Headache Pain Defined
Did you know that in the United States, over 20 million visits to the physician per year are attributed to headaches?
Pain can be caused by injury to tissue. Pain can also indicate that that there has been damage to pathways of the peripheral or central nervous systems. Diagnosis of a headache is based on the location, severity, onset and duration and location of pain. Only the boney structure of the head is not heavily supplied with pain-sensitive nerve fibres. The remainder of the head is fair territory for head pain; hence, the root cause of headache can stem from any and all structures of the head and neck. Pain emanating from the dura mater, cranial nerves and arteries give rise to the most intense and severe headaches. Most headaches, however, are achy, dull and deep within the cranial structure. Usually, a chief complaint is a tightness of the muscles of the neck and shoulders with frequent throbbing of the head.
Acute onset of headache can be described as pain with an onset of less than one week; however pain can occur only minutes or hours prior to seeking medical assistance. Acute headaches may also be defined as a sudden change in severity or pattern of an already chronic headache. Common signs and symptoms of headache can include changes in memory, balance, vision, motor and sensory functions. Cluster headaches, meningitis, and subanachroid hemorrhages present with intense pain. Cluster headaches peak between three and five minutes from initial onset and can remain quite intense for approximately 45 minutes, then subside. These headaches are often linked to allergies to alcohol, tearing eye, ptosis, and nasal congestion.
Here’s a caveat: headaches that stem from brain tumors typically DO NOT present with severity of pain. Sleep disruption is a clue for headaches stemming from brain tumors.
Inflammation of the sinuses, lesions of the eyes, teeth, gums and cervical vertebrae contribute to less localized pain - rather, they present as referred pain to a regional distribution area.
Migraine headaches are considered vascular headaches. Symptoms of migraines can include vertigo, nausea, vomit, some visual loss, fatigue, irritability and irritability. The first 24 hours of a migraine can manifest as mood changes, loss of appetite and fatigue. This is followed by severe head pain which can last for several days if gone untreated. Sleep within a quiet environment is the best medicine for the person afflicted with a migraine headache. When a migraine subsides, the patient is typically left with a sensation of complete exhaustion and tenderness of the head when palpated. Factors that can trigger the onset of a migraine and certainly activate an event are caffeine, red wine, certain perfumes and scents, estrogen levels, sleep deprivation, glaring lights, stress.
Cranial arteritis occurs primarily in adults over the age of 60 years. The location of cranial arteritis is usually the temporal artery. This type of pain is acute and patients will complain the pain is located in the temporal or fronto-occipital areas of the head. These regions of the head can be quite tender upon palpation and a certain hardness can be felt over the artery. Temporal arteritis has been associated with polymyalgia rheumatica. If this condition is not treated, permanent blindness can occur.
Tension headaches can be described as chronic, band-like pain. Posterior neck and shoulder muscles become tight while pain increases in steady increments for several hours to several days. Anxiety and depression are causes for tension headaches.
Orthostatic headaches occur after a lumbar puncture, subdural hematoma and certain benign intracranial hypertension. Cerebrospinal fluid is lost and hence, the brain’s ‘cushion’ is decreased. Tension is placed on the dural sinuses and compression and pain are resultant. This type of pain begins as the patient stands upright and is relieved while in a supine position. Vigorous head movements can trigger these headaches which can be dull or throb. The location is typically occipitofrontal. Nausea, blurred vision, tinnitus, vertigo and photophobia can also be reported.
Exposure to chemical ingredients, drugs, and other toxins can cause headaches. Persons who are exposed to benzene, nitrates, tyramine, monosodium glutamate (MSG), carbon monoxide, insecticides, and lead can suffer from acute and severe forms of head pain. Since headaches are often attributed to an alteration of blood flow, withdrawal from certain drugs such as caffeine, alcohol, calcium channel blockers, oral contraceptives and nitrates can lead to sudden onset of head pain.
Post Concussion headaches accompany dizziness, impaired memory, anxiety, vertigo and irritability. These types of headaches can be chronic, intermittent and last for up to several years after the initial head trauma.
Recurring headaches can be linked to exposure to certain environmental factors as well as changes in one’s biological system.
Facial pain can be caused by dental issues - sensitivity to hot, cold or sweet foods usually are a sign that a trip to the dentist is necessary. Painful chewing can be indicative of trigeminal neuralgia, temporamandibular joint dysfunction, or giant cell arteritis. Continual and non-focal facial pain can be a sign of nasopharyngeal carcinoma or tumors of cranial nerve five.
Case Study
A female aged 30 presents with a history of splitting headaches for the past two weeks in the temporal region of her head and behind her eyes. Aspirin and prescriptive drugs from her m.d. have not worked so far. The pain becomes worse at approximately 4pm everyday and the headaches are causing insomnia.
Upon examination and further investigation, it is determined that the patient is suffering from Blood deficiency. In this case, deficient nutrient-rich blood can be described as the sensation when one is waiting for a train in the subway on a really warm day. Just before the train arrives at the station, there is a gust of hot dry wind that races forward along the tracks and back into the tunnel. Think of the tunnel as the blood vessels. Blood is driven through the body by Qi. When there is a deficiency of Blood traveling through the vessels, it is like the train going through the tunnel. Wind rises up (just as hot air rises) to the head and creates a deficiency of oxygen-rich blood to the brain…hence, headache. Whereas this patient’s signs and symptoms could lead to Liver Wind Rising, further investigation led to the root cause as Blood Deficiency (history of anemia, vegetarian diet, dry menses, etc). Hence, the patient was treated with acupuncture and herbs for Blood Deficiency. The patient telephoned the office two days later to report there had been no headache since the first treatment. Two weeks later, the patient telephoned the office to report that she had completed the course of herbal prescription and still had no further headaches. Diet modifications were also made during this time and the patient has no further complaint.
Whatever type of acute or chronic headaches you might be experiencing, make an appointment for an evaluation and treatment. In most cases, headaches can be relieved on a permanent basis with regular treatments and herbal formulaes!
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