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A lot of people get migraines — about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.

Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

* Alcohol
* Allergic reactions
* Bright lights
* Certain odors or perfumes
* Changes in hormone levels (which can occur during a woman’s menstrual cycle or with the use of birth control pills)
* Changes in sleep patterns
* Exercise
* Loud noises
* Missed meals
* Physical or emotional stress
* Smoking or exposure to smoke

Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:

* Any processed, fermented, pickled, or marinated foods
* Baked goods
* Chocolate
* Dairy products
* Foods containing monosodium glutamate (MSG)
* Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
* Fruits (avocado, banana, citrus fruit)
* Meats containing nitrates (bacon, hot dogs, salami, cured meats)
* Nuts
* Onions
* Peanut butter

This list may not be all-inclusive.

True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.

Symptoms

Vision disturbances, or aura, are considered a “warning sign” that a migraine is coming. The aura occurs in both eyes and may involve any of all of the following:

* A temporary blind spot
* Blurred vision
* Eye pain
* Seeing stars or zigzag lines
* Tunnel vision

Not every person with migraines has an aura. Those who do usually develop one about 10-15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand.

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:

* Feel throbbing, pounding, or pulsating
* Are worse on one side of the head
* Start as a dull ache and gets worse within minutes to hours
* Last 6 to 48 hours

Other symptoms that may occur with the headache include:

* Chills
* Increased urination
* Fatigue
* Loss of appetite
* Nausea and vomiting
* Numbness, tingling, or weakness
* Problems concentrating, trouble finding words
* Sensitivity to light or sound
* Sweating

Symptoms that may linger even after the migraine has gone away include:

* Feeling mentally dull, like your thinking is not clear or sharp
* Increased need for sleep
* Neck pain

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To identify and avoid headache triggers:

* Manage your stress as best you can. Many people report getting a tension headache during a stressful event. You may not be able to control stressful events, but you may be able to control your response to those events. Relaxation exercises, biofeedback, or acupuncture may help reduce your stress level.
* Seek treatment for depression or anxiety. Taking antidepressants may reduce the number of tension headaches you experience as well as relieve your symptoms of depression and anxiety.
* Keep a headache diary. This may help identify tension headache triggers such as stress, depression, anxiety, eyestrain, poor posture, physical activities, and the general state of your health. If you suffer only occasional headaches, you may want to report on certain things, such as what was going on in your life at the time or what physical activity you were doing when a headache occurred. If you suffer from multiple headaches, you may want to keep a daily headache diary. It may take only a few months before you can identify your tension headache triggers.
* Get regular exercise, but try to avoid extremely vigorous exercise, which can trigger a tension headache. If you experience a tension headache while exercising or shortly after exercising, write down the activity you were doing, what you ate that day, and how much stress or anxiety you were experiencing in your life.
* Keep a regular sleep schedule. Fatigue, too much sleep, an irregular sleep schedule, or waking up frequently during the night may trigger tension headaches. This may be a trigger that you are able to control.
* Eat regularly and well. Eating nutritious foods regularly may help prevent tension headaches in some people. Going for long periods without eating, or eating certain foods, can trigger a headache.

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By identifying and avoiding tension headache triggers, you can help reduce the frequency and severity of your headaches. While some triggers may be out of your control, others are easily avoidable. The following points can help you prevent a tension headache:

* Keep a headache diary to identify your tension headache triggers.
* Manage stress.
* Seek treatment for any underlying depression or anxiety.
* Sleep, exercise, and eat on a regular schedule.
* Practice good posture to reduce neck strain.
* Reduce eyestrain from computers at work and at home.
* Stop clenching your jaw to reduce muscle tension in your face.

What are common tension headache triggers?

Tension headaches can result from muscles tightening in the back of the neck or head because of stress, anxiety, fatigue, hunger, anger, poor posture, or overexertion.

