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Headaches

Category: Illness or disabilities

Type

Involuntary

Introduction and description

by 'haillygoneunder'

A headache is pain anywhere in the region of the head or neck. It is a symptom and not a cause, and it can be a symptom of something relatively easily helped, or something more serious.  As such it does need to be investigated for cause.

Brain tissue itself is not sensitive to pain as it lacks pain receptors, as such the pain is caused by disturbance of the pain-sensitive structures around the brain. Nine areas of the head and neck have these pain-sensitive structures, which are:

  • the cranium (the periosteum of the skull),
  • muscles,
  • nerves,
  • arteries and veins,
  • subcutaneous tissues,
  • eyes,
  • ears,
  • sinuses and
  • mucous membranes.

There are a number of different classification systems for headaches. The most well-known is that of the International Headache Society. In some ways classification of this kind is not a great deal of help to the sufferer, it would be of more help to have headaches classified by cause, or severity of the pain on a scale of say 1 to 10.  Nevertheless here is a brief outline of the classification [in part]

  • Migraines – these are a very specific kind of head pain and are dealt with separately in this site because the symptoms are specific, the causes are specific and treatment has to be different
  • Cluster headaches - The IHS has described cluster headache as "attacks of severe, strictly unilateral pain that is orbital, supraorbital, temporal or in any combination of these sites, lasting 15 to 180 minutes."
  • Tension-type headaches  - caused by tensing of muscles
  • Secondary headaches – headaches with a known underlying cause eg  brain tumour.
  • Chronic daily headache (CDH) – a headache that occurs almost every day
  • Primary headaches  - headaches without a known underlying cause

The problems with this is that “attacks of severe, strictly unilateral pain that is orbital, supraorbital, temporal or in any combination of these sites, lasting 15 to 180 minutes” may occur everyday, and be in part caused by the tensing of muscles resulting from the known underlying cause of a back injury, so we then have a cluster, tension, secondary CDH.  Initially of course it will be a primary headache, because the cause won’t be known, but once it has been diagnosed it will be a secondary headache.  As we have said, the classification is not that helpful.

Symptoms

 

The headache itself is the symptom, however, all sorts of other symptoms may accompany this pain including tears, itchy nose, sweating, and swollen eyelids.  Pain can be dull or throbbing.

Severity can range from minor to excruciating and the duration can be only a matter of minutes to hours.  Some headaches accompanying periods and menstruation can last a whole day.

Causes

Headache is a ‘non-specific symptom’, which means that it has many possible causes.  Some of these are shown below and include stress and sleep deprivation, the effects of medications and recreational drugs, viral infections including the common cold, head injury, bacterial infection, parasites, dental problems, and hypoxia.  Even rapid ingestion of a very cold food or beverage can cause a temporary headache.

‘Bad air’

Headaches can be caused by a host of problems related to poor air quality.  Everything from a leaking car exhaust which lets fumes into the car, to the fumes from factories, the fumes from car exhausts in general, the pollution in cities, the fumes given off by leaking chimneys, the fumes given off by gas stoves or gas heaters, - both carbon monoxide and carbon dioxide.  The headache results from a combination of hypoxia and poisoning.  The following comes from an eHealthme study on co-morbidities:

On Oct, 10, 2015: 3,363 people who have tobacco abuse and Headache are studied.

Hypoxia – in general

Egg by AnnMei

Shortage of oxygen in general can cause headaches.  In this respect, we can add a whole host of mechanisms that induce hypoxia because there are all sorts of ways in which one can suffer from oxygen deprivation  -  asphyxiation; smoke inhalation or steam inhalation; drowning; gas inhalation; winding or being winded;  from forms of breathing such as hyperventilation;  from going up high mountains where the air is thin, even sleep apnea or poor air quality. 

An interesting paper:

Most hypobaric hypoxia studies have focused on oxygen delivery and therefore cerebral blood inflow. Few have studied venous outflow. However, the volume of blood entering and leaving the skull (approximately 700mls/min) is considerably greater than CSF production (0.35mls/min) or edema formation rates and slight imbalances of in- and out-flow have considerable effects on intracranial pressure (ICP). ….. Many patients in a critical care environment develop hypoxemia akin to that of high altitude exposure. An inability to drain the hypoxemic induced increase in cerebral blood flow could be an underappreciated regulatory mechanism of intracranial pressure. PMID: 26294747

 

which brings us neatly on to high altitude headaches.

High altitudes - hypoxia

High altitude, or hypobaric hypoxia, headache has recently emerged as an interesting model to study placebo and nocebo responses, and particularly their peripheral mechanisms. In the present study we analyze the response of this type of headache to either real or sham (placebo) oxygen (O2) administration at an altitude of 3500 m, where blood oxygen saturation (SO2) drops from the normal value of about 98% to about 85%. PMID: 26164587

Heart failure

Headaches are an early sign of heart failure, blood circulatory disease, endothelial dysfunction and atherosclerosis, simply because not enough oxygen is getting to the brain.  The first signs are actually a form of light headedness, but later signs progress to headaches – initially at night and then during the day when too much activity has been undertaken for the capacity of the heart.

