Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright October 11, 1988
Dear Readers:
Among the most common letters I receive deal with the topic of headaches, and how best to treat them. Definitely, the most common type of headache is known as a “tension headache”, so today’s column will deal with some generalities regarding these headaches.
I have only met one person in my life who never had a headache. She is my cousin, and she couldn’t even imagine what a headache would feel like.
Unfortunately, most of the world knows very well what they feel like. Some suffer from migraine headaches. Others from headaches caused by sinus congestion, hormone imbalances, neck arthritis, eye strain, infection, high blood pressure, blood sugar disturbances, and other more serious brain disorders.
By far, the most common type of headache is something commonly referred to as a tension headache, muscle contraction headache, or stress headache.
Many people who call their own headaches “migraines” really only have bad tension headaches. A migraine is a specific type of vascular headache which has specific properties, and it is less common than many people would think.
It is therefore essential to have your headaches properly diagnosed by a professional.
The age at which headaches begin should be considered when trying to determine their etiology. Between 13 and 25 years of age is the ripe time for these headaches to begin. They are also more prevalent in females. For these reasons, many headaches that aren’t really tension related are misdiagnosed in a young female who might complain of headaches to her doctor.
Psychological tension is a major cause of these headaches. Depression is also a cause of these headaches, but again care must be taken in the diagnosis, because depression is also a symptom of chronic pain, such as headaches. It is important, therefore, to determine if the depression or the head pain began first.
Any activity which causes muscle contraction, or tightening in the head and neck can lead to these headaches. Painting ceilings, watching a ping-pong match, or doing detailed work in a small, confined area can all bring about tightening of the muscles in the neck and scalp. This leads to a compression of the blood vessels which travel through the muscles, ischemia (lack of proper blood supply), and this then leads to muscle spasms and headache.
Forty per cent of those who suffer tension headaches have a family history of headaches. It is probable that there is a genetic link to these headaches, but it is more probable that these people learn certain behaviours and reactions to life’s stresses that might be inappropriate.
What to do to prevent these headaches might seem simple – avoid all stress. This is obviously impossible to do, and actually some stress is good for us. Instead, we must learn how to isolate the good stress (mountain climbing, skydiving, a good battle on the squash court, a hard-fought hockey game) from the bad (financial problems, job stress, marital discord) and learn how to better deal with the bad stress.
Exercises to increase circulation and improve flexibility of the neck will help. Biofeedback, meditation, yoga, massage, hot showers, whirlpools, ice massage of the neck and scalp, and taking a short nap all work well with some people. Traction, or stretching of the neck, helps with some, as does spinal mobilization of the joints in the neck. Some people resort to A.S.A. or muscle relaxant drugs to give them some relief. These should only be used as a last resort.
Anyone who thinks they suffer from tension headaches should follow these steps:
1) Have your family physician examine you and follow through with a thorough examination by sending you to a neurologist, chiropractor, orthopedic specialist, or anyone else he thinks might be able to find the source of your headaches.
2) If you do have tension headaches, you should itemize your daily activities and make notes detailing the onset of your headaches. Try to correlate the above to find out which activities are the triggers for your headaches.
3) Try to formulate better ways to deal with the stresses that you think are your headache triggers. Keep in mind some of the recommendations I have outlined, and modify them to suit your specific needs.