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There are many possible triggers of tension headache. You may have no identifiable or consistent trigger, or have several obvious ones. Potential triggers include:

* Stress
* Depression and anxiety
* Lack of sleep or changes in sleep routine
* Skipping meals
* Poor posture
* Working in awkward positions or holding one position for a long time
* Lack of physical activity
* Occasionally, hormonal changes related to menstruation, pregnancy, menopause or hormone use
* Medications used for other conditions, such as depression or high blood pressure
* Overuse of headache medication

Half the people with tension headache report that they felt stressed or hungry before their headache began.

Tension headache may be made worse by jaw pain from clenching or grinding teeth (bruxism) or by head trauma, such as a blow to the head or whiplash injury. People with stiff joints and muscles due to arthritis of the neck or inflammation of the shoulder joints may develop tension headache.

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Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches. When a headache occurs, write down 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 in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern. 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. Try acetaminophen, aspirin, or ibuprofen for tension headaches. DO NOT give aspirin to children because of the risk of Reye syndrome. Migraine headaches may respond to aspirin, naproxen, or combination migraine medications. If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications. If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. All types of pain pills (including over-the-counter drugs), muscle relaxants, some decongestants, and caffeine can cause this pattern. If you think this may be a problem for you, talk to your health care provider.

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Last week, I was suffering from a ragin’ headache. Not only was it painful. It was like the Energizer bunny…it kept going and going and going.

I asked you, my marvelous readers, if you had any advice to cure the 3 day headache and you really came through! With so many tips, I recovered from my headache and went on to feeling energetic and breathing clear. Since it is springtime, breathing clear is a tough one. But you did it and I thank you.

Since there were twenty tips, I couldn’t do them all - I picked a couple and tried them.

So here are the Top 20 DIY Headache Cures That Bring Quick Relief:

1. You might want to have your eyes checked (if you haven’t done so already). I had a new pair of prescription contact lenses made for me about 4 years ago. But they always gave me problems. I stopped wearing them and I noticed that when I was working (and staring at a computer screen) I got headaches. But the headaches would last and last. I thought there was something else wrong with me. Long story short (too late), I had PRK laser correction surgery done and I’ve been headache free since. I’m fortunate not to have allergies so I don’t have to deal with that possibility.

2. Peppermint oil applied under your nose. (Be careful with application and wash hands!!) Rice packs heated in the microwave for four minutes applied over eyes / back of neck. Also take a hot shower with Peppermint Soap (the liquid version) Oh it makes you tingle.

3. During allergy season I would suggest you use a sinus rinse like Neilmed. Once I started using it regularly, it cut down on my headaches.

4. Tiger balm on your temples, rub tendons in back of neck to release tension.

5. Snort this twice a day:
* Sinus Rinse
* 16 oz. H2O
* 1 tablespoon kosher salt
* 1/2 teaspoon baking soda
* Mix.
Pour some into palm of hand and snort.

6. Brush teeth with flossing and mouthwash. Something about swishing, gargling, changing teeth positions, spitting, etc., makes it so you can clear your head a little.

7. Gargle with salt water periodically to clear head/get rid of drip.

8. Take a bath in fairly warm water. Submerge your head so your ears are covered. Even allow them to fill with water to put pressure on the inside of your head and help it drain. Then — KEY — sit up in the tub so that your wet hair gets cold. This is supposed to help shrink the nasal/sinus membranes and gives some relief. I imagine using a cold wet towel on the head might also help, but I think the bath steam helps and that’s why this is good.

9. Eat hot stuff like chili peppers, salsa. Again, this helps drainage. Even a little bit of heat helps break things up.

10. Cold compress over eyes to help the eyes stop swelling and bring some comfort.

11. Lie down and let head drain. Try with and without a pillow, side to side, head nose pointed up toward wall, and head pointed down toward feet, and rolling from one side to another.

12. Sleep, lots of fluids, and perhaps a walk. (I know this sounds lame,) but it helps the lack of blood flow, which is the initial cause of most headaches.

