HEADLINES
A Publication of the East
Bay Headache Support Group
A member of the
American Council for Headache Education (ACHE) support group network
Volume 6, Issue 3
May 2001
May 8th Meeting: CranioSacral Therapy— Can It Help My Headaches?
The East Bay Headache Support Group is pleased to welcome Shamahl A. Nolan as guest speaker for its May meeting. Shamahl has practiced Massage Therapy since 1994, and in 1996 she began working as a CranioSacral Therapist. Her presentation will include an explanation of CranioSacral Therapy, a form of non-traditional medicine founded by Dr. John Upledger in the 1980’s. She will explain what it is and how it works to alleviate headaches; and Shamahl will also demonstrate CranioSacral Therapy on volunteer audience members.
Our last meeting, March 13, featured a most informative and lively talk by Dr. Jonathan Humphrey, a family practitioner in Danville. Dr. Humphrey spoke to the support group about his experiences in treating patients who complain of headaches. His theory about migraine is that it is an overloading process. The brain processes incoming stimuli, and when the body is overloaded, everybody gets something—some get migraines, others have diarrhea, or insomnia, or... He talked about the migraine syndrome, triggers, and preventive and abortive
medications, and then answered questions from the audience. Dr. Humphrey stressed that we must be positive and explore all the avenues, and never give up in our quest to overcome our headaches. If you missed the meeting, notes of Dr. Humphrey’s presentation were taken and will be available on May 8 and at future meetings for a suggested donation of $2.00.
For 2 years, Jim suffered the excruciating pain of cluster headaches. Night after night he paced the floor, the pain driving him to constant motion. He was only 48 years old when the clusters forced him to quit his job as a systems analyst. One year later, his headaches are controlled. The credit for Jim’s recovery belongs to the medical staff of a headache clinic. Physicians there applied the latest research findings on headache, and prescribed for Jim a combination of new drugs.
Joan was a victim of frequent migraine. Her headaches lasted 2 days. Nauseous and weak, she stayed in the dark until each attack was over. Today, although migraine still interferes with her life, she has fewer attacks and less severe headaches than before. A specialist prescribed an antimigraine program for Joan that included improved drug therapy, a new diet, and relaxation training.
An avid reader, Peggy couldn’t put down the new mystery thriller. After 4 hours of reading slumped in bed, she knew she had overdone it. Her tensed head and neck muscles felt as if they were being squeezed between two giant hands. But for Peggy, the muscle-contraction headache and neck pain were soon relieved by a hot shower and aspirin.
An estimated 45 million Americans experience chronic headaches. For at least half of these people, the problem is severe and sometimes disabling. It can also be costly: headache sufferers make over 8 million visits a year to doctors’ offices. Migraine victims alone lose over 157 million workdays because of headache pain.
What hurts when you have a headache? Several areas of the head can hurt, including a network of nerves which extends over the scalp and certain nerves in the face, mouth, and throat. Also sensitive to pain, because they contain delicate nerve fibers, are the muscles of the head and blood vessels found along the surface and at the base of the brain. The bones of the skull and tissues of the brain itself, however, never hurt, because they lack pain-sensitive nerve fibers.
The ends of these pain-sensitive nerves, called nociceptors, can be stimulated by stress, muscular tension, dilated blood vessels, and other triggers of headache. Once stimulated, a nociceptor sends a message up the length of the nerve fiber to the nerve cells in the brain, signaling that a part of the body hurts. The message is determined by the location of the nociceptor. A person who suddenly realizes "My toe hurts," is responding to nociceptors in the foot that have been stimulated by the stubbing of a toe.
Diagnosing a headache is like playing Twenty Questions. Experts agree that a detailed question-and-answer session with a patient can often produce enough information for a diagnosis. Many types of headaches have clear-cut symptoms which fall into an easily recognizable pattern.
Patients may be asked: How often do you have headaches? Where is the pain? How long do the headaches last? When did you first develop headaches? The patient’s sleep habits and family and work situations may also be probed.
Most physicians will also obtain a full medical history from the patient, inquiring about past head trauma or surgery, eye strain, sinus problems, dental problems, difficulties with opening and closing of the jaw, and the use of medications. This may be enough to suggest strongly that the patient has migraine or cluster headaches. A blood test may be ordered to screen for thyroid disease, anemia, or infections which might cause a headache. A complete and careful physical and neurological examination will exclude many possibilities and the suspicion of aneurysm, meningitis, or certain brain tumors. X-rays may be taken to rule out the possibility of a brain tumor or blood clot.
