How to handle headache

This article is provided by the Health and Temperance Department of the General Conference.

Richard L. Neil, M.D., M.P.H., is associate professor of health promotion and education for the Loma Linda University School of Health. 

It was the middle of summer. The blazing sun had ripened the grain and dried the stalks of wheat. With harvesting at its peak, the fields hummed with sounds of swinging scythes. Grunting laborers piled heavy sheaves onto oxcarts.

A certain boy had been helping his father in the fields all day. This kind of work was new to him, but he did his best to keep up with the other workers. Maybe he overexerted himself. Maybe he did not drink enough water or eat properly that day. Perhaps he tried to work in the heat without first becoming accustomed to it. Whatever the reason, he suddenly clutched his head and complained to his father, "My head, my head" (2 Kings 4:19).

The pain did not go away. Not only did it continue; it worsened. The man sent his son homebut the damage was already done. While sitting on his mother's lap, he died. Most likely that child suffered what is now known as heatstroke with its accompanying headache.

Headache has been known throughout the history of mankind. Its treatment has engaged the interest of all cultures. There are even archaeological records of trephining (opening the human skull with drill-like instruments) in ancient Africa. Presumably this was because of problems in the headperhaps headache.

When we describe all the functions of the head, superlatives come easily. Each of the five senses has its focus in the brain. Keeping us aware and alert is the special task of this crown of God's crowning creation.

The rods and cones from the back of the eyeball illumine the brain with visual images in sharpest color and finest detail. The ears capture and transmit sounds to the brain to be assessed for possible action. The sense of touch is so delicate that even one tiny hair lightly dropped into the inside of the lower eyelid sets off spasms of discomfort and pain. The sense of smell lets us anticipate and appreciate that most delightful of all experienceseating good foodeven before our mouths taste it.

Indeed, the brain is one of God's most significant gifts to mankind. The head is home for the brain that prototypical microcomputer containing more than 50 billion interconnecting nerve cells. When the head is pained or confused, we are anxious to get it back to normal.

Simple headache

Understanding headache and its possible consequences requires examination of those structures in and around the head that may cause pain in the head. As one would imagine, the head is a very complex structure. It is made up of several kinds of tissue, each with differing functions.

The skull, or calvarium, gives contour and solidity to the head. It does not usually cause pain. Nerve cells make up the tissue through which the five senseshearing, sight, taste, smell, and touchregister on the brain. The organs that mediate these sensesthe eyes, ears, nose, and mouthmay themselves be the focus of pain.

Many muscles attach to the head. Muscle spasms can produce pain in any part of the body, including the head. Blood vessels, another component of the head, carry about one fifth of the blood from each heartbeat to this most important part of the body. The blood vessels are covered with fibrous tissue that, when stretched, may cause some types of headache. Other structures in the head, such as sinuses, teeth, and various joints, can also cause pain.

With so many potential culprits, how can you decide which one is causing your headache? And how can you tell if the pain signifies some problem or is just a nuisance that can be controlled with a little aspirin and/or time?

Perhaps most important is the realization that the vast majority of headaches do not indicate a serious problem. These include the garden variety of tension headaches. There are, however, other causes of headache such as sinus infection, toothache, allergic reactions, migraine, and more serious problems such as brain tumors.

Tension headache

In assessing a tension headache, the important factors are its nature, location, and the length of time the pain lasts, along with factors that start, increase, decrease, or relieve the pain.

As the name implies, tension head ache results from tension in the muscles around the shoulders, neck, or head. It does not necessarily refer to tension in one's environment.

The muscles along the back are all connected to one another. That means that a muscle in the buttocks can eventually spread its discomfort all the way to the top of the head. Therefore, anything that causes a stretching or pulling of any of the muscles along the back, the shoulders, or the neck can eventually produce muscle spasm and pain that will be felt as headache.

Years of standing over a sink can make a person's head jut well over the front of the chest. In this situation, called "for ward head," the muscles at the back of the neck are pulled forward and eventually cry out against this stretching by producing painful spasms.

Long hours spent poring over books or sitting in meetings can produce the same consequences. In this case, it is not merely the position of the head, but its limited range of motion that causes the pain.

Stress in the course of meeting life's constant challenges also causes tension in the muscles, whether the stress comes from mediating church board meetings, battling traffic, or just planning the family vacation. In any situation that calls for concentration and mental effort, the muscles about the jaw, neck, and shoulder frequently tense unconsciously. Inner conflicts and irritations also increase the tension in the muscles.

The focusing of sight can also cause tension headache. The lens is the clear, crystalline part of the eyeball that focuses the incoming light rays that strike the back of the eyeball and thereby allow you to see. This lens gets thicker or thinner as the circumstances demand so that your vision is sharp. If your eyesight needs correction because the eyeball is not the right shape or because what you are reading is too close, the small muscles con trolling the lens are not as efficient as they should be, and this causes squinting. These muscles in and around the eyeballs and scalp then spasm, producing the pain. Eyeglasses can easily correct the problem.

How to handle tension headache

Tension headache can be described in one of several ways. Sometimes it feels like a constricting band around the head. In other cases it feels like a weight on the top of the head, or it may even mimic a light-headed sensation, leaving the sufferer feeling as though he or she is about to fall to one side or the other.

Almost always there is a trigger point somewhere in the muscles of the body. A trigger point is a tender spot in at least one of the muscle groups around the chest or neck where fingerpoint pressure will make the headache worse. Finding that point, or those muscles, is the key to solving the headache pain.

Gentle massage of the sore muscles, especially around the trigger area, will reduce the pain. It is that simple. The massage focuses attention on the muscle and allows it to tighten and relax alternately. If the massage is preceded by moist heat (as from water-heated towels) the effect will be even better.