13. My daughter has used peppermint and lavender essential oils in a rollerball applicator. You apply a small amount to your temples and she said that she felt relief almost immediately. She recommended it to a friend of mine who gets migraines quite often, and she said that, although her headache didn’t go away immediately, it only lasted about 1/10 as long as usual.

14. I suffered from a headache for several days earlier in the year. I went to a regular chiropractor appointment for my back and she adjusted my jaw and the headache went instantly. Apparently my jaw was slightly misaligned (apparently due to stress causing me to tense my teeth) and this was leading in uneven pressure in my head when I moved my jaw. If the other suggestions don’t work I would recommend going to have a check up a chiropractor.

15. I usually find headaches are due to dehydration, stress or tiredness. So upping my fluid intake, getting plenty of sleep or having some time-out (maybe a walk in the fresh air) will usually sort it out. But if my sinuses are at all involved, steam inhalation helps (put your head over a basin filled with hot water and cover your head with a towel for 10-15 minutes. You can add aromatherapy oil or some herbs or a spoonful of vicks if you like. A little lavender oil on your temples, the bridge and sides of your nose and across your forehead will help to relieve sinusitis and stress headaches.

16. If your headaches are allergy related, I have started using a neti pot on a regular basis and found it to be very helpful for relieving sinus congestion. The result is similar to the nasal rinse suggested above, but I’ve done both and much prefer the neti pot. I mix a little sea salt with warm water in the pot and rinse out my sinuses during my morning shower.

17. My worst headaches from barometric pressure. When I feel one coming on, I’ll typically check the weather to see if a front is moving in. If it appears the weather is causing it, I’ll take an Excedrin migraine early on. I hate taking pills, so acting early really does the trick in my case. I’ve wanted to purchase a barometer for some time now so that I can get used to seeing the measurement every day. This way I’d intuitively know what my “feel good” vs. “feel bad” ranges are. Was there some poor weather in your area while you were in pain? If so, a barometer may be a wise investment so you can start using your peppermint oil early on. =)

18. (1) Chlorpheniramine Maleate 4 mg tablet (Walgreens Wal-finate Allergy 4 Hour Tablets) (2) Ibuprofen 200mg each, esgic plus an ice pack. Usually he find that it starts to go away in 20 minutes, but he gets a little sleepy. Try it next time. I also use this for tension headaches.

19. I found that when I reduced my wheat and milk intake my headaches disappeared.

20. Make sure you are hydrated. You can get migraines triggered from dehydration.

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101 Headache Prevention Tips:

* Understand that headaches are largely PREVENTABLE.
* Discover a super vegetable that can possibly save you from headache pain.
* Understand how to use meditation to “de-stress” yourself.
* Understand the effect of alcohol on your headaches.
* Understand how to protect yourself from headaches while spending time in the sun.
* Discover how certain colors can actually cause you headaches.
* Discover the three types of headache pain.
* Understand why rain, especially the first rain of the season, can cause you a lot of headache pain.
* Learn exactly what migraines are and why they hurt.
* Learn 4 critical criteria for choosing your next pair of sunglasses.
* Understand what reading in a car is doing to cause you pain.
* Realize that your computer screen could be giving you headaches and what to do about it.
* Learn how to create your own soothing face pack to release tension.
* Learn 7 tips for dealing with hangover headaches.
* Find out what air-pollutants to stay away from.  They may already be causing your headaches.
* Understand what proper ventilation can to do help your headaches.
* Discover how your pillow may be causing you undue pain.
* Understand that your posture may be causing you headaches and how to change that.
* Learn 4 key factors to consider while watching television in order to reduce headaches.
* Learn which breathing exercise can help to reduce your headaches.
* Discover what the effects of hair gel may be having on your headache pain.
* Find out if you should stay away from aerosol.
* Learn to avoid shaking your head - and what it means if you experience pain when doing so.
* Learn the truth about hair dryers and why you should be cautious with them if you have frequent headaches.
* Learn to cool your head correctly - the wrong way can cause you more pain!
* Realize that your computer is giving off radiation and how this can affect you.
* Learn the best way to relax your eyes. Hint: Your eyes should not be closed.
* Learn the proper way to massage your eyes and relieve tension.
* Learn three simple techniques that can help you relax and ease your tension.
* Learn the 2 different types of migraine headaches and how they can effect you.
* Understand the importance of sleep on your headache pain.
* Understand what massages and “touch therapy” can do for your headache pain.
* Learn the 13 easy steps to a powerful exercise that will help relieve tension in your neck and head.
* Discover why hot water is not the best for your head and what you should do about it.
* Understand how organic foods can help you steer clear of unwanted pesticides and hormones.
* Realize that there is such a thing as sound pollution and how this may be affecting you in a negative way.
* Learn 2 simple and effective ways for clearing your sinuses and relieving your pain.
* Discover which ingredients in food and beverages can cause you headache pain.
* Learn which styles of dress may be causing you headache pain.
* Understand the affect that cigarettes and coffee may be having on your headache pain.
* Learn 5 essential factors that need adjusting while reading to avoid headaches.
* Understand the relationship between water and your headache pain.
* Understand that unknown allergies may be causing you headache pain.
* Girls - understand that the way you do your hair may be causing you unnecessary headache pain.
* Learn a great way to exercise your eyes and relieve tension.
* Learn an effective way to “rinse” your sinus pain away.
* Understand that some headache pain is actually heredity.
* Realize the effects of jetlag on your headaches.
* Discover another great tension reliever for your eyes that will leave you feeling very refreshed and headache free.
* Discover tension headaches - any why they are so common yet preventable.
* Learn to use Accupressure to treat and rid yourself of sinus pain. My simple 17 step plan will show you how.
* Learn 4 of the most common triggers for migraine headaches and how to avoid them.
* Understand the effects of exercise and how you can use it to stop your headache pain.
* Discover that the position you read in may be causing you headache pain.
* Realize that too much sleep may be the cause of your headaches.
* Understand why pills may not be helping you at all -and when you should stay away from them.
* Discover that much of your headache pain may be due to your failing eyesight and what you should do about it.
* Understand sinus pain, it’s causes, and the headaches it can cause.
* Learn how to use your time in the shower to relax tension with a simple exercise.

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Postural and Symptomatic Improvement After Physiotherapy in Patients With Dizziness of Suspected Cervical Origin.

Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy reduces neck pain and dizziness and improves postural performance. Neck disorders should be considered when assessing patients complaining of dizziness, but alternative diagnoses are common.

Vertigo and dizziness are common complaints accompanying neck pain. The combination of neck disorders with vertigo or dizziness was termed “cervical vertigo” by Ryan and Cope, a designation that may be misleading as most patients suspected of suffering from it report dizziness or dysequilibrium. Owing to its poor definition and the lack of reliable clinical tests, the entity has been the subject of much debate.

There is evidence of a substantial contribution of cervical proprioceptive input to ocular motor control and postural control in both animals and humans, and vestibular and neck proprioceptive information interact linearly in subjective body orientation and mental representation of space. Consequently, disturbed cervical proprioceptive input has been suggested as a probable cause of cervical vertigo, s Information on the orientation of the head in relation to the trunk is necessary for the execution of appropriate postural responses based on vestibulospinal neural output.

The vestibular receptors cannot provide this information, but it has been suggested that it is provided by the cervical proprioceptors. Furthermore, infiltration of local anesthetics into the deep tissues of the neck causes ataxia and nystagmus in animals, but ataxia without nystagmus in humans. Thus, it is reasonable to assume that disturbed cervical proprioception primarily affects postural control in humans, and patients with neck pain and concomitant dizziness have been reported to manifest impaired postural performance, as compared to healthy subjects.

