Dear Dr. Garner,
Almost every afternoon I get a headache. It is not unbearable, but is getting to be pretty annoying. I have a stressful job and my new boss is difficult, to say the least.
My wife thinks that my headaches are tension headaches, which seems to make sense. What exactly causes a tension headache, and more importantly, is there anything that can be done to stop them? My doctor has done many tests and they are all normal.
We love your column, and look forward to it each week. Please help!
Horrible Headaches in Hollis
Dear Horrible Headaches,
Most definitely there is an entity known as tension headaches. It is actually the most common type of headache there is.
The pain of a tension headache has been described as a tight band around the head. It also may cause discomfort in the back of the neck. People usually experience moderate pain sometimes accompanied by nausea or vomiting.
The headaches can last from 30 minutes to several days.
The pain may start in the morning, perhaps in anticipation of a stressful day ahead, or later in the day, from either work stress, or conflict that is anticipated at home.
Some people experience fatigue and irritability, as well as loss of appetite and difficulty concentrating and sleeping.
Tension headache is related to a change in chemicals in the brain. One of the effects of this imbalance is to tighten muscles, but the pain itself, is related to the chemical imbalance.
The change in chemistry activates pain pathways to the brain and interferes with the brain’s ability to suppress pain.
Some things known to cause tension headaches include:
1. Stress
2. Depression and anxiety
3. Skipping meals
4. Poor posture
5. Lack of physical activity
6. Medications for other conditions such as depression or high blood pressure.
7. Lack of sleep
8. Hormonal changes related to menstruation
9. Jaw grinding
10. Whiplash, or other types of head trauma
There are a variety of treatment options available. It is a good idea to see your doctor if the tension headaches are so severe that they disrupt your life, if there is a new pattern in your headaches, if it is new onset after age 50, or it is associated with any numbness, speaking difficulties or double vision.
The most basic treatment is with medications such as Tylenol and Motrin.
As these mask the problem, and don’t really get at the root, I suggest the following:
• Put a heat pack or ice pack on your head or neck
• Take a hot shower
• Get enough rest or sleep
• Take time away from things that are stressful
• Get regular exercise daily
• Yoga, massage and posture classes may be helpful
• Biofeedback training can teach you to deal with stress
• Acupuncture has been very effective in eliminating pain
Finally, last, but not least, I suggest you maintain a headache diary. Keep a book in which you record everything about your headaches, such as:
What time of day did it occur?
What were you doing when it came on?
What were your sleep patterns and the amount of sleep you received in the days leading up to the headache?
What were you doing immediately before the headache? Finally, what made the headache go away?
This information can be very helpful to you and your doctor in better understanding your headaches, and attacking the root cause, not merely covering it up with medicine.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.
