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Headaches in General

Nearly 50 million Americans suffer from chronic, recurring headaches, of which over half suffer from migraines. Over 20% of children and adolescents are also headache sufferers.

The most sensible route to travel is to establish the type of headache and its most probable cause. Once this is done, the advice for the treatment will be more specific and effective.

What type of Headache do I have and what are the more common types of Headache?
I suffer from the following signs and/or symptoms –
- Acute headaches: Seen in children, these are headaches that occur suddenly and for the first time and have symptoms that subside after a relatively short period of time. Acute headaches most commonly result in a visit to the pediatrician's office and/or the emergency room. If there are no neurological signs or symptoms, the most common cause for acute headaches in children and adolescents is a respiratory or sinus infection.
-Hormone headaches: Headaches in women are often associated with changing hormone levels that occur during menstruation, pregnancy, and menopause. Chemically induced hormone changes, such as with birth control pills, also trigger headaches in some women.
-Chronic progressive headaches: Also called traction or inflammatory headaches, chronic progressive headaches get worse and happen more often over time. These are the least common type of headache, accounting for less than 5% of all headaches in adults and less than 2% of all headaches in kids. Chronic progressive headaches may be the result of an illness or disorder of the brain or skull.
-Poor Posture: There are countless causes of headaches, but one that is often overlooked is posture. Take a minute to think about how you sit and stand. Now consider how your body feels when you are lying down. Do you experience aches or discomfort around your neck and back? Are there certain positions that seem to cause tension and trigger headaches for you? Poor posture can result in muscle tension within and around the shoulder and neck joints and muscles. It can also exacerbate headache pain stemming from other causes. Some people find that during stressful situations, posture suffers and breathing patterns may become shallow and tensed. For this reason, it can be helpful to focus on correct posture alongside deep breathing. This will allow you to alleviate physical discomfort from a hunched over posture, for example, while also utilising deep breathing exercises to ease the bodily tension that can occur from anxiety and stress.
-Consider How You Sit and Stand: It makes sense to maintain good posture by paying attention to the way you move your body. Poor posture can result in painful and chronic tension in your neck and back, leaving your muscles tensed and possibly triggering headaches. If you do find that your headaches are related to tension from poor posture, try to develop an awareness of how you hold your body during daily activities and in particular, how your sit and stand. Some of the ways you can encourage and maintain proper posture are:

-Avoid sitting or standing in one position for prolonged periods of time.
-Sit up straight and use any cushions or back supports for your lower back as needed.
-Consider a special headset if you spend a lot of time on the phone. Holding a telephone between your shoulder and head, especially for prolonged periods, can strain muscles and result in sharp tension headaches.
-Adjust computer screens so that your neck is not strained.
-When lifting anything, especially if it is quite heavy, lift with your arms and legs, not your back.

