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| Headaches, Migraine/Tension |
Last updated: Nov 19, 2009 |
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Headaches, Migraine/Tension |
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Signs, symptoms and indicators | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations
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Headaches are commonly classified under categories such as tension, sinus, migraine, menstrual and cluster among others. Many researchers and doctors are no longer drawing distinct lines between tension and migraine headaches. They may only be different degrees of the same disorder, tension headaches being less severe than migraines. Headaches have been difficult to study for several reasons and continue to be misunderstood and mistreated.
Although a headache may be associated with a serious medical condition, most headaches are not serious, even when debilitating. Headaches can be caused by a wide variety of factors, but the overwhelming majority are of the tension/migraine type. Headaches which may be more serious are those that: - occur while pregnant
- occur after exposure to a potentially toxic substance
- occur after injury to the head
- occur while taking a new medication
- occur while experiencing other serious symptoms such as a fever, stiff neck, vomiting, vision changes, tingling sensations or speech difficulties
- are different from headaches you have had in the past or are very severe and come on very suddenly.
Differences between Tension and Migraine Headaches
For years, tension headaches were believed to be caused by muscle contraction due to stress. However, the muscle changes may occur in response to the pain and not be the cause of the headache. Similarly, in migraines, blood vessel changes can follow the onset of pain and not cause it.
Tension headaches usually have a steady, constant, dull pain that may start at the back of the head or in the forehead and then spreads over the entire head, giving the sensation of pressure or a vise grip applied to the skull. The tension headache is usually present on both sides of the head. These headaches can occur every day and are normally more severe in the evenings. Tension headaches are experienced when an individual is under stress.
The more intense headaches, called migraines, are characterized by a throbbing or pounding sharp pain. The additional symptoms such as nausea, visual auras and dizziness occur simply because the headaches are more severe. Migraines are usually experienced after stressful periods have ended and the body is attempting to repair and detoxify.
Basilar Artery Migraine (BAM) is a variant on the theme of the migraine. It is a rare form of migraine, accounting for somewhere between 1 in 400 and 1 in 500 of all clinically diagnosed migraine cases. BAM belongs in the category of "episodic headaches of uncertain mechanism." This grouping includes the migraine, cluster headache, and acute cerebral vascular insufficiency. Further information about this type of headache can be found at Karyn S. Huntting's Web Site.
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 Signs, symptoms & indicators of Headaches, Migraine/Tension: | | | | | | Symptoms - Metabolic |  Afternoon headaches
 Menstrual headaches | Up to 25% of women have migraine during their reproductive years, with an average prevalence of 16% (11% without aura and 5% with aura). In 60-70% of cases in women, the headaches are related to the menstrual cycle. Attacks that occur exclusively with menses, called "true menstrual migraine", affect about 14% of sufferers. Some researchers have suggested that migraines occurring on a regular basis between days -2 and +3 of the menstrual cycle be considered menstrual migraines; premenstrual migraines occurring between days -7 to -3. |
Temple-based/rear-of-head/ocular/front-of-head headaches |
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Risk factors for Headaches, Migraine/Tension: | | | | | | Allergy | Allergy / Intolerance to Foods (Hidden)
Environmental Illness / MCS| | Central nervous system dysfunction is common, resulting in headaches, chronic fatigue, poor short term memory, hyperactivity, and increased appetite leading to food cravings and overeating. |
Allergic Tension Fatigue Syndrome |
Autoimmune |
Lupus, SLE (Systemic Lupus Erythromatosis)| | Vascular or migraine headaches occur in 10% of lupus patients. |
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Circulation |
Anemia (Iron deficiency) |
Diet |
Dehydration |
Environment / Toxicity |
Gulf War Illness |
Hormones |
Hyperprolactinemia
Low Estrogen Levels| | Women must first be exposed to elevated estrogen levels before low estrogen levels will trigger headache activity. Constant low levels of estrogen, as in menopause, are less likely to be associated with increased headache pattern. |
Low Serotonin Level
Low Adrenal Function / Adrenal Insufficiency |
Infections |
Lyme Disease |
Mental |
Stress |
Metabolic |
Hypoglycemia| | Although hypoglycemia may precipitate headache in some diabetic and nondiabetic patients, it is not a universal mechanism responsible for headache in those individuals or in normal fasting subjects. |
Aspartame Intolerance| | Double-blind studies have demonstrated that aspartame causes headaches. [Headache 1988:28(1) pp.10-14, Biological Psychiatry 1993:34(1) pp.13-17, Neurology 1994:44 pp.1787-93.] |
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Nutrients |
Vitamin A Toxicity |
Organ Health |
Liver Detoxification / Support Requirement| | A 'sluggish liver' often contributes to headaches. |
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Skin-Hair-Nails |
Rosacea |
Symptoms - Metabolic |
History of migraine headaches |
Uro-Genital |
Premenstrual Syndrome PMS C (Craving) |
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Headaches, Migraine/Tension suggests the following may be present:
Headaches, Migraine/Tension can lead to: | | | | | | Risks | Counter-indicators:
 Increased Risk of Breast Cancer| | Women who suffer from migraines may take at least some comfort in a recent, first-of-its-kind study that suggests a history of such headaches is associated with a significantly lower risk of breast cancer. Christopher I. Li, M.D., Ph.D., and colleagues at Fred Hutchinson Cancer Research Center report these findings in the November issue of Cancer Epidemiology, Biomarkers and Prevention.
