Headaches: Different Causes, Different Treatments


Headaches are a pain, literally. Not only are they painful, but they can ruin your ability to focus, limit productivity, and in some cases, take you out of commission for days at a time. There are lots of different types of headaches, with a variety of things causing the head pain. Additionally, the location of the pain and the quality of the pain can point to different causes and therefore different treatment approaches. Not surprisingly, finding things that resolve headaches depends on understanding what is causing them.


If you struggle with headaches and you would like an option beyond aspirin, ibuprofen or Excedrin, this article is for you.


Universal Treatments


Acupuncture

In my experience, I have found that acupuncture is one of the most effective clinical tools for resolving both acute and chronic headaches. Acupuncture can often provide relief from headache pain within minutes. Repeated acupuncture treatments can often improve or completely resolve issues with chronic headaches. What is particularly interesting about acupuncture is that the points used to treat headache differ depending on the location and the quality of the headache.


For example, frontal headaches often respond well to stimulation of a point called Large Intestine 4 - which is on the hand, in the web between the first finger and thumb - you can try doing acupressure on this point by finding a tender point in that muscle and holding pressure on it. If the headache is on the sides of the head, behind the eyes, wrapping around the whole head, at the base of the skull / top of the neck, or at the top of the head, the points will be different, often on the hands and feet.


Contrast Hydrotherapy

While I'm on a roll of general treatments that help most headaches, another old naturopathic remedy is a process called contrast hydrotherapy. For headache treatments you will need a basin of hot water and a basin of ice water. The name of the game is contrast. For migraines you would try putting your feet in the hot water while putting a washcloth that had been dipped in the ice water on the back of the neck. If that doesn't work, switch the hot and cold applications (feet in ice water, hot cloth on neck). For tension headaches you can try this same approach, or you may try alternating hot and cold cloths on the back of the neck. Contrast hydrotherapy is surprisingly effective.


Now, moving on to addressing specific types of headaches.


Classic tension headaches

Tension headaches are caused by tight muscles pulling on the connective tissue around the skull and brain. Muscles can be tight from emotional stress, poor posture, repetitive motion injuries, or joint misalignment in the neck or upper back. Some people even get tight muscles and headaches from cold wind (air conditioner vent blowing on your head). TMJ, clenching / grinding teeth, mild whiplash can all cause muscle tightness that is intense enough to cause tension headaches.


Tension headaches often begin in the upper neck and shoulders or at the base of the skull. Sometimes (as in the case of TMJ) they may start in the jaw or temple. The pain is generally dull and achy.


Treatment options

In addition to acupuncture and hydrotherapy, the most direct way to address tension headaches is to take steps to relax the tight muscles causing the tension headache. Massage therapy, stretching, and yoga are all options. If joints are misaligned or if muscle tension is chronic you may want to consider the addition of chiropractic care, or bodywork / physical therapy specialists that offer advanced muscle and joint release approaches such as Muscle Energy Technique.


Supplements that can help relax muscles

  • Magnesium citrate, glycinate or malate

  • Potassium

  • Herbs such as Valerian, Kava, Turmeric, Ginger and White Willow bark


Eye strain or eye pressure

The headache caused by eye strain is also due to tight muscles, but in this case the muscles are in and around your eyes. Eye strain can be caused by too much time staring at a computer screen or reading anything at a fixed distance. More commonly eye strain happens when eyeglass or contact prescriptions are not quite right. Headaches due to eye strain can often be resolved by resting your eyes. If you have a corrective lens prescription it is important to have your eyes checked to see if you need a new RX. Beyond that, eye strain headaches can be treated in the same way as both tension headaches and migraine headaches.


Sinus headache

Next is the ever-popular sinus headache. Here in central Texas, allergies are a way of life. For some of us, allergies lead to sinus congestion and even sinus infections. Pressure in the sinuses from severe congestion or infection can cause a headache under the cheekbones or in the front of the forehead. If accompanied by a fever the congestion may have moved into an infection.

The main focus for resolving a sinus headache is to drain the sinus congestion, and address infection if it is present. Preventing sinus headaches often requires reducing the symptoms of allergies.


Once again, acupuncture is my favorite and fastest tool for getting the sinuses to open up and drain. Depending on the shape of the sinuses, some people find Neti Pot flushes very helpful, however, if the sinus congestion is already consolidated, the liquid from the Neti pot often cannot penetrate the more solid mucus.


There are several herb formulas that can help open the sinuses. They often have aromatic herbs, N-acetyl cystiene and sometimes also herbs that help reduce allergies. Chinese medicine has several classic herb formulas for sinus headaches depending on their presentation.

In my clinical experience, herbs have about as much chance of resolving a sinus infection as antibiotics. The nice thing is that if the antibiotics fail the herbs usually work, and vice versa.


If it is just allergic congestion and has not progressed to an infection yet, then consider supplements focused on lowering your overall allergic response as well as supplements that help keep mucus thin so that it does not get stuck. The amino acid NAC (N-acetyl cystiene) is great for thinning out mucus. It also helps support healthy immune and inflammatory function.

  • Stinging nettle

  • Quercitin

  • Perilla

  • Bromelain

  • Vitamin C

  • Vitamin B5


Migraine

Migraine headaches are caused by a disruption of the normal mechanisms that regulate blood flow in the brain and surrounding tissues. The classic migraine aura is caused by inappropriate constriction of blood vessels. This triggers an increase in sympathetic nervous system activity which then increases blood flow too much which causes pressure and pain.


Classic triggers include

  • Foods that are high in histamine such as: Red wine, chocolate, aged cheeses or meats

  • Food additives such as aspartame or MSG

  • Stress or lack of sleep

  • Fluctuations in estrogen


Treatment options

Once again, my favorite treatment is Acupuncture, which can be helpful for calming a migraine that is in progress as well as lessening the frequency and severity of migraines over time.


Classic herb combinations that are very effective include:

  • Feverfew

  • Butterbur

  • Ginger


Nutritional supplements that are often helpful:

  • Magnesium

  • Riboflavin (B-2)

  • 5HTP (a serotonin precursor)


Additionally, herb/nutrient combinations designed to lower histamine may also be helpful:

  • Quercetin

  • Nettles

  • Bromelain

  • Vitamin C

  • Pantothenic Acid (B-5)

Danger Zone: When a headache is not just a headache

  • Whiplash or head injuries - even head injuries that seem mild, or just involve "acceleration / deceleration" scenarios can cause significant micro trauma to the delicate tissues of the brain. Sometimes this damage is not apparent until years or even decades have passed. Any head injury should be taken seriously. Aggressive use of antioxidants and anti-inflammatories is important (Turmeric and NAC in particular). Again, acupuncture can help reduce both acute and chronic inflammation in the brain or spine.

  • Sudden onset, severe headache (worst headache ever had) - this is an ominous sign of a potential brain hemorrhage and should prompt an immediate trip to the emergency room.

  • Rapidly worsening headache that happens with a fever and stiff neck is a classic sign of meningitis and should prompt urgent or emergency care.

  • Gradual, subtle onset, that slowly gets worse over weeks to months and never quite goes away, and is always in the same spot. Pain is steady, deep and dull, and is especially concerning if new neurological symptoms show up (isolated, unilateral numbness, tingling, or motor problems). A headache that presents like this could be a brain tumor and should be evaluated as soon as possible.

  • Should you experience any of the above scenarios, please seek medical care quickly.

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