Postural performance can be assessed objectively by posturography, recording the forces actuated by the subject’s feet on the supporting surface. To enhance the sensitivity of posturography in assessing balance disorders, recordings should preferably be made during or after a postural perturbation, This can be accomplished in various ways: by moving the support surface; by the application of erroneous sensory input, eg, by exposing the proprioceptive receptors to a vibratory stimulus; by exposing the vestibular nerves to a galvanic stimulus; or by exposing the subject to visual disturbance in the form of moving surroundings.

Physiotherapy, traction of the neck, injection of local anesthetics at tender points, or immobilization of the neck with a collar have been suggested as treatments for vertigo or dizziness of cervical origin. Among others, deJong and Bles described recovery of postural stability after treatment directed at the neck in occasional patients with dizziness of suspected cervical origin, but to our knowledge there have been no prospective, controlled studies.

In this study, consecutive patients were examined who had recent onset of neck pain and simultaneous complaints of dizziness or vertigo. Extracervical causes of their complaints were excluded when possible, and no medico-legal issues were known to be involved. The aim was to ascertain whether, as compared with healthy subjects, the selected patients have disturbed postural control as objectively analyzed by posturography, and to investigate in a randomized, controlled setting the effects of physiotherapy on postural performance and subjective symptoms of neck pain and dizziness/vertigo.

The performance of patients with dizziness of suspected cervical origin was significantly poorer than that of the healthy controls in the objective tests of postural performance. This indicates that postural control is impaired in these patients and suggests that cervical disorders may affect human balance function. Physiotherapy, aimed to decrease cervical discomfort, objectively improved the disturbed postural performance and reduced subjective symptoms of dizziness and neck pain. Despite the restricted number of patients, the differences between the Treatment group and the Delayed Treatment group, as well as findings within the Delayed Treatment group, suggest that the improvement was a result of the physiotherapy and not merely an effect of general care or reassuring information as to the cause of the symptoms.

Of the 65 patients considered for inclusion in the study, a majority were excluded because extracervical causes were suspected, eg, owing to histories of head or neck trauma with the possibility of traumatic otolith damage or damage to the brainstem, or neck problems secondary to a vestibular lesion. Thus, the mere combination of neck pain and dizziness should not be called cervical dizziness. These findings are in accord with Brandt’s suggestion that well-established signs and tests can yield a convincing alternative diagnosis in many of these patients? It also stresses the necessity of careful history taking and clinical examination, as well as of electronystagmography, before suspecting cervical dizziness. The patients’ subjective complaints of dizziness were classified according to type, and 10 of the patients reported dysequilibrium alone or in combination with vertigo. This is in accord with Brandt’s suggestion that cervical vertigo manifests itself as a feeling of unsteadiness.

The neck muscles were tender on palpation in all included patients, and 13 of the 17 patients also complained of headaches that were of the tension headache type. These cases may belong to a subcategory of the tension headache or tension neck syndrome, and dizziness is reported to be common in these conditions. None of the patients had had extended periods of sick leave, none was retired or opted for early retirement because of neck problems or vertigo, and none stood to gain medicolegal benefit from the outcome of the testing. Thus, malingering is an unlikely cause of the differences between patients and controls in this study, though it cannot be excluded as a possible source of error. If a patient tries to perform poorly in the postnrographic tests, this usually gives rise to a pattern of high-frequency body sway unaffected by the vibratory stimulus. None of the patients manifested such a pattern.

Vibratory stimulus of muscles produces changes in the signalling of the muscle spindles, interpreted by the CNS as indicating a lengthening of the vibrated muscle. This may induce limb, as well as shifts in body posture (vibration-induced body sway). Vibratory stimulus can thus be used as a tool to perturb human stance in a reproducible manner, and has been used in posturographic testing to reveal the effects on postural performance of different factors such as age, drugs, and vestibular or CNS disorders. Repeated posturographic testing may introduce a source of error due to learning effects. However, both Ishizaki and associates and Uimonen and colleagues reported that vibratory-induced body sway in healthy subjects yielded excellent reproducibility without significant learning effects in repeated posturographic testing, both in shortand long-term use.