"We found that, overall, women who had a history of migraines had a 30 percent lower risk of breast cancer compared to women who did not have a history of such headaches," said Li, a breast-cancer epidemiologist and associate member of the Hutchinson Center's Public Health Sciences Division.
In particular, migraine history appeared to reduce the risk of the most common subtypes of breast cancer: those that are estrogen-receptor and/or progesterone-receptor positive. Such tumors have estrogen and/or progesterone receptors, or docking sites, on the surface of their cells, which makes them more responsive to hormone-blocking drugs than tumors that lack such receptors.
The biological mechanism behind the association between migraines and breast cancer is not fully known, but Li and colleagues suspect that it has to do with fluctuations in levels of circulating hormones. |
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Recommendations for Headaches, Migraine/Tension: | | | | | | Amino Acid / Protein |  Tyrosine
Tyramine-containing Foods Avoidance| | Tyramine-containing foods are responsible for migraines in 15% of sufferers. If you have observed a sensitivity to such foods, you should try a tyramine-free diet for a short time. If headaches resolve, reintroduce foods high in tyramine. If headaches recur, you may be able to control your headaches by avoiding these foods; if not, you may be allergic to other foods. |
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Botanical |
 Coffee (Coffea genus)| | Researchers at the Diamond Headache Clinic in Chicago, Illinois have found that caffeine may make your headache feel better. Already an ingredient in some over-the-counter headache medications, caffeine may do more than speed the other
ingredients through your system to alleviate your headache faster. Caffeine, given by itself, was given to headache sufferers. The result was that 58% said it was completely successful; the same number reported ibuprofen alone was completely successful. Many said that they felt better, faster taking just the caffeine. When standard painkillers were
combined with caffeine, 70% of patients reported complete relief.
Caffeine does, of course, have a down side. It is a stimulant and some studies have actually found that high caffeine consumption is linked with suffering from more headaches, perpetuation of the headache cycle and a temporary rise in blood pressure. |
Coffee Enema| | A coffee enema will sometimes stop and often prevent headaches associated with toxicity. |
Rhodiola rosea
Antiinflammatory Combination Products
Noni |
Diet |
 Processed Foods Avoidance| | Unhealthy practices such as drinking coffee and soft drinks, eating sweets and other nutritionless foods contribute to the problem. When migraine and tension headache patients are placed on low-protein, natural plant-based diets, with no refined sweets of any type, they often recover within a month, never needing medication or further treatments to control their condition. If improvement is not complete, other detoxification techniques should be employed. When diet change has not yet produced its full effect, the use of cold and pressure are usually the most effective and practical means to control the pain. |
Therapeutic Fasting| | It is believed by those specializing in detoxification that the major cause of both tension headaches and migraines is the retention of toxins or tissue irritants within the central nervous system. These chemical irritants may cause an oversensitivity of nerve tissues to other stimuli, resulting in headache. Drugs for relieving pain are rarely necessary if headache sufferers are allowed to fast and detoxify at the first sign of headache symptoms.
