Treating And Preventing Headaches

Although many of my patients have had success with the following program, I only use the general guidelines discussed below after reviewing a patient’s personal and medical history, performing a thorough examination and evaluating the laboratory studies to make sure that the program will be beneficial.

Please see your own physician before embarking on any treatment program for headaches. Once I have examined a patient and ruled out any organic causes for head pain, I attempt to identify his or her particular type of headache. Correct diagnosis is necessary before effective treatment can begin.

To help give you an idea of what types of headaches you may suffer from, run through the checklists on pages 158 to 159. Check off the items that apply to you. Once you know the kind(s) of headache that you suffer from, you can begin appropriate measures to both treat and prevent headaches.

Preventing and treating muscle contraction (tension) headaches.

Muscle contraction headaches are usually easy to prevent and treat. Simply learning how to deal with stress can eliminate many of the headaches.  Here are some techniques for prevention:

1. Reduce the stress in your life. Look at the pace of your life and see if it is taxing you. Most of us could slow down and avoid making too many changes at once. Do we really need to accomplish all of our goals so quickly? Are we so busy looking ahead that we’ve lost sight of the good things we already have?
2. Exercise. At least three times a week, get some exercise. Low impact exercise, such as walking, swimming or bicycling, will tone the body and release pent up stress.
3. Relax. Set aside time every day to relax. A little bit of relaxation can eliminate a lot of stress.
4. Avoid or limit caffeine intake.
5. Eat a healthful diet. Make sure to eat a healthful diet based on fresh vegetables and fruits, with plenty of whole grains, small amounts of protein and two to three servings of nonfat dairy products per day. Reduce or avoid the dangerous “CATS form San Francisco” (caffeine, alcohol, tobacco, sugar, salt). Make sure that you’re getting ample amounts of vitamins A, C and E, beta carotene, the B-vitamins and the many minerals.
6. DLPA Taking DLPA when you are feeling fine can help to prevent headaches from striking. See the discussion of DLPA earlier in this chapter.
7. Use pain relievers sparingly. Overusing pain relievers that contain caffeine can lead to tolerance and “rebound headaches.”

Repeat this technique as often as you like.

1. Rest with hot or cold compresses to the head.
2. Drink a caffeinated beverage. A cup of coffee or other caffeinated beverage may help relieve persistent pain. Caffeine constricts vessels that may have triggered the headache by dilating (widening). Caffeine may also relieve pain by increasing serotonin levels (which helps to relieve pain in general).
3. Over the counter and prescription medications. If none of the other techniques works, you might try an over the counter (nonprescription) pain reliever. Should you and your physician feel that it’s necessary, prescription antidepressants, tranquilizers, muscle relaxants and other drugs may be used. Bear in mind, however, that all medicines have side effects. But be aware that the stronger the medication, the greater the risk of building up a tolerance and suffering from side effects.

Muscle contraction (“tension”) headache checklist

-  The pain feels like a constricting headband or vise, usually across the temples or head.
-  The pain is mild to moderate.
-  The pain may last for days.
-  The pain has no clear beginning or end.
-  The pain usually strikes when I’m stressed, although itmay also occur when I’m sleeping.
-  The pain often begins in the morning and gets worse throughout the day.
-  The muscles in my neck and shoulders get knotted.

Migraine headache checklist

- The pain usually strikes on one side of my head.
-  The pain is moderate to severe.
-  The pain is “throbbing” or “penetrating.”
-  The pain usually lasts an average of four to eight hours, but may continue for days.
-  There may be halos, flashing lights or other visual disturbances.
-  I’m sensitive to light and sound during the headache episode.
-  I often feel nauseated and may vomit while having the headache.
-  I may feel dizzy during the headache.
-  I may feel numb in my arm or part of my face during the headache.
-  The headaches may strike during vacations, weekends or other times that I’m not feeling stressed.

Cluster headache checklist

-  The pain is excruciating.
-  The pain is “piercing” or “burning.”
-  The pain is usually on one side of my face, but it may switch sides.
-  The pain settles behind one of my eyes.
-  My eye tears, swells and droops.
-  I get congestion or a runny nose on the affected side of my face.
-  I have flushing or sweating on the affected side of my face.
-  The pain lasts from 30 minutes to one hour.
-  The headaches strike in clusters of several headaches a day, sometimes for weeks or even months.
-   The headaches seem to start at the same time of the year.