A test called an electroencephalogram (EEG) may be given to measure brain activity. EEG’s can indicate a malfunction in the brain, but they cannot usually pinpoint a problem that might be causing a headache. A physician may suggest that a patient with unusual head-aches undergo a computed tomographic (CT) scan and/or magnetic resonance imaging (MRI). The CT scan produces images of the brain that show structures or variations in the density of different types of tissue. The scan enables the physician to distinguish, for example, between a bleeding blood vessel in the brain and a brain tumor, and is an important diagnostic tool in cases of head-ache associated with brain lesions or other serious disease. MRI uses magnetic fields and radio waves to produce an image that provides information about the structure and biochemistry of the brain.
An eye exam is usually performed to check for weakness in the eye muscle or unequal pupil size. If an aneurysm—an abnormal ballooning of a blood vessel—is suspected, a physician may order a CT scan to examine for blood and then an angiogram. In this test, a special fluid which can be seen on an X-ray is injected into the patient and carried in the bloodstream to the brain to reveal any abnormalities in the blood vessels there.
Thermography, an experimental technique for diagnosing headache, promises to become a useful clinical tool. In thermography, an infrared camera converts skin temperature into a color picture or thermogram with different degrees of heat appearing as different colors. Skin temperature is affected primarily by blood flow. Research scientists have found that thermograms of headache patients show strikingly different heat patterns from those of people who never or rarely get headaches.
A physician analyzes the results of all these diagnostic tests along with a patient’s medical history and examination in order to arrive at a diagnosis. Headaches are diagnosed as:
Vascular, Muscle Contraction (tension), Traction, Inflammatory
Vascular headaches—a group that includes the well-known migraine—are so named because they are thought to involve abnormal function of the brain’s blood vessels or vascular system. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Some people have more than one type of headache.
Excerpted from the Web site of the National Institute of Neurological Disorders and Stroke (NINDS).
Thank You To Our Supporters!
An amazing number of you responded to our request last November for corrected mailing addresses, ideas for meeting topics, and especially, donations. The Planning Committee of the East Bay Head-ache Support Group thanks you for your generous support.
Your donations, combined with donations and grants from Glaxo Wellcome Inc., Merck & Co., Novartis Pharmaceuticals, AstraZeneca Pharmaceuticals, and Travelers Insurance, have supported the following:
• The East Bay Headache Support Group has held many (56 and counting!) public educational meetings since its inception in January 1996. Thanks to John Muir Medical Center for providing a great place to meet!
• The group’s newsletters and meeting notes are made available to the public on our Web site, which enables us to reach headache sufferers outside of the San Francisco Bay Area. Thanks to Kinko’s for discounted copy services!
• The Planning Committee has created a colorful brochure (and business card) to inform other headache sufferers about the support group’s existence. If you can help distribute brochures to physicians’ offices, pharmacies, schools, etc., please contact Leslie Davis at 925-228-1084.
• In other efforts to reach more headache sufferers, we have placed a small advertisement in the April 28 issue of the Contra Costa Times.
And committee members now have Web
decals on their cars advertising the group’s Web site (at their own expense).
If you would like to sport one on the back window of your car (they’re static
cling and completely harmless and removable), Leslie Davis will order one for
you. Cost is $15.00 each, plus postage. White 1" letters read: www.HeadacheSupport.org
Personal Profile By C. Bartlett
I had my first problem headaches when I was twenty. It was a stressful time and my first sporadic headaches developed into daily headaches which I treated with Excedrin. Soon I was taking 6 to 8 pills a day. I had never heard of "rebound headaches"—few people had in the 1960’s—and if anyone had told me the Excedrin might be the cause of my headaches I would not have believed them.
Over the next 7 years I tried various treatments: physical therapy, group therapy, psychological counseling, biofeedback (a very early form), chiropractic, hypnotism and acupuncture. I took Fiorinal, Valium, Librium and birth control pills. In all that time I never met or heard of anyone who had my kind of headache. I felt very alone.
Nothing helped until I got pregnant—in
my fourth month, the headaches disappeared and did not return after my son was
born.
My luck held for the next 19 years, until I started taking birth control pills
again to treat menopausal symptoms. The headaches returned and did not cease
when I discontinued the birth control pills some months later. Again, I started
taking Excedrin. (My previous cure was not an option at the age of 46!)
But this was the nineties and the advent of sumatriptan and other migraine medicines. When I heard a headache specialist on a talk show mention "chronic daily headache" and realized that my condition had a name, I was relieved—if it had a name it could be treated. I made an appointment with Dr. Stein.
Over the last few years Dr. Stein has worked with me to find the right combination of medicines to let me manage my headaches. I know they may never be "cured," but the Elavil and Depakote I take daily have greatly reduced their intensity and frequency. That, along with some less traditional therapies like massage, Tai Chi and biofeedback, and the East Bay Headache Support Group meetings, have helped me to feel a lot more in control and optimistic.
The intention of the East Bay Headache Support Group and Headlines newsletter is to provide information and resources. It does not provide medical advice, which should be obtained from a physician.