During periods when you are not ingesting harmful food substances or drugs, your body will often use that opportunity to detoxify, which may initiate another headache. This is the time when you must try to use non drug measures such as cold compresses, rest in a dark room, banding with Velcro, and biofeedback.
Headaches can also be caused and worsened by not eating. The reason is that not eating triggers withdrawal symptoms as the body begins to detoxify and get rid of retained toxins. Remember: For a short time you may feel bad so that for a long time you can feel good. Persistent severe headaches that do not respond within a few days of fasting should always be further evaluated by a physician. |
Sugars Avoidance / Reduction
Vegetarian/Vegan Diet| | When migraine and tension headache patients are placed on low-protein, natural plant-based diets, with no refined sweets of any type, they often recover within a month. |
Artificial Sweetener Avoidance
Histamine-Restricted Diet
MSG Avoidance| | Those prone to migraines should avoid MSG and everyone should avoid it in large doses. There is no question that very high doses of MSG can overwhelm brain defenses and cause neural damage. It is interesting that it is young children with immature nervous systems who are most susceptible to MSG damage, and not the elderly. |
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Drug |
Not recommended:
 Conventional Drugs / Information| | The regular and frequent use of conventional drugs should be avoided when possible. While pain killers may provide relief, they don’t deal with the cause of the problem. Pain medications, though apparently effective, may even aggravate the problems they attempt to solve. The use of medication, even in quantities as low as ten aspirin tablets per week, can be the cause of a chronic daily headache syndrome. One medical study found that stopping all treatments and pain medication actually decreased headache frequency and intensity in the subjects by more than 50%. The best thing to do when tolerable and circumstances allow is to avoid taking medication and assist the body's detoxification process. |
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Environmental |
Chemical Avoidance| | Airborne chemicals and fragrances are increasingly cited as a trigger for migraine headaches. Until the 20th century, perfumes were made from natural ingredients derived directly from plants and animals, and as fragrances became cheaper and more widespread, they also became more synthetic. Studies have shown that inhaling fragrances can cause circulatory changes and electrical activity in the brain. These changes can trigger migraine headaches, the inability to concentrate, dizziness, and fatigue. |
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Hormone |
Melatonin| | Three cases of idiopathic stabbing headache were reported in which melatonin (3 to 12mg at bedtime) was used successfully in their treatment. [Neurology 2003;61(6): pp.865-6] |
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Lab Tests/Rule-Outs |
Test for Food Allergies| | Food allergy may be a factor in as many as 80% of migraine sufferers. In one study of 60 patients, the average number of foods causing symptoms was 10 per patient. All patients improved when offending foods were eliminated and 85% became headache free. All 15 patients who had high blood pressure at start of study saw blood pressure return to normal. The following were most often implicated as a cause of migraine: cow's milk (30%); eggs (27%); chocolate (25%); oranges and wheat (24%); cheese and tomatoes (15%). Common food triggers of migraines were milk products, sweets, corn, beef, coffee and teas amongst others. While food allergies are an important factor in migraines, they play less of a role in tension type headaches. |
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Mineral |
Magnesium| | Several researchers have provided substantial links between low magnesium levels and both migraine and tension headaches, based on both theory and clinical observations. A magnesium deficiency is known to set the stage for the events that can cause a migraine attack or a tension headache. Low brain and tissue magnesium concentrations have been found in patients prone to migraines, indicating a need for supplementation. One of magnesium's key functions is to maintain the tone of the blood vessels.
Magnesium malate or other Krebs cycle chelates (citrate, fumarate, succinate, and alpha ketoglutarate) may be best. 600-1000mg of elemental magnesium per day in divided doses with meals may be required over a one to two month period.
Serum and urinary magnesium levels are only sometimes statistically lower in migraine sufferers than in controls. However, migraine sufferers retain more magnesium than controls when magnesium is given orally, indicating a more systemic deficiency [Headache 2002;42: pp.114-19]. Earlier studies have found reduced levels of magnesium in serum, saliva, red blood cells, mononuclear cells, lymphocytes, and cerebrospinal fluid in migraine patients. |
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Miscellaneous |
Reading List| | Headache Help by Lawrence Robbins, M.D. and Susan Lang. A Complete guide to understanding headaches and the medications that relieve them (Paperback). |
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Nutrient |
Meyer's
Essential Fatty Acids| | Omega 3 fatty acids can reduce the frequency and intensity of migraines. Two small double blind studies (using fish oil) demonstrated a high percentage of effectiveness. Supplementation should continue for longer than 3 weeks, which is the time it takes to change cell membrane composition with the new fatty acids.