-Mind Your Breathing: Breathing is obviously necessary for existence, yet many of us tend to take shallow, labored breaths. Rarely do most people breathe deeply on a regular basis, but by consciously focusing on breathing and replacing superficial breathing with deeper breaths, you can better oxygenate your body, ease tension and help headache pain. The effects of deep breathing can be quite powerful and it may feel unusual at first, as it is very different from the shallow superficial breathing most people perform. Deep, slower breaths relax the nervous system and provide wonderful physical and emotional benefits for tension, which can really benefit headache pain management. It's also important to learn deep breathing as it assists in releasing tension. Try taking a slow deep breath in to a count of three, and focus on any issues in your life that are stressful and may be triggering headaches and muscle discomfort. Then, release very slowly to another count of three, and imagine your worries dissolving and releasing with your breath. The mind can be a powerful tool when used with deep breathing and may help alleviate headaches triggered by stress.
-Tension headaches: Also called chronic daily headaches or chronic non-progressive headaches, tension headaches are the most common type of headaches among adults and adolescents. These muscle contraction headaches cause mild to moderate pain and come and go over a prolonged period of time. Muscular tension - Skeletal muscles are made up of muscle fibers, bundled together. Each fiber can contract or relax on demand. All the fibers contract together to shorten a muscle. The command to contract or relax is given by the brain and relayed to the muscle by nerves. When we are under stress, we commonly tense the muscles of the shoulders, upper back, neck and face. This can lead to tension headache.
-Migraines: The exact causes of migraines are unknown, although they are related to blood vessel contractions and other changes in the brain as well as inherited abnormalities in certain areas of the brain. Migraine pain is moderate to severe, often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually occur 1 to 4 times per month. Migraines are associated with symptoms such as light sensitivity; noise or odors; nausea or vomiting; loss of appetite; and stomach upset or abdominal pain. When a child is having a migraine they often look pale, feel dizzy, have blurred vision, fever, stomach upset, in addition to having the above listed symptoms. A small percentage of pediatric migraines include recurrent (cyclic) gastrointestinal symptoms, in which vomiting is most common. Cyclic vomiting means that the symptoms occur on a regular basis -- about once a month. These types of migraines are sometimes called abdominal migraines.
-Mixed headache syndrome: Also called transformed migraines, this is a combination of migraine and tension headaches. Both adults and children experience this type of headache.
-Cluster headaches: The least common, although the most severe, type of primary headache, the pain of a cluster headache is intense and may be described as having a burning or piercing quality that is throbbing or constant. The pain is so severe that most cluster headache sufferers cannot sit still and will often pace during an attack. The pain is located behind one eye or in the eye region, without changing sides. The term "cluster headache" refers to headaches that have a characteristic grouping of attacks. Cluster headaches occur one to three times per day during a cluster period, which may last 2 weeks to 3 months. The headaches may disappear completely (go into "remission") for months or years, only to recur.
-Sinus headaches: cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches. Headaches may occur if you have a cold, the flu, fever, or premenstrual syndrome.
Bringing it all Together
Combining good posture with deep breathing exercises not only provides immediate stress and headache relief, but when performed consistently, it can prevent headaches as well. If you regularly work on deep breathing, you may find that eventually, you are breathing at a deeper level without conscious intent. What this means is that you have integrated more relaxed and deep breaths without having to 'force' yourself to breathe differently. Try to find a comfortable standing or sitting position that maintains correct posture and use deep breathing to release tension and stress. The benefit of these techniques is that they can be performed virtually anywhere and you can obtain immediate calming relief.

So the next time you experience a headache, consider your posture as a cause and check to be sure you are sitting, lying or standing comfortably. If you find your posture is poor, try adjusting it and also consider adding in deep breathing to provide headache relief.

In addition, you may want to consider visiting a physical therapist, who can help you to identify and correct any postural problems that may be triggering or causing your headaches. Keeping your spine and posture healthy as well as using deep breathing for relaxation is all part of headache management.

What Causes Headaches?
Headache pain results from signals interacting between the brain, blood vessels, and surrounding nerves. During a headache, specific nerves of the blood vessels and head muscles are activated and send pain signals to the brain. It's not clear, however, why these signals are activated in the first place.

There is a migraine "pain center" or generator in the mid-brain area. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels, causing constriction, followed by the dilation of these vessels and the release of prostaglandins, serotonin, and other inflammatory substances that cause the pulsation to be painful. Serotonin is a naturally occurring chemical essential for certain body processes.

Headaches that occur suddenly (acute-onset) are usually due to an illness, infection, cold or fever. Other conditions that can cause an acute headache include sinusitis (inflammation of the sinuses), pharyngitis (inflammation or infection of the throat) or otitis (ear infection or inflammation).

In some cases, the headaches may be the result of a blow to the head (trauma) or rarely a sign of a more serious medical condition.

Common causes of tension headaches or chronic nonprogressive headaches include emotional stress related to family and friends, work or school; alcohol use; skipping meals; changes in sleep patterns; excessive medication use; tension and depression. Other causes of tension headaches include eyestrain and neck or back strain due to poor posture.

