Wellness Track

Transcription

Wellness Track

Wellness
Track
Controlling Your
Headaches
What You Should Know About Your Headaches
Approximately 90 percent of Americans
will experience some type of headache
this year; 55 million will suffer from
chronic headaches. Although some
people simply may need to take a couple
of aspirins for relief, others require
medical intervention. The Migraine
Research Foundation reports that every
10 seconds someone in the U.S. seeks
another health problem. Other diseases or
conditions cause secondary headaches.
For instance, stress can cause myogenic
headaches, hay fever can cause vascular
headaches, a herniated disc may cause
cervicogenic headaches and sinusitis may
cause inflammatory headaches. Chronic
headaches are those that occur at least
15 days per month but are not associated
with a neurological disorder.
emergency care for a severe headache.
Most headache pain stems from an
irritation of the trigeminal nerve. This
nerve is responsible for sensation in
the face, as well as biting, chewing
and swallowing. What causes the
irritation can vary among the four
basic categories of headaches:
Headaches are classified as primary,
secondary or chronic. Primary, which
include migraines, tension headaches
and cluster headaches, are not related to
Identifying Your
Headache Type
A comprehensive chart from the National
Headache Foundation is featured at the
end of this newsletter. It summarizes
the types of headaches, common
symptoms, precipitating factors
and general treatment/prevention
information.
What Causes Headaches?
Myogenic – occur when the
muscles of the head, neck
and face tighten.
Vascular – result from blood
vessels constricting and
eventually expanding, which
applies pressure to the pain
sensors lining the vessel walls.
Cervicogenic – develop as muscles
tighten from head or neck injuries,
overuse syndromes and/or
poor posture.
Inflammatory – inflamed nerves
cause pain.
In many cases, your lifestyle can influence
the number of headaches you experience.
For instance, there is a direct correlation
between headaches and hangovers, and
stress and too many pain relievers. Food
sensitivities, skipping meals and caffeine
withdrawal are additional examples of
lifestyle-related headaches.
Working Together to
Prevent and Control
Your Headaches
Some headaches are genetic. Research
links family history with cluster and
migraine headaches. Scientists also
believe tension headaches are genetic;
the hereditary alignment of your bite can
indicate if you are prone to suffering from
tension headaches.
There are many underlying causes
and many treatments available
for headaches. Let’s make sure to
discuss your headaches if they occur
frequently or are severe in nature. To
help you classify the frequency of your
headaches, ask yourself how many times
a week you take pain relievers. More than
twice a week is frequent. As for severity,
do over-the-counter pain relievers work?
If not, your headaches may be considered
severe. Track symptoms (besides the
obvious head pain) that accompany your
headaches. Red flag symptoms include
confusion, dizziness, fever, numbness, stiff
neck, vomiting, shortness of breath,
(Continued on next page)
06-10
Headache Prevalence
Wellness
Track
Working Together to Prevent and Control Your Headaches
slurred speech and/or vision loss. You also should bring
your headaches to my attention if your daily activities lead
to headaches or if your headaches interfere with your daily
activities. Sometimes your occasional headache may feel
different than usual (e.g., the pain may be more severe or in a
different part of your head); please inform me of these changes.
If you are experiencing severe headaches that persist and/
or develop quickly or if you have a head injury followed by
headaches, it’s important to contact me.
Managing Your Headaches
These steps may help you control your headaches.
1.
Maintain a headache diary and track the
following information:
(Continued)
3. Safety proof your home to prevent slips and falls.
4. Make sure you sleep between seven and nine hours
per night. Insomnia, as well as oversleeping, can cause
headaches. If your sleep patterns are irregular, log the
number of hours you are sleeping.
5. Drink ginger, chamomile and/or peppermint teas as they are
natural headache relievers.
6. Make sure you eat on a regular basis and avoid foods and
beverages high in caffeine, sugar and/or alcohol. Watch
for a link between the onset of your headaches and
foods considered headache triggers such as red
wine, chocolate and cheese.

Type of pain (e.g., piercing,
throbbing)

Intensity of pain on a scale of 1
(mild) to 10 (severe)
Exercise on a regular basis as it can
relieve stress. Exercise also strengthens
the core muscles, which will help you
maintain proper posture and keep
your vertebrae in proper alignment.

ocation of pain (e.g., between
L
eyes, back of head)
8. For diabetics, make sure insulin
levels are appropriate for you.