Posturography has also been used to objectivize positive effects of habituation and balance retraining physical therapy on postural performance in patients with different vestibular disorders but has hitherto only been used in isolated cases to determine the effects of different treatments on dizziness/vertigo of suspected cervical origin. The physical therapy in the present study was aimed at reducing cervical discomfort and did not include vestibular rehabilitation exercises. Thus, the positive findings cannot be attributed solely to habituation of vestibular or postural reflexes. Because there is no gold standard treatment of cervical dizziness, the choice of physiotherapeutic methods was pragmatic and individualized according to signs and findings, and was aimed at reducing cervical discomfort and pain. Thus, the results do not permit meaningful discussion of the choice of physiotherapeutic regimens.

Carlsson and Rosenhal described oculomotor disturbances in patients with tension headache, as compared with healthy subjects, and reported that treatment with physiotherapy or acupuncture, reducing headaches and neck pain, also improved the disturbed oculomotor function. They also found a significant correlation between the degree of tenderness in the trapezius muscle and the severity of oculomotor disturbances. These authors suggested that the improvement in oculomotor function was a consequence of the reduction of neck muscle tension, secondary to reduction of neck muscle pain. Revel and coworkers reported that patients with chronic cervical pain of unspecified origin, as compared to healthy subjects, had poorer ability to reassume the original position of the head after a voluntary active maximal rotation of the head. This was taken as an indication of altered cervicocephalic kinesthesia and neck proprioception in these patients. In a later study, Revel and colleagues also found that a rehabilitation program, based on eye-neck coordination exercises and aimed to improve neck proprioception, significantly improved cervicocephalic kinesthesia and horizontal rotational active range of neck motion, and significantly reduced neck pain in patients with chronic cervical pain syndromes. Similar findings have been reported by Persson and coworkers in patients with cervical root compression due to disc hernias or spondylosis but without medullary compression. After surgical treatment of the root compression, patients manifested significantly improved postural performance and significantly reduced cervical pain. These reports, together with the findings of the present study, suggest that neck disorders per se can in fact cause dizziness.

Women comprised 80% of the referrals and 88% of the final study population. This female preponderance is consistent with that commonly found in different disorders of the neck, such as tension neck syndrome, cervicogenic headache, and tension headache. A similar preponderance of women was found among subjects with vertiginous complaints in a normal population, where approximately 25% to 30% of women complained of vertigo, as compared with only about 5% of men of comparable age. Similarly, the incidence of motion sickness is higher in women. As motion sickness is considered to be caused by mismatch between conflicting vestibular, visual, and proprioceptive stimuli, the skewed sex distribution might reflect greater susceptibility in women also to sensory mismatch involving cervical proprioception.

In the present study the improvement in postural performance was obvious in the posturographic tests in which vibratory stimulus was applied to the calf muscles, but not in the tests in which it was applied to the neck muscles. The patients were improved with regard to neck pain after physiotherapy, but none was completely free from pain. Thus, the muscle spindles of the neck muscles may still be sensitized. As vihration-induced body sway is believed to be induced via stimulation of the muscle spindles, the patients may still have enhanced sensitivity to vibratory stimulation of the neck. Furthermore, Abrahams and Falchetto have reported that electrical stimulation of nerves from the biventer cervicis muscle in cats facilitated the monosynaptic reflexes in the hindlimbs over supratentorial pathways. Hypothetically, the physiotherapy might have resulted in a reduction of sensitivity of the cervical proprioceptors great enough to normalize the gain of the postural reflexes of the lower extremities, thus normalizing the responses to calf muscle vibration, but not sufficiently reduced to normalize the responses to neck muscle vibration.

