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Headache: causes and treatment

Headache: causes and treatment


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What helps against headaches?

One of the most common forms of human pain is headache. Headache, also called zephalgia, can be primary, i.e. occur as an independent complaint or secondarily as a symptom of an underlying disease. In about 90% of cases, primary headaches are diagnosed, which are mainly in the form of migraines and tension headaches and are chronic. The remaining ten percent occur secondarily, for example as a side effect of high blood pressure or diabetes. Temporary headache can also appear as a "hangover headache" after excessive alcohol and tobacco consumption, when the patient is sensitive to the weather, or as an accompanying symptom of cold infections. Repeated and very severe acute pain should always be carefully examined and diagnosed.

Diagnosis

Headaches can be acute or chronic, affect the skull, face, upper cervical spine and associated symptoms. The course, location and character of the pain, triggers and accompanying symptoms provide important clues to the cause. Effective treatment should therefore be preceded by good observation and careful questioning by the practitioner, after which, depending on the therapeutic focus, the practitioner can work out a therapy plan specifically and individually. If no clear diagnosis can be made, further examinations, e.g. Layered images of the brain, giving information about the cause.

Place of pain: where does it hurt?

The pain initially differs in the location of the pain. This can occur on one or both sides, focus on the forehead, temples or back of the head, it can wander, radiate or be limited to one point. For example, people often describe headaches that radiate into the back of the head, which can be important for the treatment. Intuitively, those affected refer body language very precisely to the painful areas by holding painful areas or tracing the pain process with their fingers. This important information can be used therapeutically effectively. The treatment according to the fascia distorsion model (FDM) is based exclusively on body language instructions from the person concerned.

Character of pain: how does it hurt?

The complaints are perceived as strong, medium or light and continue to be described qualitatively as bright, dull, stinging, pressing, throbbing, pounding or pulling. On the one hand, these descriptions can sometimes already give an indication of the cause. However, such individual sensations come into play above all in certain forms of treatment, for example in the FDM mentioned at the beginning, imaginative procedures and hypnotherapy, where the images of those affected are also used.

Pain trigger: when does it hurt?

Frequency and situation can provide clues to the origin of the pain. Are there regular occurrences, do the pains start under stress, after exertion, or do they occur at the weekend or during periods of relaxation? Can a connection with food, occupations or even people be established? Are there any other special triggers, such as touching, sleeping with the windows closed or lying in a certain position? Chronic headaches are often psychogenic. Emotional stresses resulting from the professional situation or interpersonal relationships can therefore play an important role in choosing the optimal therapy.

Forms of headache

The medical literature classifies various types of headache according to frequently occurring triggers, courses, causes, main and accompanying symptoms. In practice, these descriptions are of course supplemented by individually experienced sensations and observations of the people concerned and sometimes, due to the individual characteristics, no assignment can be made. These classifications are also taken into account in naturopathy, but there are basically further hypotheses regarding the causes, so that in addition to conventional therapy of symptoms, alternative treatment approaches to restore the physiological self-organization of the organism exist and are being further developed.

Headache: causes

The most common forms of primary pain in and on the head are listed below and some diseases are mentioned in which (secondary) headache can occur as a symptom.

Migraines (hemicrania)

Migraines are referred to as seizure-like pains, which mostly occur on one side (hemi = half; cranium = head) and whose quality is often described as pulsating, stinging or throbbing. Migraine attacks usually occur periodically and can last from hours to days (4-72 hours). The accompanying symptoms are regular nausea and vomiting, sensitivity to light and noise. Many people have to wait for the seizure to lie in the darkened room. The migraine can also occur with a so-called aura, which can be accompanied by temporary visual phenomena (flashes of light, flickering) as well as neurological deficits (hemiplegia, aphasia). The causes of migraines are still largely unknown. As a trigger for a migraine attack, psychological stress and disturbances of the sleep-wake rhythm are often mentioned, but also the consumption of certain foods and luxury foods, e.g. of alcohol, chocolate and cheese. Migraine attacks can already occur in childhood, as in older people, the attacks are also shorter in children. Overall, women are more affected by migraines than men.

