Headache/migraines.

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Warning: Sudden, intense and/or unexplained headaches should always be checked by a medical practitioner.

Once cleared: you are not alone.

Dull  everyday ‘dizzy’, foggy headaches, sometimes called stress headaches, are  very common and can linger weeks. Migraines are a severe or lingering form of headaches. They can range from a blinding headache to nausea to dizziness to blurry vision to a vague, fuzzy fog.  

Neither stress, constricting blood vessels nor stiff neck joints have been proven to be a primary cause of headaches.

INSTEAD:

The brain produces headaches when it detects brain patterns triggered by risk.

Triggers

Some risk triggers are serious. These include brain pressure caused by swelling , dehydration or toxic odors/gases. These headaches are useful warnings. Most headaches are however, triggered by less serious risks that the brain has developed a sensitivity to. These include perfumes or hormone changes or stress chemicals triggered by deadlines or performance reviews, physical exhaustion, low blood sugars, lack of sleep, alcohol (or the preservatives in alcohol), some foods, prolonged awkward  postures and inflammation associated with neck, shoulder and back pain.

As with all inflammatory responses, repeated exposures to slight risks builds up sensitivity. Once sensitized, the brain is primed (or on high alert), so secondary triggers start to cause headaches. That is, once headaches are a problem MANY things can trigger them. This can lead to periods where headaches can be experienced every day.

What this means is that what might have started as a headache caused by repeated tiredness or noxious fumes then begins to be triggered by sitting still too long. OR vice verse.

Treatment

There is no magic bullet treatment. If there was hard evidence for one treatment (not just a practitioner’s word for it) it would be universally acclaimed.  As with all pain, old ‘go to’ remedies can stop working.

• Use a combination de-sensitization approach.

Hit it with everything safe (NOTdangerous or unproven drugs or odd diets), until the most soothing combination emerges.

Then keep at it. Chip away at pain. It can takes months to get rid of pain patterns that are, usually, years in the making.

This is always a one step forward half back process.

Settle pain by first eliminating all potential triggers then gradually reintroduce them from least likely to most likely to cause pain.

E.G: a break from alcohol or sitting still long periods or getting adequate sleep or avoiding pain fumes or easing stress can ease the headache reaction. Once settled, gradually reintroduce safe triggers (e.g. the occasional glass of wine) one after the other to work out what the brain can tolerate.

If safe triggers are reintroduced gradually, and the system settles, occasional late nights can be enjoyed again. And the occasional stressful situation wont hurt.

Food /fluid. Dehydration is a common trigger. Too much water is a less common trigger. Keep it sensible: don’t drink many litres a day. If in doubt, check wee colour. It should be light yellow NOT clear (too much water) nor dark amber (too little).

Many give up gluten or sugar. There is little  evidence  for this, but it may work. DO not give up too many  food types as variety is essential for a healthy gut. Poor dietary intake can trigger inflammation which, in turn, may trigger headaches.

Carbohydrate lows (the ‘hangries’) can trigger headaches.

Stress

I avoid the term stress headaches as it bundles many types of headache triggers into one basket. Anxiety can trigger headaches if sensitised to them, but it is unlikely to cause them in the first place. For example: work meetings triggered my headaches, (triggered by baby sleep deprivation). When headaches finally resolved, meetings  remained stressful but no longer provoked headaches.  If stress IS a problem or causing lack of sleep or adding to headaches, consider counselling. See ‘brain waves’ below.

Get enough sleep. Israeli research on  a township  shelled regularly found it  wasn’t the stress that triggered an increase in headaches but the lack of sleep due to (sadly) night  bombing.

Try to wake at the same time every day to develop a good sleep routine. A short nap may help prevent overtiredness but avoid long catch up naps. If children’s night waking is an issue, (as it was for me) consider occasional care or a friend/relative/partner to take them to enable a half hour nap.

Treat other aches and pain and stiffness. Headaches are usually  part of a pain pattern. Dealing with back or neck aches can help headaches.

Any soothing sensory input including heat packs or patches, acupressure, acupuncture, dry point needling on the trapezius or a massage can help settle overall sensitivity (which reduces headaches). There is no evidence that cold or heat is better, so go with the most soothing.

There is no evidence that expensive treatments such as lasers help more than a soothing heat pack and gentle home massage.

Neck and shoulder blade massages help most headaches no matter what the trigger. Many claim that this proves that pain originated from the neck. By this logic: if heat helps it ‘proves’ the problem was lack of heat. Which it isn’t.

A professional massage MUST BE soothing, not hard, at first. You should feel good after a massage not worse. Gradually build up pressure.

If touch is distressing try touch de-sensitisation. Start with easily tolerated touch a few times a day and progress slowly over days or weeks,  towards the type that irritates. This can be from hard to soft or v.v.