Season

Time of the day

Foods eaten within the last 24 hours

Stress level

he number of caffeinated foods and beverages you
T
consumed and when they were consumed

The number of pain relievers you had within the week

ecent exposure to chemicals such as household
R
cleaners, office supplies, environmental chemicals, etc.

ther symptoms accompanying the headache (e.g.,
O
dizziness, balance difficulties, slurred speech)

Evening outdoor activity and/or exposure to mosquitoes

Dental history
7.
9. Visit your eye doctor and dentist
on a regular basis.
10. Treat yourself to occasional massages as
they ease tension and relax muscles.
Emergency Care for Headaches
Some headaches require immediate medical attention. How
do you know if you should seek emergency care? If you are
experiencing the worst headache of your life and/or if your
symptoms are extreme, such as a loss of consciousness or
vision, uncontrolled vomiting and/or constant pain lasting for
days, call me immediately.
As always, I’m available if you want to talk more about
headache prevention and management. A great source for
headache information is the National Headache Foundation,
www.headaches.org.
2. Protect your head from injury by wearing seatbelts and
bicycle helmets.
Sources: The Complete Headache Chart, www.headaches.org; When to See a Physician for Your Headache, www.headaches.org; Headache Diary, uhs.
com; Larsson, B., Billie, B., Pedersen, NL., Genetic Influence in Headaches: A Swedish Twin Study, www.ncbi.nlm.gov; Headache, www.desktherapy.com;
Headache, health.usnews.com/health-conditions; About Migraine, www.migraineresearchfoundation.org
06-10
berkeley.edu; TMJ, TMD, Pain Clinic, www.montrealsexquisitesmiles.com; Headaches: Tension-Type, adam.about.com; Cluster Headache, www.wikipedia.
THE COMPLETE HEADACHE CHART
THE
COMPLETE
CHART
This overview
is for educational
purposes only HEADACHE
and is not the basis for self-diagnosis
or treatment.
Type
Type
Symptoms
Symptoms
Precipitating Factors
Hangover
Headaches
Hangover
Headaches
Migraine-like symptoms of throbbing
pain and nausea not localized to one
Migraine-like symptoms of throbbing
side.
pain and nausea not localized to one
side.
Alcohol, which causes dilation and
irritation of the blood vessels of the
Alcohol, which causes dilation and
brain and surrounding tissue.
irritation of the blood vessels of the
brain and surrounding tissue.
CaffeineWithdrawal
CaffeineHeadaches
Withdrawal
Headaches
Throbbing headache caused by
rebound dilation of the blood vessels,
Throbbing headache caused by
occurring multiple days after
rebound dilation of the blood vessels,
consumption of large quantities of
occurring multiple days after
caffeine.
consumption of large quantities of
caffeine.
Generalized head pain of short
duration (minutes to 1 hour) during or
Generalized head pain of short
following physical exertion (running,
duration (minutes to 1 hour) during or
jumping, or sexual intercourse), or
following physical exertion (running,
passive exertion (sneezing, coughing,
jumping, or sexual intercourse), or
moving one's bowels, etc.).
passive exertion (sneezing, coughing,
moving one's bowels, etc.).
Caffeine.
Exertion
Headaches
Exertion
Headaches
Post-Traumatic
Headaches
Post-Traumatic
Headaches
Hunger
Headaches
Hunger
Headaches
Temporomandibular
Joint (TMJ)
Temporomandibular
Headaches
Joint (TMJ)
Headaches
Tic Douloureux
Headaches
Tic Douloureux
Headaches
Fever
Headaches
Fever
Headaches
Arthritis
Headaches
Arthritis
Headaches
Eyestrain
Headaches
Eyestrain
Headaches
Temporal
Arteritis
Temporal
Arteritis
Tumor
Headache
Tumor
Headache
Localized or generalized pain, can
mimic migraine or tension-type
Localized or generalized pain, can
headache symptoms. Headaches
mimic migraine or tension-type
usually occur on daily basis and are
headache symptoms. Headaches
frequently resistant to treatment.
usually occur on daily basis and are
frequently resistant to treatment.
Pain strikes just before mealtime.
Caused by muscle tension, low blood
Pain strikes just before mealtime.
sugar, and rebound dilation of the
Caused by muscle tension, low blood
blood vessels, oversleeping or missing
sugar, and rebound dilation of the
a meal.
blood vessels, oversleeping or missing
a meal.
A muscle-contraction type of pain,
sometimes accompanied by a painful
A muscle-contraction type of pain,
"clicking" sound on opening the jaw.
sometimes accompanied by a painful
Infrequent cause of headache.
"clicking" sound on opening the jaw.
Infrequent cause of headache.
Short, jab like pain in trigger areas
found in the face around the mouth or
Short, jab like pain in trigger areas
jaw. Frequency and longevity of pain
found in the face around the mouth or
varies. Relatively rare disease of the
