Tension Headaches Prevention

Although tension headaches cannot be cured, it is possible to prevent future episodes. There are a number of prevention options available.

Medications to prevent tension headaches
Many prescription and over-the-counter medications may be used to prevent tension headaches and stop their progression. Some medications that help reduce the frequency and severity of future tension headaches include:

Antidepressants. Normally prescribed to relieve mental depression, these drugs prevent tension headaches by stabilizing the levels serotonin and other brain chemicals. Commonly prescribed antidepressants include:

Tricyclic antidepressants. These include amitriptyline and nortriptyline. They are commonly used to prevent chronic and episodic tension headaches.

Selective serotonin reuptake inhibitors (SSRIs). Paroxetine, venlafaxine and fluoxetine are among these. This type of antidepressant is favorable because it often causes fewer side effects than tricyclic antidepressants, but they are usually less effective in preventing tension headaches.

While helpful, antidepressants are not without their risks. Antidepressants can increase the risk of suicidal thoughts and behavior in some people. The Food and Drug Administration (FDA) has issued an advisory that people being treated with these drugs should be closely monitored for unusual changes in behavior.

Nonsteroidal anti-inflammatory drugs (NSAIDs). While they are often used as acute therapy to stop the pain of an existing headache, daily use of NSAIDs may also manage chronic tension headache in many individuals.

Anticonvulsants. These include divalproex and gabapentin. Usually used to control seizures, these medications may also be prescribed to prevent tension headaches.

Muscle relaxants. Tizanidine is an example of a muscle relaxant. In some cases, muscle relaxants are recommended for the prevention of tension headaches.

If you have tension headaches with the features of a migraine, you may benefit from taking beta blockers or calcium channel blockers. These medications are typically used to lower blood pressure and reduce the workload of the heart. Calcium channel blockers also increase the flow of oxygen-rich blood to the heart. These drugs are commonly used to treat migraines, but they can be used alone or in combination with antidepressants to reduce the frequency of tension headaches.

In order for the medications to be effective, you need to take drugs used to reduce the frequency and severity of tension headaches at regular intervals. These medications are not for everyone. They may be right for you if you:

• Experience three or more headaches per week
• Do not find relief from acute or nondrug therapy
• Have headaches lasting longer than three or four hours
• Have severe pain that becomes disabling
• Have severe pain that causes overuse of acute medication

Cannot take acute medication because of unrelated medical conditions
Because preventive medication can take several weeks to build up in the nervous system and take effect, you might not notice improvement for a couple of months or more. Some women may require a combination of medications to achieve the greatest effectiveness.

Other methods to prevent tension headaches
In addition to taking medications, you might be able to reduce the frequency of tension headaches by avoiding factors that trigger them. Identify these triggers by keeping a headache diary for at least two months. To compile this diary, record certain information after each headache occurs, including:

• When the headache occurred
• How severe the headache was
• Where the headache was located
• How long the headache lasted
• What medications you took
• What events occurred prior to the headache
• What you ate 24 hours before the headache occurred
• How your sleep patterns may have changed and how much sleep you have been getting
• How much stress you are experiencing

Lifestyle changes to prevent and relieve tension headaches may help you more than any other preventative measure. Lifestyle-related treatment methods include:

Exercise regularly. You can reduce the frequency and severity of tension headaches with regular aerobic exercise, such as walking, swimming and bicycling. These activities help to relax the muscles and increase the levels of the body's natural stress relievers. Exercise can also relieve the pain of an existing headache. Discuss physical activity with you doctor before starting an exercise routine.

Manage your stress. Stress is a common trigger of tension headaches. You can use a number of relaxation techniques, including deep breathing, yoga and meditation to relieve stress. Organizing daily activities ahead of time can also help. Biofeedback might also be recommended. During this procedure, electronic monitoring devices are used to teach you how to consciously regulate your bodily functions through relaxation or imagery. Behavior therapy may also be used to reduce stress in women with depression or anxiety.

Relax your muscles. Some of those with tension headaches may benefit from relaxing their muscles. Methods used to relieve muscle tension include thermotherapy and cryotherapy. Thermotherapy, or heat therapy, includes the use of heating pads, hot-water bottles, warm compresses, hot towels, and hot baths or showers. Cryotherapy, or cold therapy, includes the use of ice packs and cold showers or baths. Massage therapy for your head, neck and shoulders can also reduce stress and relieve tension.