Tension headache

Chronic tension headache is diagnosed almost as often as migraines. In contrast to this, the chronic or recurring tension headache is mainly described as diffuse, dull pain in the entire head. It is also called vegetative-vasomotor headache, which means that dysregulation of the vegetative nervous system leads to vasoconstrictions in the head area, which then cause the pain. Stress, neck tension, climatic factors, lack of sleep, smoking and alcohol consumption are always mentioned as triggers. The pain is usually isolated, i.e. without accompanying symptoms such as nausea or vomiting. According to the description of the symptoms, women in particular are often affected by a combination of migraine and tension headache, so that relationships between the two types of headache are discussed.

Headache and spine

The nerve, which usually triggers the tension headache because it runs over the head, comes from the second cervical vertebra. After exiting the spinal canal, it must pass through the muscles at the back of the head, where it can probably be pinched off by high tension. In chiropractic, it is assumed, among other things, that blockages in the first or second cervical spine can affect the nerve and trigger pain. The unfavorable tension on and around the cervical spine is blamed on old injuries, e.g. due to car accidents with whiplash and unfavorable permanent pushing of the head forward as part of VDU work.

Cluster headache (Bing-Horton syndrome)

The cluster headache occurs repeatedly, seizure-like and acute. The pain is felt very intensely and sometimes as unbearable. The pain episodes are in most cases replaced by pain-free intervals that can last for months. The headache is usually described as constant one-sided, with forehead and temple pain dominating. Most often, those affected wake up at night at the same time with violent pain attacks that last 30 to 120 minutes and can recur two to seven times during the day. cluster = Group, accumulation). Accompanying occasionally increased lacrimation, nasal passage, swelling of the nasal mucosa, a drooping upper eyelid and reddened conjunctiva (reddening of the eyes). Avoiding lying positions is typical. The causes of cluster headaches are not known; the triggers are nicotine and alcohol consumption as well as histamine injections.

Compared to migraines, cluster headache occurs much less frequently and occurs more frequently in men between the ages of 20 and 30. Children and the elderly can also be affected. Similar symptoms can also be seen in Sunct syndrome, in which the attacks with stinging, pulsating pain have a frequency of 3 to 200 per day.

Trigeminal neuralgia with facial pain

Trigeminal neuralgia often occurs on one side of the face with repeated attacks of very intense pain. The pain appears suddenly and lasts for a few seconds at one point. The attacks can occur up to a hundred times a day. In response to recurring attacks with stabbing, annihilating pain, many sufferers develop depression, which is often associated with suicidality.
The pain attacks that affect the 2nd and 3rd branch of the trigeminal nerve are sometimes triggered by touching trigger points or by chewing, swallowing and speaking. The causes are unknown, neural shorts between tactile and pain-guiding fibers are suspected. There is rarely a mechanical irritation of the nerve root due to a tumor, aneurysm or similar. Women are affected more often, especially from the age of 50.

Headache as a symptom of illness

If the symptoms appear as a symptom of an existing underlying illness or other known causes (injury, medication), then secondary headaches are mentioned.

Highly acute headache occurs, for example, with cerebral hemorrhage, cerebral infarction, cerebral vein thrombosis, but also with cerebral pressure due to rapidly growing brain tumors or inflammation of the meninges (e.g. in TBE). Often, consciousness disorders occur sooner or later.
In the case of traumatic complaints from concussion, whiplash or craniocerebral trauma, nausea and vomiting as well as a stiff neck can often be found. If a headache occurs years after a concussion and there is no organic finding, it may be a psychological malfunction of the trauma suffered.

Paradoxically, the regular use of pain medication over a longer period of time can in turn lead to toxic permanent headache. Likewise, sleeping pills and hormonally effective contraceptives (“birth control pills”) are considered to be potential causes. Internal poisoning that leads to headaches is often due to kidney and liver diseases, gastritis or chronic constipation. In the process, toxins remain in the body, which is restricted if the excretory organs function properly. Metabolic diseases such as diabetes mellitus or hyperthyeosis can also be accompanied by a headache (metabolic headache).