The types of activities that can lead to poor neck posture include sitting at a computer for extended periods of time, reading with the head bent forward, sitting while slouching in a chair or on a couch, sleeping with the head or neck in odd positions, or any other activity that places the head in a position forward to the body. This leads to the conclusion that headaches and neck pain can be caused by sitting at a computer.

Headaches can also be triggered by specific environmental factors that are shared in a family's household, such as exposure to second-hand tobacco smoke, strong odors from household chemicals or perfumes, exposure to certain allergens or eating certain foods. Stress, pollution, noise, lighting and weather changes are other environmental factors that can trigger headaches for some people.

Too much physical activity can also trigger a migraine in both adults and children. Be sure to consult a doctor to find out what is causing your headaches.

Are Headaches Hereditary?
Yes, headaches, especially migraines, have a tendency to run in families. Most children and adolescents (90%) who have migraines have other family members with migraines. When both parents have a history of migraines, there is a 70% chance that the child will also develop migraines. If only one parent has a history of migraines, the risk drops to 25%-50%.

Do Children Outgrow Headaches?
Headaches may improve as children gets older. The headaches may disappear and then return later in life. By junior high school, many boys who have migraines outgrow them, but in girls, migraine frequency increases because of hormone changes. Migraines in adolescent girls are three times more likely to occur than in boys.

How Are Headaches Evaluated and Diagnosed?
The good news for headache sufferers is that once a correct headache diagnosis is made, an effective treatment plan can be started. It seems logical that the majority of migraine or tension headaches originate from neck problems. It also seems logical that if we established what was causing these neck problems, and eliminated what was causing them, we could also eliminate the headaches.

Chiropractors for example, after examining thousands of patients, discovered that as many as 95% of neck pain and headache patients had one thing in common - a reversed neck curve. From the side view a normal neck should have a slight curve in it. But as many as 95% of headache and neck pain patients had either a lessening of that curve, no curve at all, or a curve that was completely reversed.

If you have headache symptoms, the first step is to go to your family doctor. He or she will perform a complete physical examination and a headache evaluation. During the headache evaluation, your headache history and description of the headaches will be evaluated. You will be asked to describe your headache symptoms and characteristics as completely as possible.

A headache evaluation may include a CT scan or MRI if a structural disorder of the central nervous system is suspected. Both of these tests produce cross-sectional images of the brain that can reveal abnormal areas or problems. Skull X-rays are not helpful. An EEG (electroencephalogram) is also unnecessary unless you have experienced a loss of consciousness with a headache.

If your headache symptoms become worse or become more frequent despite treatment, ask your doctor for a referral to a specialist. Your family doctor should be able to provide the names of headache specialists. If you need more information, contact one of the organizations in the resource list for a list of member doctors in your state.

How Are Headaches Treated?
Your doctor may recommend different types of treatment to try or he or she may recommend further testing, or refer you to a headache specialist. You should establish a reasonable time frame with your family doctor to evaluate your headache symptoms. The proper treatment will depend on several factors, including the type and frequency of the headache and its cause.

Not all headaches require medical attention. Refer to “How can I take Care of the problem myself?” Treatment may include education, counseling, stress management and medications. The treatment prescribed for you will be tailored to meet your specific needs if you can provide an accurate account of the headaches.

There are many natural remedies. These include stress and tension reduction, ice therapy (used at the base of the skull), eliminating food triggers, getting the proper amount of rest, biofeedback, neck pillows or cushions, exercise and many others.

What Happens After I Start Treatment?
When your doctor starts a treatment program, keep track of the results and how the treatment program is working. Keep your scheduled follow-up appointments so your doctor can monitor your progress and make changes in the treatment program as needed.

How can I take Care of the problem myself?
Under all circumstances, it is advisable to keep a record to help track and identify the source or what event sets off your symptoms. With this information in hand, you will be able to make the necessary changes to avoid future headaches. The information that should be recorded is the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress that you be under, how long the headache lasts, and what event or treatment or behavior patterns made it go away. You may soon see the formation of a pattern which will be most useful.

