There are many different kinds of headaches. However, there are five major
types.
They are migraine headaches, cluster headaches, tension headaches, chronic
daily headaches, and rebound headaches.
Because these are the kinds of headaches that affect the vast majority of
sufferers, I cover only these types in this book. I believe the information you
will find in this book will help you better understand what kind of headaches
you have, why you suffer from these headaches, and what you can do to
cope with them and improve the quality of your life.
What You will Learn from this Book
This book focuses on the four most common types of chronic headaches:
Migraine headaches
Cluster headaches
Tension headaches and
Chronic daily headaches.
If you suffer from chronic headaches but don't know which kind, you will
learn the symptoms of these four headache types to help you begin an
accurate diagnosis.
You will learn about headache triggers, including:
• Eating and sleeping patterns
• Environmental factors
• Vision
• Medication
• Physical exertion
• Diet and foods
An important part of headache treatment and relief is to get the right
diagnosis.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 11 of 111
In Chapter 5, you will learn:
The importance of a headache diary
What to do to get ready for your initial visit to a doctor
What your physical examination will be like
Other diagnostic tools your doctor may use
If your problem is migraine headaches, you might want to go directly to
Chapter 6, which will teach you:
9 How to choose an effective treatment
9 Understanding the prescription drugs that are most commonly used in
migraine treatment
9 Which techniques are used most often to treat specific types of
migraines
9 The use of triptans in treating migraines
9 Ergotamine tartrate and migraine treatment
9 What DHE is and how it is used to treat migraines
9 Isometheptene Mucate and migraines
9 Which nonsteroidal anti-inflammatory (NSAIDs) are used to treat
migraines
9 Phenethiazines and migraines
9 The use of Intranasal Lidocaine in migraine treatment
9 Narcotic analgesics and migraines
9 Antinauseants and migraines
9 The use of cold packs in migraine treatment
Information on treating and living with cluster headaches can be found in
Chapter 7 where you will learn:
9 How to prevent cluster headaches
9 How to stop a cluster headache that has already started
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 12 of 111
You will find chronic daily headaches treated in Chapter 8, which has a lengthy section on preventative medications.
If you are suffering from tension headaches, Chapter 9 will teach you:
9 What episodic tension-type headaches are
9 How to recognize chronic tension headaches
9 Preventing tension-type headaches
9 Treatments for tension-type headaches
In Chapter 10, you will learn about the many different kinds of alternate
treatments and self-help techniques available to combat chronic headaches.
There is also a comprehensive chart of alternate headache treatments and self-help techniques, highlighting which ones can be used effectively to treat
specific types of headaches.
Chapter 11 will teach you about using natural supplements in the treatment of chronic headaches. Here, you will learn:
9 What natural supplements are
9 Who Takes Natural Supplements
9 Herbs and supplements used in the treatment of headaches
9 A new supplement that may be useful in treating all types of chronic
headaches
Finally, Chapter 12 is all about online resources for headache sufferers. This includes:
9 Forums
9 Groups and Newsgroups
9 Websites
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 13 of 111
1. Facts about Headaches
If you suffer from headaches, you are not alone. It was recently reported
that during the past year nearly 90% of men and 90% of women reported
having experienced at least one headache.
Here's another interesting statistic. Did you know that more than 28 million
Americans suffer from migraine headaches? And that another 1.5 million
Americans suffer from trauma headaches?
On the other hand, only about one half percent of our population suffer from
cluster headaches, and that they are predominantly men -- as 80% of those
who suffer from cluster headaches are male.
It is also interesting to note that the onset of cluster headaches typically
occurs in the late 20s, but that there is no absolute age restriction. Statistics
also show that approximately 80% of cluster headaches are episodic -- the
remaining 20% are considered chronic.
For that matter, nearly everyone will have at least one tension headache in
his or her lifetime. And approximately 3% of our population suffers from
chronic tension-type headaches.
If you suffer from migraine headaches, you are actually in good company.
Many famous people have suffered from migraines, including Julius Caesar,
Joan of Arc, Karl Marx, George Bernard Shaw, Saint Paul, Thomas Jefferson,
Edgar Allan Poe, Pyotr Tchaikovsky, Robert E. Lee, Ulysses S. Grant, Pablo
Picasso, Lewis Carroll, Sigmund Freud and Vincent Van Gogh.
Headache Myths
Headaches may be one of the most misunderstood medical conditions in
America. There are at least five serious myths about headaches.
For example, one is that all headaches the same, which is clearly not the
case.
Another is that increased levels of stress cause chronic headaches. The
correlation between stress and headache is certainly true for some people
but not for others.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 14 of 111
This is where the confusion arises.
Stress may very well trigger a headache in someone who is susceptible to
migraines but, if a person is not susceptible to headaches, it is unlikely that
one will be triggered by rising levels of stress.
Another prevalent myth about headaches is that headaches are all in your
head. You cannot just imagine or cause a headache to occur.
Headaches are a medical condition caused by physiological events that can
be diagnosed and treated just like appendicitis or arthritis.
They require medical care and self-care measures to manage them, just like
other chronic conditions.
