From the Docs

What’s the Deal with Headaches?

Headaches are a serious business in this country. There are at least 45 million Americans who complain of chronic headaches, and for at least half of these people the problem is serious in that it interferes with their daily activities. Migraine victims miss almost 160 million work hours each year because of their headaches. Headache sufferers, in general, make over eight million visits to their doctors to find relief for the pain. Some experts argue that recurrent debilitating headaches are often due to inadequate diagnosis and treatment, and overuse of medications taken to provide relief.


Because the factors that trigger a headache vary from person to person, it’s important to develop an individualized treatment plan. Such a plan aids in the process of identifying and controlling factors that may trigger attacks, determining the type of medications that help prevent and treat an individual’s attacks, and examining the types of behaviors that have contributed to attacks in the past. Research indicates that triggers include stress, hormonal imbalances, and disrupted sleep and eating times. In addition, a number of substances found in foods have been suspected of causing headaches, leading to recommendations that specific trigger foods be avoided, such as alcoholic beverages, red wine, caffeine, aged cheeses, citrus fruits, chocolate, MSG and hydrolyzed vegetable protein.


There are a number of places a head can hurt. Examples include pain developing in the network of nerves in the scalp, the muscles of the head, and blood vessels that run along the surface and at the base of the brain. At the end of all these pain-sensitive nerves, there are tiny “messengers” that get stimulated by stress, tension, lack of blood supply or other headache triggers. When this happens, they send off a signal to the brain.

Some scientists suspect that people who have migraines or other forms of tormenting headaches have a lower-than-average level of endorphins — one of the body’s natural painkilling chemicals. Most researchers agree that altered blood flow to the brain, along with biochemical changes, react in a domino-like effect to bring on the pain. The nervous system responds to a signal (like stress) and starts a spasm, which narrows arteries that supply blood to the brain. This causes the platelets in the blood to clump together and release a chemical called serotonin (which also constricts arteries), making the problem worse. Hungry for oxygen, other brain arteries open wider to compensate for the reduced flow, and this triggers the production of chemicals and pain producers (like prostaglandins) that cause inflammation, swelling and increased sensitivity to pain.


There are three basic types of headaches: migraine headaches, cluster headaches and tension-type headaches. According to the National Institute of Neurological Disorders and Stroke (NINDS), there are specific features that separate each type of headache. Migraines produce throbbing pain on one or both sides of the head, and symptoms can include nausea, vomiting, sensitivity to light and noise, fever, chills, flu-like aches and sweating. Cluster headaches occur in a series of sudden, excruciating, one-sided episodes that begin as a minor pain around one eye and may continue for 15 minutes to four hours. Tension-type headaches are the most common of all headaches. They produce a dull, achy pain that feels like pressure is being applied to the head or neck. This type of headache gets its name from the role of stress in triggering the attack, but also for the contraction of neck, face and scalp muscles aggravated by stressful events. The pain involved in a tension headache is described as mild to moderate and usually disappears after the period of stress is over.


In terms of treatment options, significant progress has been made during the past decade in finding more effective ways to treat headaches. According to the American Medical Association, most headache sufferers are better able to control the pain and relieve its impact. Individualized treatment plans are aimed at relieving headache symptoms, preserving one’s ability to function at normal or near normal level, and lessening the frequency or duration of future headache attacks. Biofeedback training, stress management, diet modification, acupuncture, exercise and relaxation therapy are just some of the ways that people have learned to cope with recurring headaches. Perhaps the most important thing to understand about headaches is that, while there may be generalized types of this condition, each case is different. There is no single magic formula to make the pain go away. If headaches occur frequently, if there is a pattern in the occurrence or progression of the pain, or if they begin to interfere with one’s daily routine, it is important to get medical attention. An accurate diagnosis is the first step to a treatment program and sets the groundwork to reduce the distress of headaches.

Many of us know that the requirements of our lives can take a toll on our physical and mental well-being. If you would like to obtain further assistance regarding creating a balance between physical and mental health, you can contact Employee Support Services Bureau at (213) 738-3500 for a confidential consultation or appointment. You can also obtain additional information by visiting our intranet site at http://intranet/intranet/ESS/Index.htm. Be well.