A headache may be relieved by resting with your eyes closed and head supported. Relaxation techniques can help. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches.

Can headaches and neck pain be caused by sitting at a computer?
There is no doubt that too much time may create a problem in the neck area that could lead to chronic neck pain and headaches. First, foremost and most important is to keep a check on your posture. People usually develop poor neck curvatures because of poor posture habits. Anything a person does that places their head in a position forward to their body will lessen or reverse their normal neck curve. And poor neck curvatures DO cause head aches.

What are some guidelines if long computer hours are the problem?
Sitting at the computer and avoiding neck problems and headaches:
-Take breaks every 15-20 minutes. This should involve getting up, and walking about the room. This will provide a break from using your eyes, promote circulation, and allow the spinal tissues to be exercised to avoid postural strain.
-Maintain upright posture at all time. Avoid slumping, or sitting with your feet up. Look straight ahead at your monitor screen. The ideal position is the middle of the screen slightly above eye level. This is different than many ergonomic specialists agree, in that this position is higher. However, this head and neck position is the most favorable for your overall health. So, raise up the monitor height, so that the middle of the monitor is above eye level. This facilitates an improved neck and head position, and therefore reduces abnormal stress and strain upon the neck and shoulder muscles.
-Place your feet firmly on the floor in front of you. If you require one, use a foot stool. That is, if your chair and desk configuration does not allow you to have your thighs at a ninety degree or greater angle to the floor, then you may need a foot stool or support.
-Use a headset if you are ever on the phone while using the computer. In fact, you should use a headset whenever possible. This will most assuredly reduce strain on your neck and shoulder muscles.
-If you have bifocals, and you seldom look away from your screen to focus on other things, you should consider a pair of glasses dedicated to computer use only. In many patients, the repetitive nodding required of bifocal is very challenging to the muscles of the upper neck

car seat back support back support
If you work using a computer or spend a lot of time at home with one, see neck pain and computer use for more information

I am a Teenager. What Makes a Headache a Migraine?
A normal headache is common to almost everyone. There may be a throbbing in the front of your head during a cold or bout of the flu. Or you might feel pain in your temples or at the back of your head from a tension headache. Or you may have a dull pain around the front, top, and sides of your head.

A migraine is very different. It is defined as a recurrent headache that has additional symptoms. The pain is often throbbing and on one or both sides of the head. People with migraines often feel dizzy or sick in their stomachs. They may be sensitive to light, noise, or smells. Migraines can be disabling, and teens with migraines may need to skip school, sports or other activities until they feel better.

If you have migraines, you are not alone. Experts estimate that up to 10% of teens and young adults in the United States get migraines. Before age 10, an equal number of boys and girls get migraines. But after age 12, during and after puberty, migraines affect girls three times more often than boys.

What Causes a Migraine?

Not all scientists agree about what causes migraines. Many believe that a migraine is caused by narrowing and expanding of the blood vessels in the brain. There are also theories that the level of certain chemicals in the brain may affect the nerve system that regulates pain.

Whatever the cause, experts do agree that a variety of things set them off in people who have them. For some people, eating certain foods brings on a migraine. Others find that sleeping too long (or too little) provokes a migraine attack.

What are some more common issues that could bring on a migraine?
These are not listed in any particular sequence:

Irregular or missing out on meals;
Excessive caffeine;
Particular foods and drink (alcohol, cheese, pizza, chocolate, ice cream, fatty or fried food, lunch meats, hot dogs, yogurt, aspartame, or anything with MSG, a seasoning often used in Asian foods);
Changes in sleep patterns;
Changes in hormone levels;
Dramatic changes in weather patterns;
Long distance travel by any or a particular means. .

Experts also believe that the likelihood of getting migraines is inherited. If one of your parents is/was prone to migraines, you have a greater chance of having these types of headaches than someone who doesn't have a family history of migraines.

What is a Migraine Attack Like?
Whereas most migraines last from 30 minutes to 6 hours; some can last up to a few days.

