Headaches can be a serious health problem. Some people suffer from headaches that are severe or frequent enough to be incapacitating. Certainly, there are times when a headache signals a serious condition. In the great majority of cases, however, the pain of a headache is best seen as a message that your stress level has risen too high. The headache serves as a warning that you need a changeóperhaps to rest, deal with an emotional conflict, change your diet, or correct a problem in your personal environment at home or work.

Modern medicine classifies headaches according to the immediate cause of painful stimulation of nerve endings. The types of headaches include muscle-contraction headaches, vascular headaches, and headaches caused by inflammation or structural conditions.

Muscle-Contraction Headaches
Nearly everyone has had a muscle-contraction headache, more commonly but less precisely referred to as a ìtension headache.î Most people assume that the term ìtensionî refers to emotional stress, and in fact, many times this type of headache is brought on by stress on the job, being stuck in a traffic jam, or other such situations. But the pain of a muscle contraction headache arises from tightening of the muscles of the upper back, neck, and scalp, and this may result from any type of stress, whether physical or emotional. Extremes of heat or cold, hunger, loss of sleep, a tiring drive, and improper posture are all examples of physical stresses that can lead to muscle contraction headaches.

That the body responds to stress by increasing muscle tone makes senseóitís preparing for a ìfight or flightî response. Unfortunately, physical action isnít socially appropriate in many stressful situations, so the muscle tension just builds up. Once it reaches a certain threshold, you get a headache. The pain arises partly because the muscle is simply sore from being overworked, and partly because the tension constricts blood vessels and reduces blood flow to the tiring muscles. It is now thought that in many or most muscle contraction headaches, the physiological changes that account for vascular headaches also contribute to the pain (see the next section in this chapter). The pain of a muscle contraction headache is typically a dull, steady ache felt across the forehead, at the temples, or at the base of the head and neck. A sensation of tightness, as if a constricting band were wrapped around the head, may be felt. The scalp and neck are often tender to touch.

General Home Care
Muscle-contraction headaches are generally easy to treat at home: Simply take a break from the stress that lead to the headache, get some rest. and perhaps massage the sore neck muscles. If the headache doesnít respond to these simple measures in a short time, try a homeopathic medicine from the list in this chapter. By helping the body restore order and balance, the correct homeopathic medicine speeds relaxation of the muscle contraction and relief from the pain, without any of the side effects associated with standard painkillers.

Steps you can take to prevent recurrent muscle contraction headaches include:
Learn to recognize and avoid simple physical causes of muscle tension like poor posture, uncomfortable clothing, or unpleasant environmental conditions (an overly chilly room, irritating noise, and so on). Notice whether any of your habits are awkward or cause tension and straining, such as the way you sit at your desk, hold the telephone, or clench your jaw.

Recognize and deal with emotionally stressful situations in your life. We realize this is easier said than done, but headaches are very commonly associated with emotional stress.

Become familiar with the early signs and sensations of tension, both muscular and emotional. If you can sense tension before a bad headache comes on, you can do something to break the cycle before tension increases. Get out of the stressful situation for a few minutes, do some physical exercise to help release stored tension, meditate, pray, or do anything you find relaxing or joyful (laughter is great for releasing tension).

Learn to relax the muscles that tense up during a headache, so that you can relax them during periods of stress. We suggest you set aside ten minutes or so twice a day for relaxation exercises. Relax your whole body and your head and neck muscles in particular. Spend the last few moments of each period of relaxation imagining yourself in the situation that causes you the most stress--perhaps it's driving in rush hour traffic--keeping that relaxed feeling. After a week or so, youíll start to remember the relaxation sessions whenever youíre in that tense situation, and before long, you'll find that you can maintain greater tranquillity even then. Biofeedback can help you learn to control various physiological processes that lead to tension headaches, as can meditation.

Exercise and massage are both great for relieving tension and lifting your mood. The specialty bodywork practices--such as the Alexander technique, chiropractic, rolfing, or acupressureócan also be helpful in treating or preventing headaches.

Some people get headaches when they are hungry or when they eat foods that donít agree. Pay attention to the pattern of your headaches in relation to diet. We recommend regular meals with an emphasis on fresh vegetables, whole grains and, if desired, lean meats. Avoid sweets and caffeine. Specific foods often aggravate vascular headaches, and since many headaches may be of mixed type, it may be useful to avoid these foods.

If you have any visual difficulties, see an eye specialist. While eyestrain isnít a common cause of headache, sometimes it is to blame for recurrent headaches.

