Tension Headache

ALMOST EVERYONE GETS a tension headache now and again. Your head feels as though it’s clamped in a vise, the muscles in the back of your neck feel knotted and sensitive to the touch, and there’s pain in your forehead, temples, or through the entire head. A tension headache is caused when the sensitive nerve endings in your head and neck are irritated by tense muscles. (In a migraine headache, the nerve endings are irritated by swollen blood vessels; a sinus headache is caused by the inflammation of the sinus tissues.

For most people, tension headaches last just a few hours and then disappear, with or without the help of a few aspirin. But in some cases, a tension headache can last for days or, rarely, even years.

There are a number of things that can cause tension headaches. We can become tense in response to sensory overload: shrill, persistent noise, harsh lights, feelings of claustrophobia, working against a deadline generates tension, or performing a job where accuracy is essential. (Air traffic controllers are said to suffer frequent tension headaches.) Tension is caused by challenges that cannot be met, such as a pile of bills that exceeds the funds in the bank account. While we cannot avoid all situations that cause tension, we can learn to moderate our response.

A good way to ease work-related tension is to stretch your muscles periodically, before they become rigid and a tension headache sets in. Stand up and stretch, breathe deeply, do a few neck rolls, rolling your head round and round and then side to side. With both your hands, press beneath the bony ridges at the back of your neck until you feel the knotted muscles start to respond.

One of the most effective techniques for relaxing tension is called “progressive relaxation,” which has been successfully used to prevent headaches as well as such disorders as hypertension, colitis, and angina. It calls for relaxing the muscles in your body, group by group, starting with the extremities and working toward your neck, face, and head. Many of my patients have mastered this technique and use it frequently. I also recommend a book, The Relaxation Response, by Herbert Benson.

Heat helps relax tense muscles. Try soaking in a warm bath with your shoulders and neck submerged. Sometimes a warm shower can relax you. You may find relief with a heating pad.

I’ve had patients tell me that a nap is the most effective way for them to get rid of a headache. This may be because it relaxes the body so efficiently. Of course a nap isn’t always practical.

If you can’t take a nap you may be able to take a walk. A brisk walk can often relieve headache symptoms. It reduces tension and increases circulation and oxygen flow, which has been shown to relieve headaches.

In the long run, regular exercise may be the most effective way to prevent tension headaches. Since exercise mitigates the body’s response to stress, people given to tension headaches should incorporate exercise into their daily routine.

In addition to actual tension-causing situations, “mechanical” problems such as weakness of the back and neck can also cause headaches, as can a bad bite that sets up tension around the lower jaw. Temporomandibular pressure can be alleviated by correcting the way the teeth come together, and generally requires the attention of an orthodontist.

Some of my patients have complained of tension headaches that are in fact caused by food sensitivities. These are different from migraine headaches in that they don’t have the typical migraine symptoms but, like migraines, are caused by particular food.

I’ve had any number of patients who complain of “weekend” headaches. They’re fine all week but by Saturday afternoon they have splitting headaches, many of which are caused by caffeine withdrawal. Used to having up to four cups of coffee by lunchtime on a weekday, they sleep late on Saturday and don’t have their first sip of coffee until nearly noon. What they don’t realize is that caffeine is addictive and by delaying their “fix” hours past their usual time, they’re withdrawing. Suffice it to say, I suggest you drink no more than one cup of coffee per day on a regular basis. And if you still get a withdrawal headache on Saturday or Sunday morning, you’ll simply have to have your first cup earlier!

Withdrawal from painkillers can be another cause of headaches, if you regularly take aspirin or acetaminophen you can develop “analgesic rebound headache.” Many pain relievers contain caffeine. When you stop the medication, you develop a headache from caffeine withdrawal; as soon as you take it, the headache disappears but the cycle begins again. The medication gives temporary relief but is in fact the cause of the headache. If this describes your headache pattern, try using other non-medicinal means of dealing with them. I think, in general, it’s best to limit your OTC pain medication to no more than three days a week and no more than four tablets a day. Of course this recommendation will depend on your condition and should be discussed with your doctor, but it’s what l tell my patients who wonder if they’re overusing painkillers.

Many of my patients who complain of afternoon headaches are really suffering from symptoms of low blood sugar. The main treatment for this is to be scrupulous about regular meals at regular times and no skipped meals.

NATURAL PRESCRIPTION FOR TENSION HEADACHES

• Learn what triggers your headaches, including sensory overload and stress. When you face any of, these triggers, be sure to use relaxation techniques to fight tension Stretch your muscles periodically, once every half hour, and massage the neck and shoulders.
• Go to your doctor to find out if your headaches are connected to food allergies or sensitivities.
• Use moist heat to relieve pain: take a warm shower or bath or use a moist (or dry) heating pad on your neck.
• Take a nap.
• Take a brisk walk.
• Adopt a program of regular exercise.
• Investigate whether jaw clenching or improper jaw alignment could be causing your headaches.
• Cut down or eliminate your caffeine consumption.
• If the overuse of regular pain relievers that contain caffeine is causing headaches, cut down on use and try natural methods of pain relief.
• Be sure to eat regular meals at regular times and never skip a meal.