Facial pain and cheek pain can include can be attributed to a glaucoma attack, colds with a runny nose, inflammation of the maxillary sinuses and sinuses, tumors, dental diseases, eye disorders, multiple sclerosis (both sides) but also zoster neuralgia.

Headaches continue to occur with hypotension and high blood pressure, with pheochromocytoma and after puncture of spinal fluid. They also often appear as a symptom of climacteric, premenstrual and depressive syndrome and after a strong cough.

Conventional headache therapy

Conventional therapy depends on the diagnosis made. Therapy with painkillers is almost always in the foreground. The treatment of migraines consists on the one hand of the medicinal relief of the symptoms in the acute attack with analgesic, vasoconstricting and nausea-reducing agents. For mild symptoms, ibuprofen, acetylsalicylic acid or paracetamol are recommended, which are freely available in the pharmacy and are also used against tension headaches. In the case of severe migraine attacks, doctors prescribe triptans, ergotamines and additional antiemetics (medicines for nausea). Beta-blockers, antiepileptics and calcium channel blockers are administered between the attacks to prevent and reduce the frequency of attacks. In acute attacks, the cluster headache is interrupted by oxygen inhalation and the administration of ergot alkaloids or methyses; prophylactically, lithium and verapamil are used as long-term medication.

Treatment in naturopathy

Although the quick and repeated use of pain relievers can be understood, particularly in the case of severe headaches, unpleasant side effects and drug addiction always raise the question of alternative forms of treatment. Here are some general and special approaches and procedures from naturopathy and alternative medicine to be presented, with which the complaints can be treated professionally. There are also numerous home remedies for headaches from naturopathy, especially herbal medicine, available for self-treatment of minor complaints.

General naturopathy

In general naturopathy, slagging of the tissue is (also) responsible for the development of chronic headaches. As a means of choice, not only Prof. Brauchle in "The Great Book of Naturopathy" from 1957 initially recommended a fasting cure with juice or a raw food cure to "empty the slag stores", which then resulted in a changed diet. This should contain a high proportion of vegetables, so it should preferably be low in meat, wholesome and varied. White flour, industrial sugar, alcohol, caffeine, finished products and dishes with preservatives and flavor enhancers should be avoided as well as too much salt, citrus fruits and artificial sweeteners.

Digestive disorders and food allergies or food intolerances, behind which an improper colonization of the intestinal flora with leaky gut syndrome is suspected, play an important role when viewed in naturopathy, which is reflected in many therapeutic approaches. If there are also circulatory disorders and cold feet are a constant accompanying symptom, according to Brauchle (see above), the cold feet must first be remedied, because "from the feet [...] distant effects on the head [run]". For this purpose e.g. Alternating foot baths and finished herbal medicinal products.
In the event of tension and hardening in the neck area, healing processes should also be stimulated locally and reflexively by means of cupping reflex zones by means of bloodless cupping or a large-area cupping massage. Furthermore, with chronic headache, a climate change, e.g. into the forested low mountain range, as well as sporting activities in the fresh air and Kneipp treatments recommended. This includes daily cold whole washes, treading water and lower leg castings. This form of “vascular training” is particularly useful for vegetative-vasomotor tension headaches.

Headache in Hildegard medicine

In Hildegard medicine, a disharmony of the natural body fluids is made responsible for the development of disease by multiplying disease fluids. In the case of headaches, five causes are known from Hildegard medicine, which cause an excessive release of black bile and can thus trigger the symptoms. These include febrile and cold infections, metabolic disorders, diet errors, e.g. the four Hildegard kitchen poisons, raw food and pear juice; accidents and an unfavorable way of life and work with stress and worry.

Hildegard cupping and Hildegard bloodletting are used in the Hildegard practice especially for migraines, which is intended to eliminate the bad mix of bodily fluids (dyscrasia) that has arisen from regulatory disorders of the metabolism and hormone system.

