I sat across from a gentleman that was relating a history concerning headaches. I had asked pertinent questions and he was filling me in on the pattern of when and where he experienced headaches.
As he continued answering my questions, he seemed to be forming a thought within his own mind separate from the questions I was asking. I paused and asked if he wanted to share any other information with me.
“Well,” he replied as he absently looked out the window, “Before I came here, I couldn’t really tell you a pattern of when I get headaches. Sitting here answering your questions about when I get the headaches, and what I am doing when I get them, I sort of figured something out.”
“What’s that?”
“Well, it just dawned on me that I only have headaches when my wife is around.” He then turned his attention to me as if he expected me to explain or comment. I knew enough to simply nod and look back to my notes. The statement and subsequent silence invited a response. The best I could come up with was, “Hmmm.” (That particular response has been handy over the years.)
In most circumstances the history I get from patients is much more relevant to addressing a cause of headaches that is easily dealt with. Even in the case above we were able to improve spinal function and help reduce the amount of spinal muscle tension that was present in the neck and back, eliminating the headaches. Even though the man may still have issues related to his marriage, headache pain is not one of them.
Headaches are not normal, even though they may be common. It is never normal to have a headache. The pain is your clue that something is wrong. There are many causes of headaches. Headaches are often related to muscle tension in the neck or back, irritated spinal joints or nerves, sinus pressure, eyestrain or other similar problems. Although there are many pain relievers that can reduce headache pain, if headaches are frequent, taking pills to mask the pain is not resolving the underlying cause of the pain.
Muscle tension headaches frequently originate from the neck and upper back muscles. This can result from poor posture, sitting or standing in strained positions, holding your head steady for too long or other situations that put excess stress on the muscles. Mental or emotional stress can aggravate the problem.
In some cases, simple movement exercises can help by repeatedly contracting the muscles and then relaxing them. One maneuver I sometimes teach patients is the “yes, yes, yes - no, no, no” exercise. To do this, sit in a comfortable upright position, and slowly and gently tilt the head up and down as if nodding “yes.” Repeat three times. Follow this by slowly and gently rotating the head to one side then the other as if signaling “no.” Repeat this exercise until the neck muscles begin to feel more relaxed. Do not do circular motions. It is very important to do these motions slowly and gently and to stop if the pain is increased. For most tension-type headaches this exercise will be very helpful. Sometimes, simply going for a walk or other relaxation activities can help.
Pain medication can help, but it may mask the symptoms. Headaches will often return if the underlying problem is not resolved. Treatments that help eliminate tension-type headaches can include chiropractic, massage, acupuncture and physical therapy.
Headaches can be caused by something as benign as tight muscles, dysfunctional spinal joints or other non-threatening origins. They can also be the result of a serious condition. If your head pain is persistent, very intense, or just doesn’t feel like a typical headache, see your doctor. If the pain is sudden and severe, or accompanied by other symptoms such as dizziness, faintness, vision trouble or other ominous signs, go to the emergency room. With unexpected or severe headaches, it is always a good idea to seek emergency care.
Next week: How often should you see your doctor? Until then take steps to reduce the stress in your life.
Dr. Mark Kestner
mkestner@DrKestner.com
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