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Headache
Headaches
are NOT "Normal" Some people suffer from repeated
headaches so frequently that they consider them to be
"normal" and a regular part of their daily life. Others
try to "tough it out", go into denial that there may be
a more serious problem, or, think that it is a sign of weakness to
seek help. But pain is the body's message that something is wrong.
Pain (headache) is an alarm that should never be ignored. Over 90%
of all people experience pain in the head, neck or upper body,
with headache being the most common complaint. Next to hunger the
most common complaint of all mankind is "headache".
More than 45 million Americans
suffer from chronic, recurring headache and spend in excess of 4
billion dollars annually in over-the-counter medications, alone,
in attempts to alleviate them. They make more than 50 million
doctor office visits and cost employers more than 500 million
dollars in absenteeism per year. These pains are not diseases in
themselves but are symptoms of a disease or a dysfunction in some
anatomical structure of the head or neck. Studies show that less
than one half of one percent (0.5%) of all headaches arise from
the brain or other structures inside the head. Ninety-nine percent
plus of headaches arise from structures outside the brain
(sinuses, muscles, joints, etc.).
Headache-free living is
possible
Headache-free living is
possible without drugs or medications which, at best, just
temporarily masks the pain. The problem with using prescriptions
and over the counter medications is that
many of them (aspirin, codeine, etc.) cause an increase in
headache frequency and severity (rebound headaches).
Major categories of
headaches
There are thirteen major
categories and 129 subcategories of headaches currently recognized
by healthcare professionals. Many headaches begin in an
intermittent fashion and then evolve to being constant, called
chronic daily head pain. Here we will look at the three common and
well know types of headache, migraine, cluster & tension.
Migraine headaches
Most people consider any bad
headache a "migraine", but most headaches are not
migraines. Scientific studies show that 60% of all migraine
sufferers have not been properly diagnosed and are being
ineffectively treated for migraines when they should be being
treated for some other problem that also causes headaches.
Migraines, which in years past used to affect 5-10% of the general
population, now affect 15-30% mostly women beginning in the third
and forth decades of life. Between 1980- 1990 the prevalence of
headache disorders increased by 60%, but over 90% of all people
who suffer from headaches have never seen a specialist.
Migraine may begin with visual
symptoms (spots, flickering light, zigzag lines, etc.), then
nausea with a dull, throbbing pain and lasts from 4-72 hours. This
is called "classical migraine. If it occurs without the
visual symptoms it is called a "common" migraine. This
type has moderate to severe pulsating pain together with nausea
and sensitivity to light and noise. It has a 75% rate among women
largely due to their hormonal connection to estrogen. Physical
activity makes a real migraine worse.
Cluster headaches
Eighty-five percent of all
cluster headaches occur in males. This type of headache has very
severe pain in, around or behind the eye on one side. It occurs in
"clusters" of time, either for weeks or months,
separated by months or years of remission when it mysteriously disappears. It is
also called an "ice pick" headache due to its extremely
excruciating stabbing pain felt in the eyeball of the sufferer.
Others have described it as a red hot poker being pushed through
the eyeball. As many as eight attacks can occur per day. The
affected eye is bloodshot with tears, and the eyelid swells. There
is uncontrollable sweating of the face and forehead and discharge
from the nostril on that same side. Statistically, 47% of these
patients will have jaw pain and 53% will have toothache pain.
Tension or muscle
contraction headaches
This is the most common type of
headache, occurring more frequently in women, and, beginning
between 20-40 years of age. It can occur every day, or, from 30
minutes to 7 days at a time, several times a month for months on
end. The headache may be band- like" or associated with
sensations of tightness, heaviness or pressure. It may be dull or
pounding and its location may be on both sides of the head or vary
from time to time. It is usually not associated with nausea,
vomiting, or, sensitivity to lights or noise. Physical activity
does not make it worse. The belief that stress is the underlying
cause and once eliminated will terminate this type of headache has
been proven false. The cause and effect of stress as a headache
trigger due to its over emphases by non-traditional therapists is
currently being challenged by most headache specialists.
FALSE INFORMATION
Sinus headaches / allergy
headaches
Many patients state they have
"sinus" headaches because they have pain in the facial
region. Pain or pressure in the face is usually caused by migraine
or muscle contraction headaches. It will not be due to a sinus
unless you have an infection in that sinus and you are also
experiencing a low-grade fever. The infection causes the mucous
membranes lining the sinus to swell and block normal drainage.
Pressure inside the sinus increases causing constant and severe
pain, beginning in the morning and worsening if you bend over and
put your head down. If you don't have these symptoms, you don t
have a "sinus" headache. If you do, you need antibiotics
to treat the infection.