Homeopathy for headaches

Numerous remedies are known from homeopathy that can be effective for headache. A detailed medical history with a homeopath is therefore advisable, especially since the development of symptoms also plays a role in chronic pain. The remedy is also administered as a high potency in professional homeopathic practice, so that profound changes can occur, not only on the physical level. In the case of mild, acute complaints, proven means of self-treatment are recommended, usually as a mother tincture or in the potencies D4, D6 and D12. This includes belladonna (belladonna), especially for throbbing flu headache and bryonia (beet), if there is a bitter taste in the mouth, if movement is avoided and a quiet room is required. Bursting, pulsating pain in the head should be countered with Melilotus officinalis (stone clover). Secondary headaches are also recorded with the appropriate homeopathic remedy, e.g. if the pain occurs as part of menstrual pain. In addition to the classic individual remedies, there are now various homeopathic complex remedies for external and internal use and for injection (by a naturopath or doctor).

Hypnotherapy for headache

Hypnosis can be used for different types of headache. We work with relaxation exercises and pain communication, with healing images and symbolizations. By giving the pain a shape (shape, color, etc.), it can be concretized and then changed if necessary. One aspect that plays a major role is the lack of awareness of body signals that result from repeated overwhelming situations (of different types). The natural rhythm of tension and relaxation is often disturbed in people with chronic headache, which can lead to permanent misregulation of muscle tension in tension pain. Migraineurs notice the strong mood changes before and after the attack. As with working with biofeedback devices, reactions that have a positive effect on pain should be learned (again). Further, effective measures in this sense, which can also be used in addition to hypnotherapy, are progressive muscle relaxation or regularly practiced yoga.

Various scientific studies exist, e.g. a study published by Faran in 2002 ("Pharmacological and Psychological Approaches of Migraine Treatment"), in which drug and hypnotherapeutic treatment courses in migraine patients were compared. Among other things, there is a significant reduction in the frequency and duration of the migraine attacks, as well as the subjectively felt pain.

Manual therapy for headache: osteopathy

Osteopathy and Rolfing see the whole body as relevant for diagnosis and treatment. A very common connection to the temporomandibular joint is due to increased tension in the mouth, asymmetries and other factors.

Pelvic obliquities or strengths in the thoracic spine are also used, for example, for better function and to balance the tension on the head. The anatomical models play no role in the fascia distortion model (FDM): Ultimately, the statements and body gestures of the patients decide on diagnosis and treatment.

The pulling pain above the head is treated in the same way by moving the thumb down - the pulling burning pain is seen as twisting of the galea aponeurotica, a coarse connective tissue plate on the head. Selective headaches are seen as disturbances in the bone-soft tissue transition (so-called continuum distortions), which must be treated with strong thumb pressure. Large headaches are seen as twisting of the superficial fascia and are usually treated by pulling the hair diagonally upwards. (jvs)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Matti Scholz et al .: DGU guidelines 012-011 Injuries to the upper cervical spine, German Society for Trauma Surgery (DGU), (accessed on September 13, 2019), AWMF
  • Andreas Straube: Therapy of episodic and chronic tension-type headache and other chronic daily headache, guidelines for diagnostics and therapy in neurology, German Society for Neurology, (accessed September 13, 2019), AWMF
  • Michael Rubin: Trigeminal Neuralgia, MSD Manual, (accessed September 13, 2019), MSD
  • Manfred A. Ullrich: Treating migraines and trigeminal neuralgia successfully, Spurbuch Verlag, 2014
  • Stephen D. Silberstein: Migraines, MSD Manual, (accessed September 13, 2019), MSD
  • Arne May: S1 guideline on cluster headache and trigeminal autonomic headache, German Society for Neurology (DGN), (accessed September 13, 2019), DGN
  • Charly Gaul, Hans Christoph Diener: Headache: Pathophysiology - Clinic - Diagnostics - Therapy, Thieme Verlag, 1st edition, 2016

ICD codes for this disease: R51ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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