jaw. Frequency and longevity of pain
neural impulses; more common in
varies. Relatively rare disease of the
women after age 55.
neural impulses; more common in
women after age 55.
Generalized head pain that develops
with fever. Caused by swelling of the
Generalized head pain that develops
blood vessels of the head.
with fever. Caused by swelling of the
blood vessels of the head.
Pain at the back of head or neck.
Intensifies on movement. Caused by
Pain at the back of head or neck.
inflammation of the blood vessels of
Intensifies on movement. Caused by
the head or bony changes in the
inflammation of the blood vessels of
structures of the neck.
the head or bony changes in the
structures of the neck.
Usually frontal, bilateral pain, directly
related to eyestrain. Rare cause of
Usually frontal, bilateral pain, directly
headache.
related to eyestrain. Rare cause of
headache.
A boring, burning, or jabbing pain
caused by inflammation of the
A boring, burning, or jabbing pain
temporal arteries. Pain, often around
caused by inflammation of the
ear, on chewing. Weight loss, eyesight
temporal arteries. Pain, often around
problems. Rarely affects people under
ear, on chewing. Weight loss, eyesight
50.
problems. Rarely affects people under
50.
Pain progressively worsens, projectile
vomiting, possible visual disturbances
Pain progressively worsens, projectile
speech or personality changes;
vomiting, possible visual disturbances
problems with equilibrium, gait, or
speech or personality changes;
coordination; seizures. Extremely rare
problems with equilibrium, gait, or
condition.
coordination; seizures. Extremely rare
condition.
Caffeine.
10% caused by organic diseases
(aneurysms, tumors, or blood10% caused by organic diseases
vessel malformation). 90% are
(aneurysms, tumors, or bloodrelated to migraine or cluster
vessel malformation). 90% are
headaches.
related to migraine or cluster
headaches.
Pain can occur after relatively minor
traumas. Cause of pain is often
Pain can occur after relatively minor
difficult to diagnose.
traumas. Cause of pain is often
difficult to diagnose.
Strenuous dieting or skipping meals.
Treatment
Treatment
Liquids (including broth).
Consumption of fructose (honey,
Liquids (including broth).
tomato juice are good sources) to
Consumption of fructose (honey,
help burn alcohol.
tomato juice are good sources) to
In
extreme
cases, treat by
help
burn alcohol.
terminating caffeine
In extreme cases, treat by
consumption.
terminating caffeine
consumption.
Cause must be accurately
determined. Most commonly
Cause must be accurately
treated with aspirin,
determined. Most commonly
indomethacin, or propranolol.
treated with aspirin,
Extensive testing is necessary to
indomethacin, or propranolol.
determine the headache cause.
Extensive testing is necessary to
Surgery to correct organic
determine the headache cause.
disease is occasionally indicated.
Surgery to correct organic
disease is occasionally indicated.
Possible treatment by use of antiinflammatory drugs, propranolol,
Possible treatment by use of antior biofeedback.
inflammatory drugs, propranolol,
or biofeedback.
Prevention
Prevention
Drink alcohol only in
moderation.
Drink alcohol only in
moderation.
Avoiding excess use of
caffeine.
Avoiding excess use of
caffeine.
Alternative forms of
exercise. Avoid jarring
Alternative forms of
exercises.
exercise. Avoid jarring
exercises.
Standard precautions
against trauma.
Standard precautions
against trauma.
Regular, nourishing meals
containing adequate protein and
Regular, nourishing meals
complex carbohydrates.
containing adequate protein and
complex carbohydrates.
Same as treatment.
Caused by malocclusion (poor bite),
stress, and jaw clenching.
Caused by malocclusion (poor bite),
stress, and jaw clenching.
Relaxation, biofeedback, use of
bite plate. In extreme cases,
Relaxation, biofeedback, use of
correction of malocclusion.
bite plate. In extreme cases,
correction of malocclusion.
Same as treatment.
Cause unknown. Pain from
chewing, cold air, touching face. If
Cause unknown. Pain from
under age 55, may result from
chewing, cold air, touching face. If
neurological disease, such as MS.
under age 55, may result from
neurological disease, such as MS.
Anticonvulsants and muscle
relaxants. Neurosurgery.
Anticonvulsants and muscle
relaxants. Neurosurgery.
None.
Caused by infection.
Aspirin, acetaminophen, NSAIDs,
antibiotics.
Aspirin, acetaminophen, NSAIDs,
antibiotics.
None.
Anti-inflammatory drugs, muscle
relaxants.
Anti-inflammatory drugs, muscle
relaxants.
None.
Muscle imbalance. Uncorrected
vision, astigmatism.
Muscle imbalance. Uncorrected
vision, astigmatism.
Correction of vision.
Same as treatment.
Correction of vision.
Same as treatment.
Cause is unknown. May be due to
immune disorder.