Did you know that headaches are more prevalent during early adulthood and
often become less common after middle age?
For example, migraine headaches are most common in people aged 25 to 55,
which unfortunately, is a time when most of us are in our peak work years.
Migraine headaches are experienced more by women than men.
The reason for this may be that migraine headaches can be influenced by
changes in hormonal levels, such as those that occur during a woman's
menstrual cycle or during pregnancy.
But then, men also get migraines and not all women do.
And, most women who suffer from migraines experience them throughout
the month, even when their hormones are not fluctuating.
Here is another fact that is sad but true. Regardless of all those
advertisements you see on television or the articles you may read in some
publications, there is no “miracle” drug that can stop headaches in
minutes and not all headaches can be wiped away by taking any pill.
While various medications can play a vital part in treating headaches, the
most effective drug therapies often require a combination of drugs.
It is also sad but true that relatives, friends and co-workers often may not
understand the impact that headaches have on a person's performance.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 15 of 111
For that matter, people suffering from chronic headaches often believe that
they themselves are to blame. This misperception can actually work to
prevent people from seeking help for their headaches.
Another common misconception is when some people think that you are
suffering from headaches because there is something wrong with you
emotionally.
This is also untrue. Chronic headaches are not the sign of psychological or
mental problems. They're a biological disorder. While it is true that some
people who have mental health problems do get headaches, the headaches
are not necessarily because of these problems. It is also true that while
people who are suffering the pain of a throbbing headache may be calm
angry, irritable or moody, this does not mean they have a mental disorder.
Headaches are an established medical condition.
You cannot just imagine or cause a headache to occur. Headaches are not
just a complaint from someone who is acting hysterically or who is a
hypochondriac.
Headaches are a medical condition caused by physiological events.
They require medical care and self-care measures to manage them, just like
any other chronic condition.
Are you a guy? Then you should pay attention to this -- men are especially
reluctant to see a doctor about chronic headaches because they don't wish to
appear unable to handle the problem on their own. But, seeing a doctor is
exactly what they should do.
Another misconception is that people complain about headaches who
cannot handle pain. There is no scientific evidence that suggests that
people with severe migraine headaches, for example, are more sensitive to
pain than people who do not have migraines.
In fact, many people are able to carry on with everyday activities despite
their migraine headaches, which shows they are resilient.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 16 of 111
Finally, some people think that sinus headaches are chronic headaches.
The fact is that sinus headaches occur only when you have sinusitis or
infected sinuses – in other words only once in a while and only for a short
time.
If you have chronic headaches and believed it was because of your sinuses,
you need to stop thinking this and find out what kind of headaches you really
have.
As you'll read in this book, there are medications you can take to stop or end
a headache, and there are drugs and methodologies you can use to lessen
the effect of your headaches.
But, anyone who tries to tell you that there is one medication, alternative
treatment or supplement that can permanently "cure" your chronic
headaches, is just not telling you the truth.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 17 of 111
2. General Information about Headaches
Did you know that the brain itself is not sensitive to pain? This is because it
lacks pain-sensitive nerve fibers. There are several areas of the head that
can hurt, including a network of nerves that extends over the scalp, and
there are certain nerves in the face, mouth, and throat that can hurt.
However, the meninges and the blood vessels do have pain perception. As a
result, irritation of the meninges and blood vessels can result in headaches.
The muscles of the head may also be sensitive to pain.
Pain in the neck or upper back may also be interpreted as headache. It ranks
among the most common of local pain complaints.
What Causes Headaches?
There are a wide variety of headache causes. These range from eyestrain and
sinusitis to life-threatening conditions such as encephalitis, meningitis,
cerebral aneurysms and brain tumors.
In some cases it is very easy to determine what is causing your headaches. If
you suffered head trauma and now have chronic headaches, it is easy to
figure out what caused them.
On the other hand, the causes of many other types of headaches are still not
well understood.
At one time, scientists and doctors believed that migraine headaches were
caused by the constriction and dilation of blood vessels and that tension
headaches were caused by muscle contraction.
While scientists still believe that these play a part in causing headaches, a
much more complicated explanation is beginning to emerge.
Many scientists now speculate that both migraine and tension headaches
have the same origin in the brain.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 18 of 111
One New Theory
One new theory holds that headache pain begins with the trigeminal nerve.
This nerve, the largest in the head, is located in the brainstem and carries
sensory impulses to and from the face.
When this nerve is stimulated by a certain headache trigger, it releases a
burst of neurotransmitters. This normally prompts the release of yet another
neurotransmitter called serotonin.
Serotonin acts as a filter, screening out important things such as familiar
background noises and other people's conversations, while admitting signals
that demand attention, such as a baby's cry or your name being called.
The more serotonin, the greater the screening action, which is why high
serotonin levels correlate with sleep.
It is thought that, under normal circumstances, increased serotonin levels
counteract pain signals from the trigeminal nerve.
But, serotonin levels often prove to be too low in people suffering from a
headache.
In fact, scientific tests have proved a clear relationship between headaches
and serotonin levels.
In one experiment, test subjects got headaches when injected with a drug
that depleted their serotonin level.
