Pain in My Head – Migraines and Cluster Headaches

Migraines

The migraine is a poorly understood condition that affects millions. These severe types of headaches are often explained as “excruciating”, “explosive” and “white-hot stabbing pain”. Most people believe the migraine is a vascular headache, where the blood vessels dilate. This may account for it’s severe symptoms not being limited to just your head. A migraine attack usually strikes one side of the head, or a specific location with other complaints such as nausea, dizziness, vomiting, numbness, sensitivity to lights and sounds plus other visual disturbances

An aura is a visual disturbance that occurs usually just before the onset of a full- blown migraine. It is thought this visual disturbance is caused by a constriction of the blood vessels of the head, just before they dilate. It is the dilation that causes the pain. However, you do not need to experience an aura to suffer the migraine.

Migraine Triggers and Thresholds

Basically, each migraine begins with a trigger, or the cause of the headache. Triggers vary from person to person, moment to moment. Common triggers are certain food additives, such as MSG, commonly found in Chinese take-out and hot dogs; chocolate; smoke/pollution; fresh-cut grass; differences in hormonal levels; stress; barometric pressures, etc.

The threshold is your genetic predisposition. If you suffer from chronic headaches, chances are you have relatives with the same problem.

Your threshold is how much of the triggers you can handle before your headache is activated. For example, if one of your triggers is chocolate and you decide to indulge during PMS, chances are, you’re threshold is low this time of month – hence – excruciating migraine! Yet, two weeks later, the same amount of chocolate does nothing to trigger your pain.

The key is to identify your triggers or combinations of triggers and your common dips in thresholds. As mentioned, women are predisposed to lowered thresholds during certain times of their menstrual cycle. But there are other things that can lower your threshold – a common cold, stress or fatigue – all can play a role in your pain.�

Sound complicated? At first, it would appear so. Try keeping a headache journal. See if you can determine when the headache will strike or if it comes on suddenly. Also, jot down pertinent information to track triggers – chocolate, preservatives, your period – or maybe it was seasonal allergies or a cold – anything that may have caused the pain. After a while, it will be easier to see certain trends, therefore allowing you to manage some of your triggers.

Coping With A Migraine

Migraine management is tricky. You must be persistent and patient, seeking medical advise from a qualified medical professional as well as educating yourself about the treatment options out there.

Medication. Most migraine sufferers will tell you OTC’s like taken to treat the tension type headaches don’t even dent the migraine pain. Most severe migraine sufferers require a prescription medication.�

For infrequent severe migraines, triptans such as Imitrex, Zolomig and Axert are sometimes effective. For those suspectible to complication risks of triptan, an opiod such as Codeine and Oxycodone are sometimes effective. However, care must be taken to avoid rebound headaches (see lesson one) – rebound headaches have been known to occur after just two consecutive doses, so these medications are recommended for the infrequent sufferers. Chronic sufferers may want to explore non-drug options.

Non-Drug Treatment Options

1. Headache journal. Documenting triggers and thresholds to reduce risks of headache pains. Common triggers: hormones, barometric pressure or weather changes; sensory stimuli, such as perfumes, lighting, smoke, etc.; physical exertion – aerobics, exertion, dehydration; sleep deprivation or changes in patterns; stress; and finally food-related – caffeine, MSG/preservatives, nutrasweet, etc.�

2. Dark room, quiet atmosphere and cold cloths on back of neck and directly over area of pain may decrease pain and other side effects of migraines. Lay on back or side, not on belly, as this will increase the blood rushing to your head and cause a worsening of symptoms.�

3. Relaxation techniques. Anything that limits stressors is a good thing, as they may lower your threshold for triggers (refer to lesson one).�

4. Massage techniques. Releasing the muscle tension of the head, neck and shoulders can do wonders for the migraine sufferer between attacks. Self-massage idea: place two tennis balls inside a clean sock. Feel the ridges on the back of your head towards your neck. Place tennis balls under both ridges and lie on your back. Gently relax head into tennis balls with a tucked chin.�

5. Chiropractor treatments between attacks can realign musculature and increase overall relaxation and efficient movement of the body.

6. Biofeedback. This is an electronic means to teaching relaxation. It teaches you to gain control over normally involuntary body functions, such as heart rate, blood pressure and muscle tension through a series of lights and sensors.�

7. Acupuncture. A Chinese pain treatment dating back thousands of years used to prevent and cure health problems by the insertion of superfine stainless steel needles into the first layers of skin, then stimulating them with a small electrical current.�

8. Hypnosis. This is used as a tool for pain relief. It assists you with gaining control of your pain through “blocking” it enough to regain control and set about to find real solutions to your pain.

Cluster Headaches�

Like the migraine, cluster headaches involve swelling and inflammation of blood vessels around the head. The pain is localized, affecting one part of the head, usually around the eye. Pain is described as “searing”, “boring” or “excruciating”. The nose becomes congested or runny, and the eye on the side affected with pain may become bloodshot and teary.�

Cluster headaches typically last only 20 minutes or so, but can reoccur several times in one day, thus the name “cluster” headache. And yet, long periods of time may elapse between attacks – weeks, even years. Attacks are usually cyclic, occurring at the same time of day or same season.�

This formidable headache is dominant in men, and can cause the sufferer to physically harm themselves to rid themselves of pain, or to contemplate suicide.�

Most cluster headache sufferers are smokers. Typically, the victim is taller than average and rugged in appearance.

Coping with Cluster Headaches�

Since cluster headaches rapidly strike without warning, and commonly wake the sufferer from sleep, it is difficult to treat.�

Cluster Headache Medications

As with the migraine, typically, the OTC does nothing to diminish the pain. Seek advise from a qualified medical professional if you think your headaches are considered clusters. There are a variety of medications such as somatostatin or lidocaine, administered through the nose, which can be effective in preventing or aborting cluster pain. Steroids can also be effective for short periods of time, to help break the cycle.

Chronic cluster headaches are best treated with non-drug options

Non-drug Options

In 70 -80% of cases, cluster headache pain is effectively treated with oxygen inhalation. Inhaling five to eight liters of 100% oxygen per minute for ten to fifteen minutes may short circuit the painful dilation of the blood vessels, hence, giving relief.

Others report vigorous physical exercise at the earliest signs of the cluster headache may temporarily relieve the pain. But, use caution, since vigorous exercise often exacerbates other types of headaches. If an increase in pain is noted, stop immediately.

Avoid things like smoking and drinking, which can have an adverse effect on the blood vessels. In severe cases, surgical procedures to kill the pain sensors in the area may be successful, but is not recommended for the occasional sufferer. Consult with your physician for the best option for you.

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