Every migraine begins in a different way. Some people just don't feel right. Lighting, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to perform physical activities during this time may worsen the pain.
Some people get auras, a kind of warning that a migraine is on the way. The most common auras include blurred vision and seeing spots, colored balls, jagged lines, or bright or flashing lights or smelling a certain odor. The auras may only be seen in one eye. An aura usually starts about 10 to 30 minutes before the start of a migraine. Some individuals may experience a migraine premonition hours to days prior to the actual onset of the headache. This is slightly different from auras and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.
Some people with migraines also have muscle weakness, lose their sense of coordination, stumble, or even have trouble talking either just before or while they have a headache.
How Do Doctors Diagnose and Treat Migraines?
Because migraine headaches vary in different people — in some people, for example, they are triggered by hormones; in others, stress and lifestyle influence headaches — how doctors treat someone depends on the type of migraine being experienced by that person.

A doctor may recommend someone having migraines to keep a headache diary to help figure out what triggers the headaches. If your doctor has asked you to keep such a diary, the information you record will help the doctor establish the best treatment. A doctor may also take blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out more serious medical problems that might cause a person's migraines.

Part of the treatment may involve making certain changes in your lifestyle — like changing your sleep patterns or dietary habits or avoiding certain stress factors that trigger your migraines. Your doctor may also start you on a pain relief medication or also prescribe medicines that help with nausea and vomiting. Some people need preventive medicines that are taken every day to reduce the number and severity of the migraines.

Some doctors teach a technique called biofeedback to their patients with migraines. This technique helps a person learn to relax and use the brain to gain control over certain body functions (like heart rate and muscle stress) that cause tension and pain. If a migraine begins slowly, many people can use biofeedback to remain calm and stop the attack.

There have also been studies indicating that some alternative methods, such as acupuncture and the use of certain herbs, can help some people. However, it is important to ask your physician about alternative medicines before deciding on them by yourself. This is especially true of herbal treatments because they can interfere with more traditional methods of treatment.

How can I prevent a Migraine?
The best way to prevent migraines is to learn what sets them off and then try to avoid these triggers. Take a break from activities that provoke a migraine, such as using the computer for a long time. If you know that certain foods trigger your migraines, try to avoid them. Some people find that cutting back on caffeine intake or drinking a lot of water can help prevent migraines.

Make a plan for all the things you have to do — especially during stressful times like final exams — so you don't feel overwhelmed when things pile up. Regular exercise and fun activities can also reduce stress and make you feel better. If your doctor has prescribed medication, always have a dose on hand. Then if you feel a migraine coming, take your medicine. You can also try lying down in a quiet, dark room until the pain starts to go away.

The key is a diary. Migraines are so different for different people, so it helps to keep a headache diary and get to know what provokes migraines in your own case. The more you understand your headaches, the better prepared you can be to fight them.

Can Exercise help migraine sufferers?
The National Institutes of Health estimate that 28 million Americans suffer from migraines. People who suffer from chronic, severe migraines have long been advised not to exercise vigorously, to stick with low-intensity routines, and sometimes, to refrain from exercise altogether. However, a recently published Swedish study shows that these precautions may not be necessary. In fact, exercise, particularly cycling, may be beneficial for chronic migraine sufferers.

Twenty-six patients who had all been diagnosed with chronic migraines were surveyed at a headache clinic. They were assigned an exercise program based on indoor cycling, which was performed 3 times per week for 12 weeks. Total oxygen uptake, physical fitness, migraine status, side effects, and quality of life were evaluated. Results showed that quality of life increased with exercise and significant improvements in migraines were present: this includes lower pain, headache frequency, symptom intensity, and lower medicine intake.

Headaches are usually caused by muscle tension, vascular problems, or both. Migraines are vascular in origin, and may be preceded by visual disturbances, loss of peripheral vision, and fatigue. Most headaches can be relieved or ameliorated by over-the-counter pain medications.

A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are extremely rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and occasionally by taking medications.

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