Checking off several items on any one list suggests that you usually get that type of headache. But if you check off several items on more than one list, you are most likely getting tension headaches related to fatigue and stress.

I also advise my patients to keep a log of every single headache that they get. The log helps doctor and patient with diagnosis, treatment and prevention. Make several copies of the headache log on this page and keep careful track of all headache pain.

Headache log.

Date __________________________________________
Time headache started____________________________
Time headache ended ____________________________
The pain is located _______________________________
The pain feels like ________________________________
On a scale of 1 to 10, with 10 being worst, the pain rates a —

Other symptoms.

Possible triggers * ________________________________
Medication used _________________________________
Other treatment _________________________________
After treatment, on a scale of 1 to 10, the pain rates a _____

* Possible triggers include stress, the let-down period after stress, missing a meal, medication, certain foods, hormonal changes, changes in the weather, lack of sleep, cigarette smoke, withdrawal from caffeine, bright lights, oversleeping, exercise and other factors.

Preventing and treating migraine headaches

1. Avoid migraine triggers. Certain foods, fatigue, hunger, bright lights, altitude, motion, hormonal factors and changes in the weather can trigger headaches. Staying away from those triggers may relieve the problem significantly. Both becoming overtired or oversleeping can trigger an attack, so make sure that you get enough, but not too much, sleep every night. Hunger, stress, alcohol and bright light can also trigger migraines in susceptible people.
2. Reduce stress. Although migraines tend to strike after a stressful period, they do seem to be related to stress. Reduce your stress as much as possible.
3. Preventive medication. Discuss the use of preventive medications with your physician if your migraines are lessening the quality of your life.
4. General good health measures. Healthful eating habits, exercise and other good habits strengthen your overall health, helping you to absorb the stress caused by migraines.

If the migraine has already struck, try the following techniques:

1. Rest in a quiet, dark place with hot and cold compresses.
2. Vitamin B2. Discuss using this vitamin, which can reduce pain by over half, with your physician.
3. Scalp and neck massage.
4. Herbal remedies. Several herbs are useful, including feverfew, ginkgo bioba, chamomile, coriander, turmeric, bay leaves, skullcap, valerian and willow bark Be sure to discuss their use with your physician before taking them.
5. Pain medications. Pain medication is often necessary during a migraine headache. Start with the milder medications such as Midrin before moving on, if necessary, to stronger ones.

Preventing and treating cluster headaches

The dilation of the blood vessels that occurs during a cluster headache can be prevented. In addition to the strategies for preventing tension headaches, you can:

1. Eliminate alcohol, a known headache trigger.
2. Eliminate dietary triggers. Avoid any foods and drinks that may trigger your cluster headaches
3. Avoid cigarette smoke.
4. Stick to a regular sleeping schedule.
5. Consider preventive medication. If your cluster headaches are striking on a daily basis and last for more than 15 minutes, your physician may want to prescribe a preventive medication. I like to use magnesium, a safe and natural calcium channel blocker, as a preventive.

Cluster headaches can be quite severe, so painful that relaxation techniques are not much help once the pain has struck. Deep breathing may help a little to alleviate the fear that accompanies the onset of these attacks. In addition to the techniques for treating tension headaches, you can also try the following:

Inhale pure oxygen. Oxygen can help to lessen the pain of cluster headaches in many people. Discuss this carefully with your physician, especially if you have any pulmonary problems. You’ll need a doctor’s prescription to get the oxygen from a medical supply house. Pain medication. For severe headaches that do not respond to other treatments, your physician may prescribe a pain reliever.

Preventing and treating exertion headaches

Exertion headaches can be very painful, but they are rarely serious. Neither are they usually caused by underlying medical problems. Modifying your physical activities should help to lessen the frequency and intensity of your headaches. Take it a little easier. Always warm up before exercising and cool down afterward. Slow down gradually from peak activity. If an exertion headache does strike, lying down in bed, holding cold compresses to your head and massaging your scalp will often quell the pain.

Preventing and treating organic headaches

There are no specific treatment or prevention strategies for organic headaches it all depends on the underlying cause(s). If you have or suspect that you have organic headaches, see your physician immediately. When those terrible headaches used to send me to bed crying as a child, I thought I would never be free from them. Now I know that with careful prevention and treatment, most of the pain can be eliminated, often without using strong medications.

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