Headaches inflict their misery in a variety of ways, from a dull, steady ache to a blinding, throbbing pain. Nearly everyone has them at least occasionally, but an unfortunate few experience near-constant head pain. Yet no matter how mild or severe your headaches are, many effective strategies relieve and even prevent headaches. This report offers in-depth information on the most common kinds of headaches and the treatment strategies that work best for each, including a number of self-help and alternative techniques, such as acupuncture, which has garnered more credibility in recent years as a way to avert recurring headaches. This report also explores a variety of preventive strategies, such as using stress management, physical therapy, or exercise in tandem with medications. Another aspect of prevention is learning to recognize and change things that may trigger your headaches — for example, reducing emotional stress, changing your diet, or getting more sleep. Advances in the medical management of headache mean that relief is no longer just possible, but probable. Although some form of head pain will occasionally visit most people, no one should have to live and suffer with headaches.
Prepared by the editors of Harvard Health Publishing in collaboration with Egilius L.H. Spierings, M.D., Ph.D., Associate Clinical Professor of Neurology, Harvard Medical School. 39 pages. (2018)
- Headache basics
- What type of headache do you have?
- When to see your doctor
- The office visit
- Diagnostic tests
- Self-help and alternative strategies to ease headache pain
- Aspirin and other pain relievers
- Avoiding triggers
- Mind-body techniques
- Physical therapy
- Tension headache
- Triggers and aggravators
- Relieving tension headache
- Preventing tension headache
- Migraine headache
- Anatomy of an attack
- Timing of attacks
- Who’s at risk?
- Migraine triggers
- Preventing migraine headache
- SPECIAL BONUS SECTION: Mitigating migraine pain: Past, present, and future
- Medication overuse: A common complication
- Relieving chronic daily headache
- Preventing chronic daily headache
- Further options
- Cluster headache
- Relieving cluster headache
- Preventing cluster headache
- Sinus headache
- How sinus headache develops
- Relieving sinus headache
- Preventing sinus headache
- Headache diary
Migraine pain has been called indescribable, yet 35 million Americans know it all too well. Horror author Steven King, himself a migraineur, penned a vivid description of a migraine in his novel Firestarter:
"The headache would get worse until it was a smashing weight, sending red pain through his head and neck with every pulse beat. Bright lights would make his eyes water helplessly and send darts of agony into the flesh just behind his eyes. Small noises magnified, ordinary noises insupportable. The headache would worsen until it felt as if his head were being crushed inside an inquisitor's lovecap…. He would be next to helpless."
Migraine is the French derivation of the Greek word hemikrania, meaning "half a head," referring to the typical pattern of migraine distress — pain only on one side of the head, most often at the temple. The affected side can vary from one attack to the next or even during a single episode.
Migraine pain ranges from moderate to severe. They can keep you from functioning or sleeping, and can even rouse you from sound slumber. Most people describe the pain as pulsating or throbbing. It can also be sharp, almost as if a dagger is piercing your temple or eye.
As if the throbbing, intense pain of a migraine isn't bad enough, some sufferers must also cope with nausea during an attack. What's the connection between head pain and stomach upset? The body's "fight or flight" reaction. The illustration below explains the biology behind this phenomenon, which reflects the body's normal response to any type of stress, including pain.
1) During a migraine headache, arteries in the head (especially in the temporal area) dilate.
2) The widened arteries stretch nerve fibers that encircle the arteries, causing them to send impulses to the brain. In turn, these nerve impulses cause pain and activate the sympathetic nervous system (SNS), which originates in the spinal cord and extends to organs throughout the body, including the stomach and intestines. The SNS controls the body's "fight or flight" response, mobilizing the body for action by speeding up the heart rate, raising blood pressure, and slowing digestion.
3) To slow digestion, the SNS closes the pyloric sphincter (the ring of smooth muscle that separates the stomach from the upper part of the intestines). As a result, the stomach dilates and any leftover food stays in the stomach, which can cause the nausea and vomiting that often accompany migraine headaches. This phenomenon also explains why migraine medications taken by mouth aren't very effective—they aren't well absorbed into the bloodstream.
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