Likewise, the headache went away when they were injected with serotonin.
A lack of serotonin has also been implicated in depression and sleep
disorders -- two problems that afflict many of those suffering from chronic
headaches.
Another theory holds that teeth clenching may be the main cause of migraine
headaches as teeth clenching causes a chronic contraction of the temporalis,
or temporal muscle.
It has also been shown that patients with chronic tension-type headaches
show increased muscle and skin pain sensitivity.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 19 of 111
And, the hyper-excitability of central noriceptive neurons in the trigeminal,
spinal nucleus, thalamus, and cerebral cortex, is believed to be involved in
the cause of chronic tension-type headaches.
Headaches and Hormones
There is strong evidence that there is a relationship between hormones and
migraine headaches because women get this type of headache more than
men.
Another important fact supporting this theory is that women do not get
migraine headaches until after puberty when they begin to produce higher
levels of female hormones.
Also, sixty percent of women with migraines report that their headaches
happen more often before, during or after menstruation which is when
hormone levels change.
This type of headache is sometimes called a “menstrual migraine”.
Third, these headaches tend to lessen in number during the second and third
trimesters of pregnancy and the headaches often stop, or get worse, for
menopausal women – again proving a relationship between hormones and
headaches.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 20 of 111
3. Types of Headaches and Their Symptoms
There are four basic types of headaches. They are vascular,
muscular/myogenic, traction and inflammatory.
The most common type of headache, the migraine headache, is vascular.
This type of headache is usually characterized by severe pain on either one
or both sides of the head, an upset stomach and, at times, vision problems.
The second most common type of vascular headache is the "toxic" headache
produced by fever.
Cluster headaches are also a kind of vascular headache. So are the rare type
of headaches caused by high blood pressure.
Tension headaches are the most common form of muscular/organic
headaches. They appear to involve the tightening or tensing of facial and
neck muscles, and may radiate to the forehead.
Tension and inflammatory headaches are generally symptoms of other
ailments such as stroke or sinus infection.
Non-chronic types of Headache
There are other types of headaches, which are non-chronic; they occur only
once, or once in a long time.
Included among these are:
• · Ictal headache
• · Ice cream headache
• · Thunderclap headache
• · Toxic headache
• · Coital cephalagia or sex headache
• · Sinus headache
• Medication overuse headaches
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 21 of 111
Major Types of Headaches and Their Symptoms
Migraine Headaches
Migraines are clearly the most common type of severe chronic headache.
Statistics suggest that that more than 6 million Americans suffer from
migraine headaches.
How can you tell if you’re suffering from migraines? Migraine headaches are
marked by pain that can be almost unbearable – to the point where all you
want to do is lie down and wait for them to go away.
In addition to this pain, there are other symptoms that typify migraines.
Nausea and vomiting
Sensitivity to light and sound
Cold-like symptoms
Inability to function normally or below normal at work and at home
when suffering the headache
Head pain that has a pulsating or throbbing quality
Moderate to severe pain --possibly on only one side of your head,
although it can occur on both sides
Pain so intense it interferes with your regular daily activities
Pain that becomes worse if you engage in physical activity
Feeling of being nauseated with or without vomiting
A heightened sensitivity to light and sound.
If you do not treat a migraine headache, it will typically last from 4 to 72
hours. But, how often the migraine occurs will vary from person to person.
You might experience a migraine headache as often as several times a month
or just several times a year.
Some migraines are accompanied by auras and some are not. If you do
experience an aura, it will most likely occur about 15 to 30 minutes before
your headache begins. In some cases, the aura may continue after your
headache starts or can even continue after it ends.
© 2009, Douglas Hanna All Rights Reserved
“Everything About Chronic Headaches” by Douglas Hanna
Page 22 of 111
These auras may include:
Blind spots in your vision that slowly spread
Dazzling zigzag lines in your field of vision
Sparkling light flashes
A sensation of tingling or a pins-and-needles sensation on one arm or
leg
In rare cases, weakness or language and speech problems.
You may also have one or more sensations which indicate an imminent
migraine headache. These sensations are called Prodromes and may occur
several hours to a day or so before your headache actually begins.
The sensations can include:
Thirst
Irritability or depression
Drowsiness
Cravings for sweets
Feelings of elation or intensive energy
Cluster headaches
The main symptom of cluster headaches is described by its title – headaches
that occur in a cyclical pattern or cluster.
These clusters may last from weeks to months, followed by periods during
which the headache attacks stop completely. While the cluster pattern can
vary from one person to another, most cluster headache sufferers have one
or two cluster periods a year. Then, during remission, they may experience
no headaches for months or even sometimes years.
Only about 1% of the U.S. population suffers from cluster headaches, which
is a good thing as it is one of the most painful kinds of headache.
Unlike migraine headaches, cluster headaches affect more men than women.
People of any age can be affected by cluster headaches, but it is most
common for people between adolescence and middle age.
© 2009, Douglas Hanna All Rights Reserved
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Cluster headaches usually strike quickly and without warning.
If you suffer from cluster headaches, you know how the excruciating pain can