However, another study using 6gm per day over 4 months for migraines showed no benefit over placebo. [Cephalalgia 2001;21(8): pp.818-822] |
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Oriental Medicine |
Acupuncture| | Subjects (400) were randomly chosen to receive either usual care (typically medication), or acupuncture treatments for a
period of one year. Those receiving acupuncture were restricted to a maximum of 12 treatments every three months
and also had the option of using medication in instances where the acupuncture failed. During the study period, each
subject kept a diary, rating the severity of headaches with a six-point scale.
When the diaries were analyzed, researchers found that, compared with the usual care group, those in the acupuncture
group had an average of 22 fewer days with a headache, and some had well over 30. Acupuncture patients also used 15% less medication, made 25% fewer visits to the doctor and had 15% fewer sick days off from work.
Based on these uniformly positive outcomes, the authors of the study concluded that acupuncture leads to "clinically
relevant benefits for primary care patients with chronic headache."[BMJ 1999;319: pp.973-976]
Researchers in Germany divided 270 patients with similar symptoms into three groups for a randomized, controlled trial. Over an eight-week period, one group was treated with full traditional acupuncture, one with minimal acupuncture, and one with neither method.
Headache rates dropped by almost half among those in the “traditional acupuncture” group. On average, they experienced 7 fewer days of headaches in the four weeks following the trial than they did in the four weeks preceding it. Those in the “minimal acupuncture group” fared almost as well, with an average drop of 6.6 days with headaches. The third group only saw an average drop of 1.5 days - just a tenth less than what they had experienced prior to the study.
The researchers concluded that acupuncture works as well or better for tension headaches than treatments already accepted. [British Medical Journal, July 29, 2005] |
Emotional Freedom Technique (EFT)| | Newcomers who use this simple process by themselves achieve relief 50% to 80% of the time and, in many cases, the relief is complete and permanent. More sophisticated uses by an EFT expert may be required for some migraine sufferers. |
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Physical Medicine |
Pressure| | Many individuals with migraine can obtain effective relief by simply applying an elastic band around the head, securing it with Velcro, and inserting rubber discs (or any available substitute such as a bottle cap) for added local pressure over the areas of maximum pain. A study utilizing a 2-inch elastic band approximately 25 inches long with Velcro at each end showed impressive results with this non-drug approach for relief. Firm rubber discs the thickness of a finger and a little over an inch in diameter were employed. Patients were instructed to place these discs under the elastic headband over the area of maximum pain. Almost every patient in the study reported benefit. Twenty-three patients used the band for a total of 69 headaches. Forty of the headaches were relieved by more than 80% and 15 additional headaches improved by more than 50%. |
Massage| | In a study of tension headaches, individuals were treated with either a combination of spinal manipulation and massage, or massage and a placebo laser treatment. Both groups experienced an improvement in symptoms suggesting that massage alone provides benefits for the treatment of tension headaches. |
Craniosacral Therapy (CST) |
Vitamins |
Vitamin B Complex
Vitamin B1 (Thiamine)| | Large doses of vitamin B1, along with the other B vitamins, have helped many suffering from headache pain. |
Vitamin Niacinamide
Vitamin B6 (Pyridoxine)| | One older study reported that L-tyrosine (200mg), vitamin B6 (2.5mg) and niacinamide (10mg) when given in combination for the treatment of hay fever, hives, allergic headaches and poison oak dermatitis produced significant symptomatic relief when 1-3 tablets were taken four times/day in milder cases and up to 6 tablets 4-6 times/day in more severe cases. In some cases characterized by more chronic disorders, such as chronic sinusitis, a worsening of symptoms often occurred during the first few days of treatment. This study found that treatment with each the nutrients individually, or with any two in combination, was ineffective. (Widmann RR, Keye JD Epinephrine precursors an control of allergy. Northwest Med 1952:51:588-590.) |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Strongly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended | | | May have adverse consequences |
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Few, save the poor, feel for the poor. 'The Poor' 