In the present study, comparison of the patients after physiotherapy to the group of healthy subjects showed the patients’ posmral performance still to be poorer but not in all tests, and the differences between the groups had diminished. Thus physiotherapy improved but did not normalize the patients’ postural performance. Before physiotherapy the patients manifested significantly greater velocity of body sway than did healthy subjects in three of the four stimulus-free periods of quiet stance. After physiotherapy there were no significant differences between the patients and the healthy subjects in any of the stimulus-free periods. Similarily there were no significant differences in any of the four stimulus-free periods between pretreatment and posttreatment values for the patients. These findings emphasize the importance of using perturbation stimuli in posturography to reduce stochastic variations of unperturbed stance if differences between normal subjects and patients with various lesions are to be found.

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Definition

A headache involves pain in the head which can arise from many disorders or may be a disorder in and of itself.

Description

There are three types of primary headaches: tensiontype (muscular contraction headache), migraine (vascular headaches), and cluster. Virtually everyone experiences a tension-type headache at some point. An estimated 18% of American women suffer migraines, compared to 6% of men. Cluster headaches affect fewer than 0.5% of the population, and men account for approximately 80% of all cases. Headaches caused by illness are secondary headaches and are not included in these numbers.

Approximately 40–45 million people in the United States suffer chronic headaches. Headaches have an enormous impact on society due to missed workdays and productivity losses.

Causes and symptoms

Traditional theories about headaches link tensiontype headaches to muscle contraction, and migraine and cluster headaches to blood vessel dilation (swelling). Pain-sensitive structures in the head include blood vessel walls, membranous coverings of the brain, and scalp and neck muscles. Brain tissue itself has no sensitivity to pain. Therefore, headaches may result from contraction of the muscles of the scalp, face or neck; dilation of the blood vessels in the head; or brain swelling that stretches the brain’s coverings. Involvement of specific nerves of the face and head may also cause characteristic headaches. Sinus inflammation is a common cause of headache. Keeping a headache diary may help link headaches to stressful occurrences, menstrual phases, food triggers, or medication.

Tension-type headaches are often brought on by stress, overexertion, loud noise, and other external factors. The typical tension-type headache is described as a tightening around the head and neck, and an accompanying dull ache.

Migraines are intense throbbing headaches occurring on one or both sides of the head. The pain is accompanied by other symptoms such as nausea, vomiting, blurred vision, and aversion to light, sound, and movement. Migraines are often triggered by food items, such as red wine, chocolate, and aged cheeses. For women, a hormonal connection is likely, since headaches occur at specific points in the menstrual cycle, with use of oral contraceptives, or the use of hormone replacement therapy after menopause.

Cluster headaches cause excruciating pain. The severe, stabbing pain centers around one eye, and eye tearing and nasal congestion occur on the same side. The headache lasts from 15 minutes to four hours and may recur several times in a day. Heavy smokers are more likely to suffer cluster headaches, which are also associated with alcohol consumption.

Diagnosis

Since headaches arise from many causes, a physical exam assesses general health and a neurologic exam evaluates the possibility of neurologic disease that is causing the headache. If the headache is the primary illness, a doctor elicits a thorough history of the headache. Questions revolve around its frequency and duration, when it occurs, pain intensity and location, possible triggers, and any prior symptoms. This information aids in classifying the headache.

Warning signs that should point out the need for prompt medical intervention include:
• ”Worst headache of my life.” This may indicate subarachnoid hemorrhage from a ruptured aneurysm (swollen blood vessel) in the head or other neurological emergency.
• Headache accompanied by one-sided weakness, numbness, visual loss, speech difficulty, or other signs. This may indicate a stroke. Migraines may include neurological symptoms.
• Headache that becomes worse over a period of 6 months, especially if most prominent in the morning or if accompanied by neurological symptoms. This may indicate a brain tumor.
• Sudden onset of headache. If accompanied by fever and stiff neck, this can indicate meningitis.