Improve your posture. Good posture can prevent muscle tension. There are a number of techniques you can use to perfect your posture:

• Hold your shoulders back and head high when standing. Also, pull in your stomach and buttocks and tuck in your chin.
• When sitting, keep your thighs parallel to the ground and do not slump your head forward.
• Avoid sitting, standing or working in one position for an extended period of time.
• Avoid wearing high heels or shoes that do not fit properly.
• Regularly perform stretching and strengthening exercises for your neck and shoulders.
• Place weight on both feet when standing. When standing in place for an extended period of time, elevate one foot on a stool. Change to the other foot periodically.
• When sitting for an extended period of time, use a footstool to elevate your feet. Get up and move around every 30 minutes.
• Sit in straight-back chairs and keep the head supported.
• Avoid carrying shoulder bags or purses weighing more than two pounds (one kilogram).

Other ways to prevent tension headaches include:

• Don't smoke
• Don't drink too much caffeine
• Don't drink alcohol
• Eat a regular, balanced diet
• Maintain a regular sleep pattern and get plenty of sleep and rest
• Keep warm if your headache is triggered by the cold
• Try using a different pillow
• Try sleeping if a different position

When compared to people who do not experience headaches, those with tension headaches are more likely to experience anxiety and depression. These complications, which often result from living with chronic pain, can in turn trigger more headaches. If you are anxious or depressed, you might benefit from counseling or a headache support group.

Tension headaches do tend to come back after they have been treated, but you don't have to dread their return. There are many ways you can prevent the recurrence and reduce the severity of tension headaches. Many useful lifestyle changes, such as exercising and eating regularly, are good for your general health as well..

Sleep Disorders

Insomnia is the inability to sleep for a reasonable amount of time to maintain adequate restfulness. It is the most common type of sleep disorder.

Insomnia is not defined by the total number of hours slept. Most adults require seven to eight hours of sleep a night, but some only need four or five.

According to the National Center on Sleep Disorders Research, about one in three American adults experience insomnia in a given year. About one in 10 American adults experience insomnia that is chronic or severe. Insomnia is more common among women (especially after menopause) and the elderly. About half of people over age 65 have frequent sleep problems.

Many conditions can cause insomnia. Some possible causes of insomnia include:

• Lifestyle factors (e.g., drinking caffeine or alcohol before bedtime)
• Medical conditions (e.g., peptic ulcers)
• Psychiatric conditions (e.g., depression)
• Medications (e.g., antidepressants)
• Other sleep disorders (e.g., sleep apnea)

Symptoms of insomnia may include difficulty falling asleep, waking up frequently during the night, daytime drowsiness or irritability.
Many people visit their physician with complaints of insomnia. A review of their medical history, a physical examination and details of medications and lifestyle may help pinpoint the cause. Patients should also be evaluated for psychiatric conditions. They may be asked to keep a sleep diary to document sleep patterns and behaviors. In some cases, patients may be referred to a sleep center where sleep is analyzed by sleep disorder professionals. This is usually done to rule out other sleep disorders.

Several approaches may be used to treat insomnia, depending on its cause. Lifestyle changes, such as increased exercise or elimination of alcohol or caffeine, may help the condition. Sedative medications may also be prescribed, although they are not a long-term solution. Some forms of therapy, such as relaxation therapy, may help some patients.

About insomnia
Insomnia is difficulty falling asleep or staying asleep, resulting in inadequate length of sleep and/or poor quality of sleep. The disturbances caused by insomnia affect people during their waking hours.

People with insomnia may wake frequently during the night and have difficulty falling back asleep or may wake up too early in the morning. Insomnia is the most common type of sleep disorder.

Sleep requirements differ among individuals. Therefore, insomnia is not defined by how long it takes to fall asleep or the total number of hours spent sleeping. Most adults require seven to eight hours of sleep, but some people need only four to five hours.

Primary insomnia is difficulty with sleep that is diagnosed after other underlying causes (such as medications or diseases) have been either ruled out or treated. Factors such as chronic stress, hyperarousal, poor sleep habits (such as drinking caffeine before sleeping) and behavioral conditioning may contribute to primary insomnia. If insomnia can clearly be attributed to an underlying cause, it is called secondary insomnia. However, when another medical or mental health disorder is also present, it can be difficult to determine whether the insomnia is due to the disorder or if the other disorder is secondary to insomnia. In addition, some people may indicate they have insomnia, although a sleep study shows no sleep disturbances.

Insomnia may be:
Transient. Lasting for a single night to a few weeks. Most people experience transient insomnia at some point in their lives. It is a common response to jet lag or stressful situations, such as job loss or death of a loved one.

Intermittent. Episodes of transient insomnia that occur from time to time.
Chronic. Insomnia occurs on most nights or lasts a month or longer. This is often the result of a medical, neurological or psychiatric disorder or other factors.

Studies have not conclusively proven whether insomnia causes long-term health problems, but some research has shown that insomnia can be linked to problems with immune system functioning and muscle endurance.