Consider a checkup for misalignment or injury of the temporomandibular joints (TMJ). These joints attach the jaw to the rest of the skull on either side, just in front of the ears. One quick test: Try placing a two to-three inch piece of Popsicle stick or tongue depressor between the teeth to separate the upper and lower jaws. If this relieves your headache, you may have a TMJ problem. Evaluation is best performed by an ear, nose, and throat specialist or a dentist.

For more information on self-treatment of headaches, we recommend Headache Help by Lawrence Robbins, MD, and Susan Lang (1995) and Migraine: What Works by Joseoph Kandel, MD, and David Sudderth, MD (1996). For more details on learning to deal with stress, see Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn, PhD (1990) and PNI: The New Mind/Body Healing Program by Elliott Dacher, MD (1993).

Migraines and Other Vascular Headaches
Many people use the word ìmigraineî to refer to any really bad headache, but migraine headache, as medically understood, denotes that pain resulting from a complex series of specific changes in the blood vessels of the head and brain. During a migraine, the blood vessels first become overly constricted and then widen abnormally. This sequence of constriction and widening affects the blood vessels on one side of the head more intensely, and often it is especially pronounced in a particular area of the brain.

The symptoms of migraine headaches are directly related to these changes in the blood vessels. During the initial phase of blood vessel narrowing, decreased blood flow to the brain leads to malfunction in the area of greatest constriction. So, before any pain is felt, the typical migraine begins with some sort of warning symptom, called an aura. The most common aura is disturbance of vision, which may take the form of bright or colored zigzag lines, areas of cloudy vision, flashing lights, and so on. Other people have auras with such symptoms as slurred speech, dizziness, weakness or numbness of one side of the body, and other signs of neurological impairment.

The migraine headache pain begins when the previously narrowed blood vessels then open too wide. Normal brain function is restored by the return of blood flow, but stretching of the vessel walls, along with inflammation caused by chemical changes in the blood, stimulates pain-sensitive nerve endings in the vessel walls. At first the pain is localized on one side of the head, but it often spreads to the other side as the headache progresses. The pain is intense and throbbing in character. Accompanying the headache may be symptoms such as nausea, vomiting, or diarrhea, intolerance of light, dizziness, and sweating or chilliness.

This description of the migraine applies to the ìclassicî type, but other forms of migraine are not uncommon. Sometimes the headache begins without a prior aura. On the other hand, ìmigraine equivalentsî may occur; there may be the neurological disturbances (visual changes and so on) or vomiting typical of a migraine, though there is no headache.

The tendency to have migraines clearly runs in families and seems to be due, in part, to a genetic predisposition, They first occur before the person reaches the age of thirty, usually in the early-teen years. Migraines often start in childhood, particularly around the time of puberty. Even very young children can get migraines. Before the child is old enough to tell you about the headache, the first sign you may see in your two-to-four year old is recurrent vomiting. The child who gets headaches may well be saying something about a difficulty in her life that she finds hard to express openly. Do your best to identify stress your child faces, and work with her to find ways to resolve the conflict.

A migraine headache is most often triggered by psychological stress but, curiously, it is characteristic that the attack begins when the stress is relieved. High-pressure business people, for instance, may dread the ìrelaxingî weekends that bring on their headaches. Other stresses that frequently lead to migraines include going without food, sleeping too long, bright lights, and fluctuations in hormone levels (some women get migraines every month before the menstrual period or when they ovulate). Foods and drinks including nuts, chocolate, coffee, cheese, citrus, and alcohol may also trigger migraines, as do some drugs.

Another type of vascular headache is the ìcluster headache.î These are severe, one-sided headaches that occur in spells, most often during sleep. The pain is accompanied by redness and tearing of the eye, and the nostril drops on the painful side.

General Home Care
An untreated migraine lasts at least several hours, often a full day. Many migraine headaches are so severe, simple measures like rest or aspirin offer little or no help. Relaxation measures may bring some relief. Learning to warm the hands by increasing blood flow through biofeedback has been especially effective, probably because the circulatory system in general is affected. Suggesting to yourself that the hands are becoming warm and heavy is the best way for most people to achieve this without a biofeedback device. Dealing effectively with stress and avoiding the factors that you know lead to your headaches are critical for preventing migraines. Constitutional homeopathic treatment from a professional practitioner is the most helpful preventive approach for those whose headaches donít respond to simple home care measures or to self-care homeopathy.

Many different conventional medicines are used to treat and prevent migraines; some are strong drugs with many potentially serious side effects. We recommend that you opt for conventional treatment only if your headaches persist after youíve tried self-care methods and professional homeopathic treatment.

Other Headaches
Less common than muscle-contraction and migraine headaches are the various types of headaches caused by infection, inflammation, and structural changes in the face and head. Many of these are serious conditions requiring medical treatment.

For information about acute sinus headaches, see the section on sinus conditions in Chapter 4 on colds and coughs.