But the best way to handle a tension headache is to treat it early and, if possible, prevent it. Prevention is actually quite simple, and there are very few rules:

1. Maintain good posture. This means standing straight, sitting upright, and avoiding spending long periods in abnormal positions. If you find yourself slouching in your chair while sitting, or standing with your chin well over your chest, Or gazing for a sustained period of time at any object, immediately change position or focuseven if it means getting up and moving about the room.

2. Make sure your vision is properly corrected. Making sure your vision is checked by a qualified optical specialist can be worthwhile in any case. That is especially true if there is a vision problem of which you are unaware and which is causing nagging headaches.

3. Watch your diet. Such things as food colorings, sugar, or preservatives have been linked by some people to headaches. While the mechanism behind this is obscure, it may be that these substances make the muscles more sensitive to prolonged periods of stretching.

4. Be careful of that pillow. Headaches that come on in the morning may be associated with sleeping on your back with a pillow under your head. In that situation the neck is stretched forward and produces the same effect as standing with the head forward. Sleeping on your stomach or doing without the pillow will correct the problem.

5. Exercise your neck. Neck motion is necessary to keep the muscles supple and relaxed. You should never move your head in a circular motion on your neck. Instead, slowly move the head in a "yes" fashion to its full extent. This can be accompanied by trying to put each ear on the near shoulderagain slowly, deliberately, and as far as it will go comfortably. Then rotate your head so that your chin first tries to touch the right shoulder, then the left. All these motions should be repeated at least three times each. This series of exercises can be performed at any time and in any place. They are especially helpful if the neck begins to tighten after hours of study or desk-type work.

Paying attention to these simple rules should keep you free from the tension headache.

Other types of headache

Unfortunately there are other, more serious causes of headaches. Frequently the symptoms of these headaches cannot be clearly distinguished from the simple tension headaches except by a physician. In general, if any headache lasts for more than a few hours, or has associated signs or symptoms as described below, it should be checked by your doctor as soon as possible.

Migraine headaches tend to be recurrent, throbbing, and episodic. They are usually found on one side of the head and seem to be related to disturbance in the blood flow to the head. Nausea and vomiting are frequently associated with the headaches, which may be preceded by visual symptoms including flashing lights, sparks, or geometric patterns. These headaches are quite severe in their onset and are usually not mistaken for tension. Closely related are cluster headaches, which may come at any time of the year, affect predominantly middle-aged males, and as their name implies, occur in clusters or groups. Medical care is usually needed for these headaches.

Allergic headaches can occur as a result of eating foods you are sensitive to. These headaches are not caused by true allergies, but are actually bodily reactions to certain chemicals in foods or other substances. By watching the pat tern of headaches after exposure to foods or other substances, you can make your own diagnosis, usually without having to seek medical assistance.

Mouth problems ranging from abscessed teeth to temporal-mandibular joint problems can cause headaches. These can be identified if your headache pattern is associated with eating or chewing. In the absence of obvious tooth pain, tapping each tooth lightly with a firm object can often locate an abscessed tooth. In any event, checking with your dentist may reveal an abnormal bite or other dental abnormality that may be causing headaches.

Sinus problems may express themselves as headaches. The sinuses are hollow areas in the bones of the skull that drain into the nasal cavity. If the drain age openings are clogged by infection, painful pressure builds in the cavity as fluid accumulates. These headaches are usually accompanied by a full sensation in the nose, a fever, and a history of nasal infections or colds. Definitive treatment by a physician may be necessary.

Almost everyone who has a severe headache wonders whether a brain abnormality or tumor might be the cause. While these problems are rare, they should be looked for in any case in which the headache is sudden, severe, or pro longed in an otherwise well person. They may be associated with seizures or drowsiness and are not relieved by usual measures. Other associated findings with this variety of headache may include double vision and weakness or paralysis of certain parts of the body. If any of these symptoms occur, attention should be given to the headache immediately. 1

Miscellaneous causes of headache include high blood pressure, infections of the brain such as meningitis or encephalitis, depression, medications, and injuries. Obviously, these types of headache require medical diagnosis and treatment. 2

Medicines and headaches

Treating headaches is a multi-million dollar business. Most people who experience a headache immediately reach for aspirin or one of the newer aspirin-like substances. Aspirin does nothing to reduce the muscle spasm of the tension headache. All it does is alter the perception of pain and reduce any inflammation that may be present.

Obviously, the first order of business is to find the source of the pain and correct that. Medication should be used only as a temporary measure while seeking medical care and eliminating the cause of the pain.

"By study of the human organism, we are to learn to correct what may be wrong in our habits and which, if left uncorrected, would bring the sure result, disease and suffering, that make life a bur den. The sincerity of our prayers can be proved only by the vigor of our endeavor to obey God's commandments."3

In the absence of serious causes, most headaches result from tension in the muscles. Delegation of authority, adequate physical exercise, worthwhile diversionary reading, and a proper sleep pattern can help to reduce their frequency.

Following these principles, along with a deep, abiding trust in divine providence to guide and sustain your life, can be the answer to living with your head functioning at maximum efficiency and with minimum discomfort.

1 S. A. Schroeder, M. A. Krupp, and L. M.
Tierney, Current Medical Diagnosis and. Treatment,
1988 (Norwalk, Conn.: Appleton and Lange,
1987).

2 T. M. Harrison et al., Principles of Internal
Medicine (New York: McGraw-Hill, 1980).

3 Ellen G. White, Counsels on Health (Mountain
View, Calif.: Pacific Press Pub. Assn., 1951), p. 504.


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Richard L. Neil, M.D., M.P.H., is associate professor of health promotion and education for the Loma Linda University School of Health. 

July 1989

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