The eHealthme site has some interesting statistics on headache co-morbidities, and heart conditions of various sorts figure quite prominently in their case studies of headache, for example:

On Nov, 11, 2016: 469 people who have Abnormal Heart Rhythms and Headache are studied

 and

On Nov, 28, 2016: 51 people who have Atherosclerosis and Headache are studied.

and

On Nov, 08, 2016: 12,610 people who have Blood Pressure Increased and Headache are studied.

 

Stress and associated lack of sleep

 

When we are stressed we often tense our muscles.  It is done unconsciously and it is part of the flight or fight response.  Over a length of time this can result in backache and neck pain which often translates into headaches, as the constriction of the neck muscles also constricts blood flow and results in a sort of hypoxic state.

It is made worse if we do not rest enough and sleep, as there is then no time for the muscles to repair themselves and relax again.  Repair occurs during sleep. 

The result of lack of sleep, can be gradually worsening backache and worsening headaches, as the muscles tense even more to compensate for the fact they are damaged.  In the back, this leads to chronic back pain and even a compressed spine.  And headaches can become cluster headaches. The following comes from an eHealthme study on co-morbidities:

On Nov, 03, 2016: 5,889 people who have Tension and Headache are studied.

Sleep disorders and primary headaches are both more prevalent among nursing staff than in the general population. However, there have been no reports about the comorbidity of poor sleep and primary headaches among nursing staff…. Stratified random cluster sampling was used to select 1102 nurses from various departments in three hospitals in north China. … The response rate was 93 %. Among 1023 nurses, the prevalence of poor sleep was 56.7 %. Of these, 315 nurses (34.13 %) had poor sleep comorbid with primary headaches. . PMID: 26449228

Some more statistics on co-morbidities from eHealthme:

On Nov, 27, 2016: 5,893 people who have Stress And Anxiety and Headache are studied.


 And a table also from eHealthme of comorbidities - headache and various sleep disorders:

Sleep Disorder

1,278

Sleep Disorder Due To A General Medical Condition

1,271

Sleep Disorder Due To General Medical Condition, Insomnia Type

1,271

Sleepiness - During The Day

149

Sleeping Difficulty

1,807

Sleep Issues

1,810

Sleeplessness

1,814

Sleep - Natural Short Sleeper

4

Sleep Phase Rhythm Disturbance

2

 Pharmaceuticals

 

Pharmaceuticals are a very very major cause of headaches.  Although there is a tendency for doctors to cite illegal drugs as one cause [and they are], legal drugs appear to cause far more.  For example:

……Like all drugs, methylphenidate has its unwanted side effects. Most common are: loss of appetite, weight loss, sleeping disorders, irritability, and headache. These side effects are well-known and documented in the literature. By analysing the available literature we have found cases of psychiatric side effects such as: psychosis, mania, visual hallucinations, agitation, suicidal ideas. PMID:  22500377

The eHealthme site list hundreds of drugs that could cause headache; follow this LINK to see the full list and all the headaches each drug has caused.  The link will take you to the entry on eHealthme for headaches.  Scroll down and you will find a section called Drugs that could cause, derived from Adverse Drug reports submitted to the FDA in the USA.  As of November 2016, around 3,300 pharmaceuticals have caused headaches as a side effect.

There appears to be a strong correlation between headaches and the following classes of drug:

 Pregnancy and hormonal problems

 

 

The major changes that take place during pregnancy in the hormones of women - progesterone and estrogen - can cause headaches through imbalance. 

The exact route by which they do so seems poorly studied, but it may be partly related to blood pressure, as hormone imbalance in general causes rises and falls in blood pressure, and as we have seen these can cause headaches

 

 

 

On Dec, 05, 2016: 5,721 people who have Pregnancy and Headache are studied.

 Teeth problems or dental treatment

In the author's practice, as a dentist treating orofacial pain, patients with cluster headache have dental or midfacial complaints as a primary presentation. PMID:  16539865

 Brain damage/head trauma

Psychosis is a symptom complex that may include hallucinations, delusions, disorders of thought, and disorganized speech or behavior. .. …… If psychosis is caused by a medical condition, the patient may exhibit cognitive changes and abnormal vital signs, and may have visual hallucinations. ….. Clinicians should ask about recent head injury or trauma, seizures, cerebrovascular disease, or new or worsening headaches. A subacute onset of psychosis should raise suspicion for an oncologic cause. PMID:  26131945

 

Parasites

 

Mental illness by which psychosis is meant here is known to be caused mainly by imbalances of certain neurotransmitters in the brain. But, what is causing these imbalances? There has been a recent flurry of interest focusing on the possibility of parasitical disease. The appropriateness of this is based on the fact that organisms of the animal kingdom produce the same neurotransmitters. In fact stinging insects release them in their venoms. The proposal here is that insect larval parasites acting on the human brain and body may release such neurotransmitters and cause imbalances and altered mental states and is supported by the occurrence of previously unexplained physical symptoms such as; diarrhoea, constipation, spasms, anaemia, bloating, insomnia, headache, migraine, weight loss, low blood pressure, low grade fever, amnesia and signs of allergy which may accompany mental illness. Some of these symptoms have been previously attributed to the medications prescribed to alleviate the psychotic symptoms but, many are also parasitical signs. …. the regularity with which humans are bitten, stung and have their foods infected with insects at all stages as a demonstration of how insectal disease may have the potential for common infection and disease; mental and physical.  PMID:  23726691

Viruses

This is but one example of many.  Numerous viruses can cause headaches.  Dengue fever, also known as breakbone fever, is a mosquito-borne tropical disease caused by the dengue virus, so in some senses this is both parasitical and viral.