DIY massages can help. Look for trigger points that bring on that ‘OOOh that feels good’ feeling.  Try  pressing between the scapular and the spine, and on  the bridge of the nose. Relaxing scalp massage or gently running fingers through hair can help.  Keep at it. It takes a lot more than one or two massages to help entrenched headaches. And combine massage with all other treatments in the toolkit.

Massage is safer than neck manipulations which have not been proven to help headaches.

Lie down (or, if at work, sink back in your chair) for a few minutes to

• Prevent headaches build up.

• De-stress.

• Ease out tight muscles.

Do simple movment actions to ease into a pain minimising posture (see my Utube) but move in and out of it regulary. Even GOOD posture is bad if held rigidly. If experiencing back, neck shoulder or headache build up, try relaxing completely, sinking into the chair every 30 minutes. Be mindful of muscle tension.

Try this: While working at a screen,  head facing (and staying) forward, gently rotate the rest of the body side to side (that is:gently rotate the body on the neck without moving the head) 5 times each way. Try this exercise in standing. If balance is good try it in the shower, with hot water on the  neck and shoulders and back. Keep  safe: don’t do this if falling/dizziness is a risk.

Also: gently squeeze shoulder blades back and down to ease strain from shoulder blade muscles. These often tighten or lock into a forward roll position which can contribute to a headache/shoulder pain pattern.

Regularly lift arms overhead and then, if possible, put your hands behind your head without bending your head forward as often as you can. Moving shoulders helps relax neck muscles. Really.

Exercise little and often. Exercise reduces inflammation and eases stress that can contribute to pain. Break up days with a walk. Move a lot : Sit to stand and walk around regularly. Don’t sit an hour or two hunched over the  computer.

Avoid forceful, too quick or too slow stretches. Ease soothingly into a movement, hold it for 5 seconds, and relax. Do little and often. Do not push hard into pain.

Overall: moderate fitness exercise should add up to an hour a day (but  avoid extreme exercise and dehydration). Exercise can improve sleep.

 Feldenkrais or Tai chi are soothing options. Consider beginner yoga.

Prevent pain do not react to it.

Taping can  settle shoulder blade pain linked to headaches by relaxing muscles. Try one piece of dynamic tape from shoulder blade to shoulder blade to hold them slightly and soothingly back and down. Take care with tape allergies. Test tape first (those prone to headaches are usually also prone to allergies due to an over reactive protective system). Never rip tape off. Pull skin away from tape NOT tape away from skin.

‘DIY’ Neck traction. Lie  down, knees bent or over a pillow with the back of the  head (the bump bit)  on a low rolled up towel or warm (not too hot) heat pack and let the  chin sink in soothingly for several seconds so as to  feel the  neck elongate. Shift a bit and then repeat 5 times.

Have a medical check up if :

 *Hormone changes, particularly menstrual cycle changes trigger migraines.

*Sinus, teeth or other medical problems create pain.

Dentists?? There is not a lot of evidence that night teeth splints help headaches by realigning teeth or preventing grinding (possibly personal bias because I can’t sleep with one). I’m interested in hearing about experiences with teeth guards.

Talk   to a Medical practitioner or chemist about anti inflammation  medication such as ibuprofen or Voltarin. Take these medications for a short period only, 2-3 days at a time (never double dip different anti-inflams and do not take them if on blood pressure med).  Mild pain killers such as paracetamol may help and can be taken with anti-inflammation medication.

A short course of anti-histamines can help resolve triggers related to allergies/sinus pain.

DON’T take any medication for long, as side effects and resistance builds up.  Consult with a specialist if uncertain.

Never take strong painkillers which can cause ‘kick back’ headaches /addiction. Codeine and Endone are highly addictive and should not be used more than two days and then only with medical supervision. After three days, these drugs create pain to signal more is needed (this is the beginning of addiction). I have seen opiate headaches begin four days after joint surgery and wisdom teeth removal.

Reset brain waves

Triggers create risk brain patterns that, in turn, set off headaches. Brain wave feedback is still at the experimental stage. Some (not all) can learn to settle headache producing brain waves through relaxation or mindfulness or meditation. Try to induce a ‘ spacey’ feeling by focusing on something neutral. Interestingly this can be focusing on the headache in a relaxed way rather than trying to ignore it and worrying about it.

Some get this ‘zoney’ feeling when taking anti-inflammation medications. Stronger drugs (such as anti-depressants which are used for migraines) induce this ‘disassociative’ feeling : learn to DYI without strong drugs.

At a very simple, practical level: Give the brain quiet down time before headaches build up. Take mini breaks: try mindfulness, focusing on something intensely to refocus the brain,  or use breathing to relax, or meditation, or go for a walk. This can take a lot of time and patience to achieve but as an ex headache sufferer myself, can I say it is worth it? I did have a kick start, as I was able to try out cutting edge neural feedback as part of my research degree.

Once headaches are settled: work hard to prevent them returning. Don’t get complacent.  

Good luck with resolving your headache. And if all of the above do not help, do not hestitate to get a second medical check up.

Anne Brennan