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Headache: causes and treatment

This text complies with the specifications of medical literature, medical guidelines and current studies and has been reviewed by medical doctors and physicians.

R51 ICD codes are internationally valid codes for medical diagnoses. They are found e.g. in medical reports or on incapacity certificates.

What helps against headaches?

One of the most common forms of human pain is headache. Headache, also referred to as cephalgia, may be primary, i. as a separate 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 migraine and tension-type headaches and are chronic. The remaining ten percent occur secondarily, for example as a concomitant in hypertension or diabetes. Temporarily headache can also occur as “hangover headache” after excessive alcohol and tobacco consumption, weather sensitivity or as a concomitant of colds. Recurrent and very severe acute pain should always be carefully examined and diagnosed.

diagnosis

Headache can be acute or chronic, skull, face, upper cervical spine and associated with concomitant symptoms. Course, localization and pain character, 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, who then, depending on the therapeutic orientation, can purposefully and individually develop a therapy plan. If a clear diagnosis can not be made, further examinations, e.g. Shooting the brain, giving information about the cause.

Pain Place: Where does it hurt?

The pain initially varies in the location of the pain. This can occur on one or both sides, affecting the forehead, temples or back of the head, it can travel, radiate or be limited to one point. For example, sufferers often describe headaches that radiate in the back of the head, which may be important for the treatment. In terms of body language, the affected persons intuitively point very precisely to the painful areas by holding painful areas or tracing the course of pain with their fingers. This important information can be used therapeutically effectively. Thus, the treatment according to the fascia-distorsion model (FDM) is based exclusively on body language instructions by the person concerned.

Brain functioning and headache trigger. Picture: Picture dwarf / fotolia

Painful character: how does it hurt?

The complaints are perceived as strong, moderate, or mild, and further qualitatively described as bright, dull, piercing, oppressive, throbbing, hammering, or tugging. For one thing, these descriptions can sometimes give an indication of the cause. However, such individual feelings come to bear above all in certain forms of treatment, for example in the aforementioned FDM, imaginative procedures and hypnotherapy, where work is also carried out with the pictures of those affected.

Pain trigger: When does it hurt?

Indications of the onset of pain can be obtained by frequency and situation. Are there regularities in onset, do the pain begin under stress, after exertion, or do you experience it at the weekend or during periods of relaxation? Can a connection with food, occupation or even persons be ascertained? Are there other special triggers, such as touching, sleeping with the windows closed, or lying in a certain position? Not infrequently, chronic headaches are also psychogenic. Emotional burdens resulting from the occupational situation or interpersonal relationships can therefore play an important role in choosing the optimal therapy.

Forms of headache

The medical literature classifies various forms of headache according to common triggers, processes, causes, major and concomitant symptoms. In practice, these descriptions are of course supplemented by individually experienced sensations and observations of the affected people and sometimes can be made due to the individual expression no assignment. In Naturopathy, these divisions are also taken into account, but there are in principle further hypotheses on the causes in question, so that in addition to the conventional therapy of the symptoms of alternative treatment approaches to restore the physiological self-organization of the organism exist and are further developed.

Headache: causes

The following are the most common forms of primary pain in and around the head and some disorders that may be secondary to (secondary) headache.

Migraine (Hemicrania)

With migraine one calls attack-like pains, which occur mostly unilaterally (hemi = half, cranium = head) and which are often described in their quality as pulsating, piercing or throbbing. Migraine attacks occur i.d.R. periodically and can last from hours to days (4-72 hours). Accompanying symptoms include nausea and vomiting, sensitivity to light and noise. Many people have to wait for the attack lying in the darkened room. The migraine can also occur with a so-called aura, which may be accompanied by transient visual phenomena (flashes of light, flicker) and neurological deficits (hemiplegia, aphasia). The causes of migraine are still largely unknown. The trigger for a migraine attack is often called psychic stress and disturbances of the sleep-wake cycle, but also the consumption of certain foods and stimulants, e.g. of alcohol, chocolate and cheese. Migraine attacks can already occur in childhood, as in older people, even in children, the attacks of shorter duration. Women are more frequently affected by migraine than men.

Often there is a migraine behind a headache. (Henrie / fotolia)

Tension headache

Chronic tension-type headache is diagnosed almost as frequently as migraine. However, in contrast to this, chronic or recurring tension-type headache is described predominantly as diffuse, dull pain throughout the head. It is also referred to as vegetative-vasomotor headache, which means that dysregulation of the autonomic nervous system leads to narrowing of the blood vessels in the head, which then causes the pain. Stress, neck tension, climatic factors, lack of sleep, smoking and alcohol consumption are repeatedly mentioned as the trigger. The pain is usually isolated, i. without accompanying symptoms such as nausea or vomiting. In particular, women are often affected by a combination of migraine and tension-type headache according to the symptom description, so that relationships between the two types of headache are discussed.