Many patients state they have
"allergy headaches" because they have a stuffy nose or
drainage from one nostril. This is another problem. Allergies are
rarely the direct cause of a headache.
Stress is not the cause of
headaches
Most people think that
occupational stress, family/marital stress or financial stress is
the prime cause of their headaches and, if only they could get rid
of their stress they would simultaneously get rid of their
headaches. Such is not the case. Stress is never the prime cause
of headache, but it can and will exacerbate an existing headache
or a predisposition to headaches. People with headaches and mild
stress in their lives think all people respond to stress with
headaches. However only a small percentage do. Stress has
completely different effects on different people. If twenty people
were confined in a room and subjected to a sustained stressful
situation like constant pounding on the walls of that room, only a
very few would get headaches. A few would get high blood pressure,
others hair loss, others would get psoriasis, some might stutter
or develop facial tics, etc. Stress, regardless of its cause, does
not affect all people the same way, i.e., with headaches.
Time to look elsewhere
If you have sought solutions to
your headaches and face pains from biofeedback, hypnotism,
acupuncture, chiropractic, tissue massage, physical therapy,
nutrition, etc, without success, perhaps it is time for you to
consider a fresh approach.
Symptoms associated with
headaches
Many headaches are accompanied
by dramatic, often stroke-like clinical symptoms which can be even
more disconcerting and disabling than the headache pain itself.
Additionally, these symptoms may be magnified by the effects of
excessively used painkillers, sedatives, etc.
that are inappropriately self-administered.
A list of these symptoms of
which you should be aware is:
-
Mental and cognitive
impairment.
-
Irritability, depression and
forgetfulness.
-
Blurred vision, double
vision, visual disturbances.
-
Inability to talk, walk,
etc.
-
Nausea, vomiting, diarrhoea.
-
Sensitivity to noises and/or
lights.
-
Sleep disturbances, or,
constantly sleeping.
-
Inappropriate behaviour such
as moaning, screaming, crying and
outbursts of anger.
-
Running nose, nasal
stuffiness.
-
Changes in blood pressure,
heart rate, skin pallor.
-
Alterations in routines of
daily living activities.
Accurate information
It has been estimated that as
much as 75% to 92% of all headaches are related to jaw
malalignment and jaw muscle dysfunction with most occurring in the
large muscle in the temple area that is used to close the jaw.
Head pain described as "migraine" often is not true
migraine but is really a severe form of this jaw muscle pain that
is caused by a TMJ problem: usually a malalignment of the lower
jaw to the upper jaw as evidenced by a bad bite; or, a dislocated
jaw joint directly in front of the left or right ears, as
evidenced by popping or grating noises upon mouth movement. The
muscle goes into spasm to prevent you from overusing your jaw. The
problem is also within the jaw joint. This joint contains a piece
of cartilage about the size and thickness of a silver dollar,
similar to the knee joint containing the kneecap. It is when this
cartilage goes out of place (dislocation) that the muscles
surrounding the jaw joint go into spasm to limit your use of your
jaw and you feel the pain/s on the side of your head.
What do people mean?
Lately, when people say,
"I have TMJ", they are referring to various problems of
an arthritic or muscular nature
which primarily affect the parts of the jaw joint/face muscle
complex and which can also produce secondary symptoms in other
structures with pain ranging from the neck to the forehead to the
top of the skull and to the eye or ear. This pain can be very
severe and prolonged at times.
True TMJ problems are felt in
the joint area itself with the patient noticing reduced jaw joint
motion, pain, click, grinding, etc. True headache problems often
affect jaw muscles causing pain and altered ability to move the
mouth. Since the entire temple area and side of the head contains
a large jaw muscle (called the temporalis muscle) headache in this
area most often relates to dysfunction in this jaw muscle and not
to "migraine". Frequently temporomandibular joint,
headache and muscle contraction problems occur together.
Poorly understood problem
Until recent years these
problems were poorly understood with patients often going from one
doctor to another in an effort to find relief. It is not unusual
for a patient to report having consulted many general
practitioners, chiropractors, orthopaedists, neurologists,
dentists, otolaryngologists, internists, gynaecologists and plastic
surgeons among others. When the true nature of the problem goes
undetected many patients are finally referred to a psychiatric office. For many patients the only answer has been that the
patient just has to "learn to live with it" for the rest
of their life.
Fortunately our knowledge has
increased to the point where it is clear that malfunction in the
joint-muscle complex is the true culprit. Treatment is aimed at
eliminating inflammation within the jaw joint, relieving
associated muscle pain and restoring the various parts of the
joint to their normal anatomical positions. Such treatment has
become a primary responsibility of the dental profession.
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