Cause is unknown. May be due to
immune disorder.
Steroids after diagnosis.
Confirmed by biopsy.
Steroids after diagnosis.
Confirmed by biopsy.
None.
Cause of tumor is usually unknown.
If discovered early, treat with
surgery or newer radiological
If discovered early, treat with
methods.
surgery or newer radiological
methods.
None.
Strenuous dieting or skipping meals.
Caused by infection.
Cause of pain is unknown.
Cause of pain is unknown.
Cause of tumor is usually unknown.
Same as treatment.
Same as treatment.
None.
None.
None.
None.
None.
This overview is for educational purposes only and is not the basis for self-diagnosis or treatment.
Type
Symptoms
Treatment
Prevention
Tension-Type
Headaches
Dull, non-throbbing pain, frequently
bilateral, associated with tightness of
scalp or neck. Degree of severity
remains constant.
Emotional stress. Hidden
depression.
Rest, aspirin, acetaminophen,
ibuprofen, naproxen sodium,
combinations of analgesics with
caffeine, ice packs, muscle
relaxants. Antidepressants if
appropriate, biofeedback,
psychotherapy. If necessary,
temporary use of stronger
prescription analgesics.
Avoidance of stress. Use
of biofeedback, relaxation
techniques or
antidepressant
medication.
Migraine
without Aura
Severe, one-sided throbbing pain,
often accompanied by nausea,
vomiting, cold hands, sensitivity to
sound and light.
Certain foods, the Pill or
menopausal hormones, excessive
hunger, changes in altitude,
weather, lights, excessive smoking,
and emotional stress. Hereditary
component.
Ice packs; isometheptene
mucate, combination products
containing caffeine, ergotamine,
DHE injectable and nasal spray,
5-HT agonists; analgesics or
medications, which constrict the
blood vessels. For prolonged
attacks steroids may be helpful.
Biofeedback, betablockers (propranolol,
timolol), anti-convulsant
(divalproex sodium).
Calcium blockers and
NSAIDs may prevent or
treat migraine headaches.
Migraine
with Aura
Similar to migraine without aura,
except warning symptoms develop.
May include visual disturbances,
numbness in arm or leg. Warning
symptoms subside within one-half
hour, followed by severe pain.
Same as migraine without aura.
At earliest onset of symptoms,
treat using biofeedback,
ergotamine, dihydroergotamine
or a 5-HT agonist. Once pain has
begun, treatment is identical to
migraine without aura.
Prevent with same
techniques as migraine
without aura.
Cluster
Headaches
Excruciating pain in vicinity of eye.
Tearing of eye, nose congestion,
flushing of face. Pain frequently
develops during sleep and may last for
several hours. Attacks occur every day
for weeks/month, then disappear for up
to a year. 90% of cluster patients are
male, most ages 20-50.
Alcoholic beverages, excessive
smoking.
Oxygen, ergotamine, sumatriptan
or intranasal application of local
anesthetic agent.
Use of steroids,
ergotamine, calcium
channel blockers and
lithium.
Menstrual
Headaches
Migraine-type pain that occurs shortly
before, during, or immediately after
menstruation or at mid-cycle (at time of
ovulation).
Variances in estrogen levels.
Same treatment as migraine.
Small doses of
vasoconstrictors and/or
anti-inflammatory drugs
before and during
menstrual period may
prevent headaches.
Hysterectomy does not
cure menstrual
headaches.
Hypertension
Headaches
Generalized or "hairband" type pain,
most severe in the morning.
Diminishes throughout day.
Severe hypertension: over 200
systolic and 110 diastolic.
Treat with appropriate blood
pressure medication.
To prevent, keep blood
pressure under control.
Aneurysm
Symptoms may mimic frequent
migraine or cluster headaches, caused
by balloon-like weakness or bulge in
blood-vessel wall. May rupture
(stroke) or allow blood to leak slowly
resulting in a sudden, unbearable
headache, double vision, rigid neck.
Individual rapidly becomes
unconscious.
Congenital tendency. Extreme
hypertension.
If aneurysm is discovered early,
treat with surgery.
To prevent, keep blood
pressure under control.
Sinus
Headaches
Gnawing pain over nasal area, often
increasing in severity throughout day.
Caused by acute infection, usually with
fever, producing blockage of sinus
ducts and preventing normal drainage.
Sinus headaches are rare. Migraine
and cluster headaches are often
misdiagnosed as sinus in origin.
Infection, nasal polyps, anatomical
deformities, such as a deviated
septum, that block the sinus ducts.
Allergy
Headaches
Generalized headache. Nasal
congestion, watery eyes.
Seasonal allergens, such as pollen,
molds. Allergies to food are not
usually a factor.
Treat with antibiotics,
decongestants, surgical drainage
if necessary.
Antihistamine
medication; topical, nasal
cortisone related sprays or
desensitization injections.
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None.
None.