Headache and spine

The nerve, which usually causes 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 disconnected by a high voltage. In chiropractic, it is assumed, among other things, that blockages of the first or second cervical vertebra can affect the nerve and trigger pain. The unfavorable stress conditions around and around the cervical spine are pushed to old injuries, e.g. by car accidents with whiplash and unfavorable permanent forward-sliding of the head in the context of video work.

Cluster headache (Bing-Horton syndrome)

The cluster headache occurs repeatedly, adversely and acutely. The pain is very intense and sometimes perceived as unbearable. In most cases, pain episodes are replaced by pain-free intervals that can last for months. The headache is usually described as a constant one-sided, with forehead and temple pain dominate. Most of the time, the affected people awaken at night at the same time with violent attacks of pain that last 30 to 120 minutes and can recur two to seven times during the day. cluster = Group, accumulation). Accompanying symptoms include increased lacrimation, runny nose, swelling of the nasal mucosa, a drooping lid, and reddened conjunctivae (reddening of the eyes). Typical is the avoidance of reclining positions. The causes of cluster headache are unknown, triggering nicotine and alcohol intake as well as histamine injections.

Compared to migraine, cluster headache is much rarer and occurs more frequently in men between the ages of 20 and 30 years. Even children and the elderly can be affected. A similar symptom is also seen in the Sunct syndrome, in which, however, the attacks with stinging, pulsating pain has 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 pains appear in a flash and persist for a few seconds at one point. The attacks can occur up to one hundred times a day. Many sufferers develop depression, often associated with suicidality, in response to recurring attacks of piercing, devastating pain.
Triggered are the pain attacks that affect the 2nd and 3rd branch of the trigeminal nerve, sometimes by touching trigger points or while chewing, swallowing and speaking. The causes are unclear, neural short circuits between tactile and pain-conducting fibers are suspected. Rarely, there is a mechanical irritation of the nerve root by a tumor, aneurysm or similar. Women are affected more often, especially from the age of 50 years.

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Headache as a disease symptom

When the symptoms appear as a symptom of an existing underlying disease or other known causes (injury, medication), there is talk of secondary headache.

High-grade headache, for example, occurs in cerebral hemorrhages, cerebral infarction, cerebral venous thrombosis, but also in intracranial pressure due to rapidly growing brain tumors or inflammation of the brain’s membranes (for example in TBE). Often it comes sooner or later to dysregulations.
In case of traumatic complaints caused by concussion, sphincter or cranial cerebral trauma, nausea and vomiting as well as a stiff neck can often be found. If headaches occur even years after a concussion, and if there is no organic finding, this may possibly be a psychic mishandling of the trauma suffered.

Paradoxically, the regular use of painkillers over a longer period of time may in turn lead to persistent headache. Likewise, sleeping pills and hormonal contraceptives (“contraceptive pills”) are considered as potential causative agents. Internal poisoning leading to headaches is often due to kidney and liver disease, gastritis or chronic constipation. This leaves toxins in the body, which is restricted in healthy function of the diverting organs. Likewise, metabolic diseases such as diabetes mellitus or hyperthyroidism can be associated with headache (metabolic headache).

Pain in the face area and cheek pain can u.a. to a glaucoma case, colds with colds, sinusitis and sinusitis, tumors, dental diseases, eye disorders, multiple sclerosis (bilateral) but also zoster neuralgia.

Headache continues to be associated with hypotension and hypertension, pheochromocytoma and spinal cord fluid puncture. They are also a symptom of climacteric, premenstrual and depressive syndrome and severe cough.

Headaches can occur in many different forms and at any age. (Image: sebra / fotolia.com)

Conventional therapy of headache

Conventional therapy depends on the diagnosis made. Almost always, the therapy with painkillers in the foreground. The treatment of migraine consists on the one hand in the medical relief of symptoms in an acute attack with analgesic, vasoconstrictive and nausea-reducing drugs. For lesser ailments Ibuprofen, acetylsalicylic acid or paracetamol are recommended, which are available free in the pharmacy and are also used for tension headaches. In severe migraine attacks doctors prescribe triptans, ergotamines and additionally antiemetics (medicines for nausea). For the prophylaxis and reduction of seizure frequency betablockers, antiepileptics and calcium antagonists are administered between the attacks. The cluster headache is interrupted in an acute attack 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 analgesics, especially in case of severe headaches, is understandable, unpleasant side effects and drug dependence repeatedly raise the question of alternative forms of treatment. Here are some general and specific approaches and procedures from naturopathy and alternative medicine are presented, with which the complaints can be treated professionally. For the self-treatment of minor ailments are also numerous home remedies for headaches from naturopathy, especially herbal medicine, available.