The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing a worsening dengue crisis over the past few years. …..A total 667 dengue patients were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. …. Overall mortality was 1.2 % in our study.PMID:  26423145

 

Dehydration

 

In some cases it is dehydration that causes headaches.  As drinking more water [not an excess, but simply more] is ‘low cost’ and safe, then there is no harm in trying this anyway.  It has the advantage that if the cause is a pathogen, it can help the body flush the pathogen away.

Chronic mild dehydration may trigger headache. Increased water intake could help. A small trial shows modest benefit; however, a larger methodologically sound randomized controlled trial is needed to confirm efficacy……………..Patients from primary care registered as 'headache', 'tension headache' and/or 'migraine' for more than one year who suffer at least two episodes of moderately intense headache or more than four mildly intense episodes of headache per month with a daily fluid intake of less than 2.5 litres per day…………… Drinking more water resulted in a statistically significant improvement .   Drinking water did not reduce headache days…………….. The intervention is low risk and of negligible cost. PMID:  26200171

Bacterial infection

The best known bacterial infection which gives headaches of an unparalleled severity is that which produces meningitis, but many other bacterial infections can cause headaches and furthermore they can enter via the nose and thus by-pass the blood brain barrier.  The use of nasal sprays to suppress the immune response can often leave the way open for bacterial infection to enter via this route

 

Acute bacterial sinusitis is common in the pediatric population, and although intracranial complications of sinusitis are rare, they are associated with significant morbidity and mortality. History and physical examination may be imperfectly sensitive for the presence of acute bacterial sinusitis and its intracranial complications. We present a case of pediatric sepsis in which the diagnosis of intracranial extension of bacterial sinusitis was not made during the first phase of care and describe complications that followed. Emergency physicians should consider subdural empyema in patients presenting with fever, nausea and headache with worrisome vital signs and laboratory values suggestive of a severe infection.  PMID:  26230110

 

Rheumatoid arthritis

In the eHealthme study of co-morbidities there was a very strong correlation between headaches and rheumatoid arthritis:

On Nov, 25, 2016: 17,035 people who have Rheumatoid Arthritis and Headache are studied.

The pain of rheumatoid arthritis can cause insomnia and stress, as such this is one case where a disease has knock-on effects that themselves cause headaches.  But it was also noticeable that there was a link between this disease and the use of imunosuppressants.  In other words the use of the immunosuppressants had allowed pathogens to spread in the body and it was these pathogens that were not only exacerbating the arthritis, but possibly causing brain damage as well - and the headache.

Surgery

 

Plastic surgery and other sorts of surgery on the head and its muscles and nerves can cause permanent damage that results in permanent muscle tension or damage to nerves, leading to headaches.

Dr Kolstad's blog
a 60 minute facelift ...relies on pulling the skin tightly together without any (or minimal) recontouring of the muscle layer.  When the muscle layer is not properly redraped, the skin needs to be pulled tighter to achieve a good result.  Pulling the skin too tightly risks unnatural pulled faces, wide scars and can result in pain.  A skin-only facelift has become popular because it is cheaper, has less downtime, and does not need to be performed in an operating room.  It can be emotionally traumatic to have such poor outcomes after facelift surgery. 

 

 Multiple sclerosis

Perhaps the strongest co-morbidity identified by the eHealthme study into the co-morbidites of headache was multiple sclerosis. 

On Nov, 30, 2016: 22,791 people who have Multiple Sclerosis and Headache are studied.

 Multiple sclerosis,  like rheumatoid arthritis is a name for a set of symptoms it isn't a cause.  The cause - whatever it is - attacks the nerves and it appears that this virus, heavy metal, bacteria, pathogen of some sort,  attacks the nerves with such aggressiveness on occasions that it affects the nerves of the head too.

Just like rhematoid arthritis, the pain of MS in general can cause insomnia and stress, as such this is one case where a disease has knock-on effects that themselves cause headaches.  But there may too be a link again between this disease and the use of imunosuppressants.  In other words the use of the immunosuppressants allows the pathogens causing the MS to spread in the body possibly causing brain damage as well - and the headache.

Treatment

 

Find the cause. 

Although we tend to think that aspirin, pain killers such as NSAIDs and painkillers are the easy option, we should not do so.  They alleviate but do not cure and they have side-effects of their own

On Sep, 16, 2015: 161,325 people reported to have side effects when taking Aspirin. Among them, 3,623 people (2.25%) have Death.

 The treatments include more sleep, water, foods [see below] which heal or help via a variety of methods. 

Otherwise you need to go to the sections for each cause, where solutions are offered via the healing observations there.

 

 

 

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