maxillary area or radiate into the neck. During a series of cluster attacks, the pain remains localized to the same side...The pain is not described as rhythmic or pulsating, but as deep pain remaining constant throughout the attack. A cluster headache usually occurs without warning, although a feeling of pressure in the temple maybe present, and it progresses to maximal intensity quickly, usually in 5 to 10 minutes. During the attack, patients do not find lying down helpful: they may pace, rock, put pressure on the area, or bang their heads against the wall… Cluster headaches commonly occur in the spring and fall and last 4 to 6 weeks…Episodic attacks often occur at the same time each day, frequently at night shortly after falling asleep. Approximately 50% of patients have nocturnal attacks, which waken them from a sound sleep. Additional signs and symptoms. Attacks may be accompanied by lacrimation (tearing), conjunctival hyperemia(bloodshot), miosis (contraction of the pupil), ptosis (drooping upper eyelid), and eyelid edema(swelling), as well as nasal congestion, rhinorrhea (watery discharge from nose), and forehead sweating. (=AWW) Systemic signs may include bradycardia, hypertension, and increased production of gastric acid... Although foods do not precipitate attacks as in migraine, both alcohol and nitroglycerin can provoke these headaches; other triggers include sleep and increased body heat. Cigarette smoking appears to be provocative in a small percentage of patients, perhaps 5%. Because these are provocative rather than causative agents, relinquishing cigarettes or alcohol will not resolve the disorder. ?The ability to sleep, especially rapid eye movement sleep, to trigger attacks may be related to oxygen desaturation. Patients whose headaches are provoked by sleep may fear falling asleep and suffer severe sleep deprivation. A relatively recent finding is that increased body heat, which can be experienced after exertion, a hot bath, or elevated temperature in the environment, may trigger cluster headaches…While patients with migraine are often counseled regarding stress reduction and dietary changes, these factors have not been found to be operative in cluster headaches. Patients should be advised to avoid triggers such as alcohol and overheating.” Patient Care. August 30, 2001. Effective options To Treat Cluster Headaches. 7. CHRONIC DAILY HEADACHE (CDH) “Chronic daily headache, for example, lasts at least 4 hours a day, occurs at least 15 days per month, and is not secondary to another disorder. Chronic daily headache can be classified into 4 types: transformed migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. It affects approximately 4% of Americans and is more common in men than women. Risk factors for daily chronic headache include analgesic overuse, stressful life events, certain environmental factors, fluctuating estrogen levels, caffeine, and habitual snoring.” Pain Medicine News. September 2006. John Hopkins Special Report. (See Headache: A Marker of Depression Chung/Kraybill. Journal of Family Practice. Vol. 31. No.) Iron Deposits in Brain Tissue: Neurology Reviews, November 2006, reported morphologic changes in the brains of those who suffered from repeated migraine attacks. In a study involving patients with episodic migraine (with and without aura) and those with chronic daily headache, K. M. Welch and colleagues found a positive correlation between the duration of illness and the increase in tissue iron levels in the periaqueductal gray matter (in the brain) of both groups (the increase was greater in the chronic group). One implication of these increases in iron deposition is that over time, migraine attacks can permanently alter the periaqueductal gray matter, thus affecting the perception of pain, Dr. Bigal emphasized. 'Because the periaqueductal gray matter is the center of the brain’s powerful descending analgesic neuronal network. The periaqueductal gray matter may be in close relation to the migraine generator. So you are changing and damaging an area that is very important to the modulating and onset of migraine attacks'. These findings suggest, in Dr. Bigal’s view, that repeated migraine attacks lead to repetitive damage, which in turn results in more migraine attacks and a reduced threshold for further migraines.” Neurology Reviews. November 2006 Medication Overuse And Chronic Headache: Dr. Ann I. Scher, epidemiologist at the Uniformed Services University at Bethesda, Maryland, in an interview with Neurology News, November 2006, shared, “The role of medication overuse in the etiology of chronic headache is, in my opinion, not well established in the literature…I don’t think that it is possible to show-in an observational study- that medication overuse leads to chronic daily headache... There are some similarities between people’s chronic headaches and other chronic conditions, so there’s question in my mind whether there are shared genetic or maybe nongenetic risk factors that can make episodic pain become chronic, independent of the site. Chronic lower back pain may share some risk factors with chronic headache…" Snoring and Chronic Headache: “People with chronic headaches were approximately 2.5 times more likely to regularly snore than were people without chronic daily headache. Frequent headache and sleep apnea are often associated, according to independent studies conducted by researchers at Dartmouth Medical School and Johns Hopkins School of Public Health. Snoring may be an indication of sleep apnea, which could potentially lead to changes in brain function and headache, and “a higher risk of cardiovascular problems, according to Jeanetta Rains, PhD, Director of the Center for Sleep Evaluation at Elliott Hospital, Manchester, New Hampshire, and Adjunct Assistant Professor of Psychiatry at Dartmouth Medical school, Lebanon, New Hampshire. “The good news is there are treatment options,” said Dr. Rains. Once the person is breathing normally at night, the headache often improves or goes away, and the risk of cardiovascular implications is decreased.” Neurology Reviews. October 2001. Dr. Ann I. Scher, epidemiologist at the Uniformed Services University at Bethesda, Maryland, shared in an interview with Neurology News, November 2006. "Among other risk factors, she pointed to snoring, citing data that she and colleagues published in 2003 indicating that daily snorers were at increased risk for chronic daily headache, compared to nonsnorers (odds ratio, 3.3).” Neurology News, November 2006. Stress and Chronic Daily Headache: “Specific stressful life changes may be risk factors for onset of chronic daily headache (CDH) among episodic headache sufferers, according to a recent case-controlled study reported summarized in CNS NEWS. July 2001. The dominant factors found in this study were major problems with children, moving and extremely stressful ongoing situations such as an abusive relationship, according to Anne I. Scher, PhD, who presented the study at the American Academy of Neurology.” The study was a retrospective review of 55,000 adults living in metropolitan areas who had previously taken part in a general health survey. CNS NEWS. July 2001. OVERVIEW “Approximately one-third of all patients who visit their primary care physician suffer from headaches, according to a large, multicenter, retrospective study presented at the 2003 American Headache Society.” Pain Medicine News. November/December 2003. As you can see the cause of headaches are complex. The good news is that much research is being undertaken to understand their cause and help manage headache, both episodic and chronic. “Effective management of migraines must include proper diagnosis, effective communication between patient and physician, and appropriate, individualized behavioral therapy and pharmacotherapy. When all of these components of treatment come together, migraine patients will experience considerable improvement.” “Healthy lifestyle changes should also be promoted and should include a focus on diet, exercise, and sleep patterns. “ CNS News. May 2001. Practical Strategies for Headache Management. AWW takes headache seriously and believes that nutritional and lifestyle management are the foundation of whole body health. Contact AWW Today Let us customize your prescription medications, nutrients and alternative care. Southwest Help*Adobe Walls Caring . Promote Wellbeing ~Supplement Often
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