According to the National Center on Sleep Disorders Research, about one in three American adults experience insomnia in a given year. About one in 10 American adults experience insomnia that is chronic or severe. Insomnia is more common among women (especially after menopause) and the elderly. About half of people over age 65 have frequent sleep problems.

Children also experience insomnia, for many of the same reasons as adults, such as stress or poor sleep habits. They can also experience insomnia as a result of nightmares and night terrors.

Changes that occur with age and may impact sleep include:
Sleep pattern changes. Sleep becomes less restful after age 50. More time is spent in the earlier, transitional stages of sleep than the later stages (deep sleep). The later stages are the most restful kind of sleep.

Activity changes. Older adults are less active than younger adults and activity helps facilitate a good night’s sleep. Older adults may also have more free time than younger adults and may have habits that interfere with sleep, such as daytime napping and caffeine consumption.

Health changes. Chronic pain conditions that may interfere with sleep, such as arthritis or back problems, occur more frequently with age. Also, sleep disorders that result in insomnia, such as sleep apnea (when breathing stops periodically throughout the night) and restless legs syndrome (unpleasant sensations in the legs during the night), increase with age.

Migraine Overview

It's not pain you're likely to forget if you've ever experienced it. The excruciating throb of a migraine, often accompanied by nausea or sensitivity to light and sound can be brutally painful. As anyone who's suffered a migraine can tell you, these headaches, when left untreated or treated ineffectively, can disrupt every aspect of a person's life, from the ability to work to day-to-day activities and relationships. They can eventually lead to a loss of self-confidence, sense of control and self-esteem.

In the U.S. alone, as many as 28 million women and men-roughly 13 percent of the population-suffer from migraine headaches, according to the American Migraine Study II.

Women experience migraines three times more frequently than men. Researchers have found that migraines have a greater overall impact on the lives of female sufferers, affecting their self-esteem, professional development and family and social life.

What are Migraines?
Migraine is a biologically based disorder. Its symptoms are the result of changes in the brain, not a weakness in character or an inappropriate reaction to stress. For many years, scientists believed migraines were linked to the dilation and constriction of blood vessels in the head. They now believe migraine is caused by inherited abnormalities in certain cells in the brain. People with migraine have an enduring predisposition to attacks triggered by a range of factors. Specific, abnormal genes have been identified for some forms of migraine.

People who get migraine headaches, then, appear to have special sensitivities to various triggers, such as bright lights, odors, stress, weather changes or certain foods and beverages.

If you get a migraine, you may experience an aura 10 to 30 minutes before the attack. An aura may cause the sensation of seeing flashing lights or zigzag lines, or you may temporarily lose vision. Other classic symptoms include speech difficulty, weakness of an arm or leg, tingling of the face or hands and confusion. About 20 percent of migraine victims experience an aura prior to an attack. Even if you don't have an aura, you may experience a variety of vague symptoms beforehand, including mental fuzziness, mood changes, fatigue and unusual retention of fluids.

The pain of a migraine is described as intense, throbbing or pounding and is felt in the forehead, temple, ear, and jaw, around the eye or over the entire head. It may include nausea and vomiting, and can last a few hours, a day, or even up to three or four days.

Migraines can strike as often as several times a week, or as rarely as once every few years. Some women experience migraines at predictable times--near the time that menstruation begins or every Saturday morning after a stressful workweek.

In addition to the classic migraine described above, migraine headaches can take several other forms:

Hemiplegic migraine: Patients with hemiplegic migraine have temporary paralysis on one side of the body, a condition known as hemiplegia. Some people may experience vision problems and vertigo--a feeling that the world is spinning. These symptoms begin 10 to 90 minutes before the onset of headache pain.

Ophthalmoplegic migraine: In ophthalmoplegic migraine, the pain is around the eye and is associated with a droopy eyelid, double vision and other sight problems.

Basilar artery migraine: Basilar artery migraine involves a disturbance of a major brain artery. Preheadache symptoms include vertigo, double vision and poor muscular coordination. This type of migraine occurs primarily in adolescent and young adult women and is often associated with the menstrual cycle.

Status migrainosus: This is a rare and severe type of migraine that can last 72 hours or longer. The pain and nausea are so intense sufferers often must be hospitalized. The use of certain drugs can trigger status migrainosus. Neurologists report that many of their status migrainosus patients were depressed and anxious before they experienced headache attacks.

Headache-free migraine: This type is characterized by such migraine symptoms as visual problems, nausea, vomiting, constipation or diarrhea. Patients, however, do not experience head pain. Headache specialists have suggested that unexplained pain in a particular part of the body, fever and dizziness could also be possible types of headache-free migraine.