Headache diagnosis may include neurological imaging tests such as computed tomography scan (CT scan)
or magnetic resonance imaging (MRI).

Treatment

Headache treatment is divided into two forms: abortive and prophylactic. Abortive treatment addresses a headache in progress, and prophylactic treatment prevents headache occurrence.

Tension headaches and migraine headaches can be treated with aspirin, acetaminophen, ibuprofen, or naproxen. In early 1998, the FDA approved extra-strength Excedrin, which includes caffeine, for mild to moderate migraines.

Prescription medications such as antidepressants and muscle relaxants can address tension-type headaches, and ergotamine tartrate or sumatriptan can relieve or prevent migraines. Cluster headaches may also be treated with ergotamine and sumatriptan, as well as by inhaling pure oxygen. Prophylactic treatments include prednisone, calcium channel blockers, and methysergide.

Alternative treatment

Alternative headache treatments include:
• acupuncture or acupressure
• biofeedback
• chiropractic
• herbal remedies using feverfew (Chrysanthemum parthenium), valerian (Valeriana officinalis), white willow (Salix alba), or skullcap (Scutellaria lateriflora), among others
• homeopathic remedies chosen specifically for the individual and his/her type of headache
• hydrotherapy
• massage
• magnesium supplements
• regular physical exercise
• relaxation techniques, such as meditation and yoga
• transcutaneous electrical nerve stimulation (TENS).
(A test that electrically stimulates nerves and blocks the signals of pain transmission)

Prognosis

Headaches are typically resolved through the use of analgesics and other treatments.

Prevention

Some headaches may be prevented by avoiding triggering substances and situations, or by employing alternative therapies, such as yoga and regular exercise. Since food allergies are often linked with headaches, especially cluster headaches and migraines, identification and elimination of the allergy-causing food(s) from the diet can be an important preventive measure.

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You’ve probably had your share of headaches. Some may have been worse than others and some may have scared you half to death because you saw lights and then threw up. Different kinds of headaches have unique symptoms.

Tension headaches usually affect both sides of your head, not just one spot. The pain and tension will begin at the back of your head and spreads forward. The pain may feel dull or a squeezing feeing like a rubber band has been placed over your head. The muscle tension often begins in your shoulders, neck, or jaw before spreading to your head. Your neck, jaw, shoulders and head will all feel tight and uncomfortable. The pain is normally dull and achy, not sharp. Tension headaches are often the result of stress, fatigue, issues of holding your head in one position too long or sleeping in an abnormal position.

Cluster headaches are a rare kind of headache where the pain is sharp and extremely painful. They tend to occur several times a day for months (hence the name ‘cluster’) and then go away for about the same amount of time they were there. You can expect cluster headaches to visit you again.

Sinus headaches cause pain and tenderness in the front of your head and face. This is because inflammation in the sinus passages that lie behind the cheeks, nose, and eyes causes you pain. The pain will be worse when you bend forward and first thing in the morning when you get up. Postnasal drip, sore throat, and a runny nose will accompany these headaches.

Migraine headaches are ones that are extremely painful and interfere with your daily activities. They are usually accompanied by other symptoms like visual disturbances or nausea. They tend to begin on one side of your head, although the pain may spread to both sides. Before the painful throbbing headache begins, you may have an aura. An aura is a visual disturbance which can include blurry vision, flashing lights, zig zaggy lights, or perceiving that chunks of your vision are missing. Migraines can make you photosensitive, sensitive to movement and sick to your stomach.

Anyone over the age of 50 who is having headaches for the first time should be aware of a condition called temporal arteritis. In this condition your vision becomes impaired and you have pain when chewing. This can lead to blindness so you should seek medical attention immediately.

Other more rare causes of headaches include brain aneurysm, stroke, brain infections or TIA’s.

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