General Naturopathy

In general naturopathy one makes a slagging of the tissue (with) responsible for the development of chronic headaches. As a means of choice is recommended not only by Prof. Brauchle in “The Great Book of Naturopathy” from 1957 introductory a fasting with juice or a raw food cure for “emptying the slag storage”, which then flows into a converted diet. This should contain a high proportion of vegetables, so preferably be low in meat, full and varied. On white flour, industrial sugar, alcohol, caffeine, finished products and dishes with preservatives and flavor enhancers should be dispensed with as well as too much salt, citrus fruits and artificial sweeteners.

Digestive disorders and food allergies or food intolerances, which are suspected of a deficient colonization of the intestinal flora with leaky-gut syndrome, play an important role in the study in naturopathy, which is reflected in many therapeutic approaches. If there are also circulatory disorders and cold feet are a constant accompanying symptom, then according to Brauchle (see above), the coldness of the feet must first be eliminated, since “nervous […] effects from the feet run to the head”. Serve for example Replacement footbaths and herbal finished medicines.
In case of tensions and indurations in the neck area, healing processes should also be stimulated locally and reflexively via Schröpfreflexzonen by bloodless cupping or large-scale cupping massage. Furthermore, in chronic headache, a climate change, e.g. in the wooded low mountain range, as well as outdoor exercise and Kneipp treatments recommended. These include daily cold washes, water treads and lower leg casts. Especially with vegetative-vasomotor tension headaches, this form of “vascular training” makes sense.

Headache in Hildegard medicine

In the Hildegard medicine a disharmony of the natural humors by the propagation of illness juices is made responsible for the development of illness. In the case of headaches, five causes are known from Hildegard medicine, which can cause an excessive release of black bile and thereby trigger the symptoms. These include febrile and cold infections, metabolic disorders, dietary errors, e.g. the four Hildegard’s kitchen poisons, raw food and pear juice; accidents, unfavorable life and work with stress and worry.

Especially in migraine in the Hildegard practice Hildegard cupping and the Hildegard bloodletting are applied, which is the poor mixture of body fluids (dyscrasia), which is caused by regulatory disorders of metabolism and endocrine system, should be eliminated.

Homeopathy for headache

From homeopathy, numerous remedies are known that can be effective in headache. A detailed history of a homeopath is therefore advised, especially because in chronic pain and the development of symptoms plays a role. The remedy is also administered as a high potency in the professional homeopathic practice, so that profound change, not only on a physical level, can occur. In the case of mild, acute complaints, self-treatment is recommended for proven remedies, usually as mother tincture or in potencies D4, D6 and D12. This includes Belladonna (Belladonna), v.a. with throbbing flu headache, as well as Bryonia (turnip), when bitter taste persists in the mouth, when movement is avoided and a quiet room is demanded. Bursting, pulsating pain in the head should be able to meet with Melilotus officinalis (stone clover). Secondary headaches are also detected with the appropriate homeopathic remedy, e.g. when the pain is in the context of menstrual pain. In addition to the classic individual remedies, there are today various homeopathic complex remedies for external and internal use and for injection (by naturopath or doctor).

Hypnotherapy for headache

Hypnosis can be used in different forms of headache. Work is done with relaxation exercises and pain communication, with healing images and symbolizations. By giving the pain a form (form, color, etc.), it can be concretized and then possibly changed. One aspect that plays a major role is the lack of perception of body signals resulting from repeated over-demand situations (of various kinds). In many cases, the natural rhythm of tension and relaxation in people with chronic headache is disturbed, which can lead to a permanent dysregulation of muscle tension in tension pain. In migraine sufferers fall in this context, the strong mood changes before and after the seizure. As with working with biofeedback devices, ways of reacting (learning) that positively affect pain should be (re) learned. Other effective measures that can also be used in addition to hypnotherapy are progressive muscle relaxation or regularly practiced yoga.

There are several scientific studies, e.g. a 2002 published study by Faran (“Pharmacological and Psychological Approaches of Migraine Treatment”), were compared in the drug or hypnotherapeutic treatment courses in migraineurs. It could u.a. a significant reduction in the frequency and duration of migraine attacks and the subjective pain are recorded.

Manual therapy for headache: osteopathy

Osteopathy and Rolfing regard the whole body as relevant for diagnosis and treatment. There is a fairly common connection to the temporomandibular joint due to increased oral closure tension, asymmetry and other factors.

Also pelvic obliquities or strengths in the thoracic spine are used, for example, for better function and to compensate for the stress conditions on the head. Anatomical models are irrelevant in the Fascial Distortion Model (FDM). Ultimately, the patient’s statements and body gestures determine diagnosis and treatment.

The pulling pain over the head is also treated by thumb tracing – the burning burning pains are seen as twists of the galea aponeurotica, a rough connective tissue plate on the head. Selective headaches are seen as disturbances in the bony soft tissue junction (called continuum distorsions) that need to be treated with heavy thumb pressure. Large-area headaches are seen as a twisting of the superficial fascia and are usually treated by pulling on the hair diagonally above. (Jvs)

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