All headache sufferers should do cervical shower exercises. Simply stand with the water stream directed to the back of the neck and slowly, gently turn to see who is standing behind you for three minutes. This removes lactic acid from the muscles and makes the blood vessels less "irritable." Avoid extreme chilling to the neck. For example, you can bring on your headache if you chill the back of your neck and then suddenly apply heat. The cold constricts the blood vessels, followed by the sudden dilatation of the vessels by the heat. This replicates the migraine mechanism. Wear a scarf when you go to a movie in case you need it and NEVER drive at night with the wind blowing on your neck.
Many of my patients respond to small doses of slow release vasodilators to keep the blood vessels open in order to avoid the constriction.
If your chair is too low so that you have to strain your neck, this can be a trigger. My patient purchased a low slung sports car and developed headaches. A $2.95 seat cushion cured him because he was seated too low. Check the lighting at your desk too. T.V. headache? As a rule, the softer the couch the worse it is for the headache-as well as the back patient. Trying to view the TV screen when one is slumped down will cause a headache. Try to have a chair similar to a secretary posture type.
If your visual correction is off, this can trigger a headache because the eye and other muscles squeeze in order to focus. Thus, if your headaches come on after reading, check the prescription. Squinting does the same thing. My patient stated that since she moved into the new office overlooking the harbor not only she, but most of the other secretaries were getting headaches. The cause of this was that they had all turned their desks so as to view the harbor and the glare of the sun and water caused them to squint. When they moved their desks to avoid the glare the headaches ceased.
Migraine patients must be careful of their vitamin formula. If these contain Niacin which is a vasodilator, this can be a common trigger and cause the headache. Apparently any food or drink can be a trigger. By keeping a headache diary these and other triggers can be identified. Common foods are red wine and smelly cheeses. If you suspect a particular food, avoid it for two weeks and then test the food on an empty stomach. If it brings on the headache, check with your doctor as to which foods are related. For example, melons are related to avocados.
As an ear nose and throat specialist I have a unique advantage in being able to differentiate between sinus pain and headaches. Much frontal sinus area pain comes from the posterior neck because of the way the nerves are connected. However there are individuals whose headaches are triggered by congestion and the pus of an infection. To avoid this trigger, it is beneficial to use pulsatile saline irrigation whenever there is thick mucus or pus in your nose and sinus.. This device can be used by anyone age 5 or older. Removing thick mucus or pus also may prevent a sinus infection .
Any symptom whatsoever is made worse by anxiety reinforcement-the more it itches the more you rub it, the worse it feels the more nervous you get, the more you rub it, and so on. This applies to contact lenses as will as headaches. It is important to learn MUSCLE relaxation because you cannot feel anxiety if your muscles are relaxed.
A good practice is to stand or sit before the mirror. Breath in at the count of four and out at the count of 6. As you exhale let this be a signal to your body to relax your muscles. You can look at the mirror and SEE if the muscles of your face are relaxed.. If you are doing this correctly, your mouth should open as you relax the jaw muscles. Now, if you feel a headache coming on do the breathing as you did with the mirror. This works because respiration uses the large muscle, the diaphragm, and actually sends a signal to the diaphragm to relax. So you utilize this signal to relax the face, etc. See Relaxation Excercises
Jaw joint pain is commonly due to reinforcement, but also comes on when the jaw muscles are unbalanced. Most jaw joint pain patients open the mouth to the side because the muscles are unbalanced. You can prevent this pain by drawing a straight line on the mirror, and mark the middle of your jaw, lip and forehead. Sit as in the above instructions, and allow your jaw to open in the midline as you relax . Continue this daily until you jaw readily opens in the midline. Temperomandibular joint pain is reduced by taking papaya enzyme tablets, one four times a day, dissolve in the mouth between the cheek and the gums. This reduces joint swelling, hence the pain, and helps the jaw to assume the midline position.
All headache patients do better on an exercise program and sometimes the right series of exercises can be the "cure". I make sure that my patients do engage in an exercise program, whether to reduce "stress" or improve circulation or muscle action. I frequently refer to physical therapists in order to have them prescribe an individualized program. Incidentally, I recommend that patients who want to lose weight
One patient had certain neck muscles that needed strengthening. Another hated exercise because he couldn't do 100 pushups - in other words he was trying to do precisely the wrong types of exercise! When the individual program was prescribed, he did fine. Walking is always good and I recommend, if you don't already have a dog, that you find one in the neighborhood and "borrow" him to take walking. Few dogs get enough exercise, so it is good for you, the dog, and the dog's owner.
Conclusion: In any illness, the patient benefits when he or she assumes responsibility for their health. Headache medications are improving, however there are still actions the patient can take themselves that can be crucial to preventing their headache. These include the headache diary, exercise and muscle relaxation.
Migraine Headaches
Migraine headaches differ from Tension or neck headaches because they
occur in episodes, they may have symptoms that they are coming on such as
spots, visual changes, or neck pain before the headache starts. These can
awaken you from a sound sleep.
Feels better being in a dark room. Prevention. If a sister or mother has migraine, the woman should not take birth control pills. If associated with menstrual weight gain, a mild diuretic such as Diamox may help, also avoid salt 10 days before onset of menses. Since migraine is a matter of blood vessels that are too spastic, they close vigorously, then slam open, doing gentle neck stretching in the shower, the shower to the back of the neck, may help train the blood vessels not to be so spastic. Some patients may be cured by taking slow release Niacin, 125 milligrams twice a day. This tends to keep the blood vessels open so they won't slam open. On the other hand, regular niacin, often found in vitamins may bring on the headache. Red wine and smelly cheeses are also common triggers.. Caffeine helps this headache and can even be taken as a strong coffee enema. The older drugs such as Esgic or Fiurinal are helpful. The newer drug Imitrex has been very good in my hands. As of March 96, many of the patients whom I switched from injectable Imitrex to oral, have requested to go back on the injectable form. Sometimes anxiety may reinforce the headache symptoms. For this, see Relaxation Excercises.
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Last Update 5/5/96
Murray Grossan M.D.
ENTconsult@aol.com