Tension Headache

Do you feel a dull ache on both sides of the head? Do the muscles in the neck and head feel tight ? You are most likely suffering a tension headache or stress headache as it is otherwise referred. Such headaches are one of the most common forms of headache and can occur in adults and adolescents. The pain due to tension headache is vise-like and is generalized. Tension headaches may result from fluctuations in the levels of brain chemicals such as serotonin, endorphins and others. Tension headaches are noticed more often in women.

Tension headaches occur due to contraction of neck and scalp muscles. This contraction can be a reaction to stress, anxiety or posture. Excessive smoking, alcohol use, sinusitis, eye strain can also bring on tension headache. Unlike migraine, tension headaches do not cause nausea and vomiting or numbness. Episodic tension headaches come a couple of times a month and last a few hours. If there are frequent episodes of tension headache, the condition is chronic. Skipping meals, stress, hormonal changes and hypertension medication can trigger tension headaches. Such headaches often have a genetic predisposition.

Treatment:
There are many issues to consider before arriving at treating headaches - frequency, severity, the effect on lifestyle, the results of previous treatment and any history of drug abuse. Mild cases of tension headaches which occur occasionally can be managed with symptomatic treatment by using Analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs).

Tension headaches are treated with NSAIDs, aspirin or acetaminophen. A non sedating muscle relaxant such as Skelaxin provides relief to persons suffering from tension headaches. Those who suffer from frequent bouts of tension headaches may need medications to reduce anxiety such as amitriptyline, nortriptyline or desipramine. But overuse of these medicines can lead to rebound headaches. You can try some of the following measures to bring tension headaches under control:

• Enough rest
  
  
• Regular exercise regimen
  
  
• Warm or cold compress on the head and neck
  
  
• Relaxation exercises, yoga, deep breathing, acupuncture
  
  
• Good posture while sleeping, reading, using the computer
  
  
• Massage
  
  
• Swimming
  
  

Prophylactic Therapy :
If the frequency of headaches is so regular or if the severity of the headache is so high that the patient can't normally cope, then prophylactic therapy might be indicated. Antidepressants are the drugs of choice for treating tension type headache. Relief of headache may take about 3 to 4 weeks and the patient may have the following side effects:

• sedation
  
• dry mouth
  
• blurred vision
  
• constipation
  
• urinary retention
  

Amitriptyline - single dose of 25 mg at bed time may be a good option. Trazodone (75 to 300 mg at bedtime) or Fluoxetine (20 to 40 mg at lunchtime) are other options if the patient does not tolerate the sedative and anticholinergic effects of amitriptyline.

There are other alternate options like Cervical Epidural Nerve Block which can be performed on a regular basis depending on clinical symptoms.

Headache

A headache in many cases can be a symptom of other underlying issues. In most cases, a headache subsides with the intake of an OTC painkiller or given adequate rest. To pinpoint the exact cause for a recurring, persistent headache, it calls for a detailed history of the patient as a starting point.

A headache is often one of the common symptoms associated with a wide range of ailments, drug interaction or change in weather to hormonal variations. The following list is not exhaustive - but only to suggest as a sample of some possible causes.

Allergic rhinitis - can cause fatigue and headache. Some drugs like alpha blockers cause side effects like drowsiness, tiredness, headache, nervousness, irritability, stuffy or runny nose, nausea, pain in the extremities. Metronidazole drug can also result in headache, nausea and vomiting if taken with alcohol.

Premenstrual Dysphoric Disorder (PMDD) or Premenstrual syndrome (PMS) has symptoms which include abdominal pain, headache, nervousness and irritability along with breast tenderness before menstruation. Antihistamines cause drowsiness and headache as a side effect.
Heat stroke can cause severe head ache, high fever and dry skin.

A cancer in the adrenal medulla known as Pheochromocytoma can cause high blood pressure, headache, palpitations and excessive perspiration.
Cerebral Aneurysms may cause headaches lasting for days or weeks - called as Sentinel Headaches as they are a warning to an impending rupture or Spontaneous Subarachnoid Hemorrhage (SSH).

Migraine Headache refers to the recurrent headache on one side or both sides - often accompanied by nausea or vomiting with episodes of aversion to light.

Cluster Headache is the excruciating pain centered around one eye or temple.

Tension Headache - the common form of headache refers to the dull ache that may appear to exert pressure on the head.

Comparison of Tension Type Headache and Migraine Headache

Biofeedback Training

Biofeedback training is a process wherein the patient is trained to improve his/her health by using signals from his/her own body. It helps a person control physiological processes such as blood pressure, heart rate and muscle tension. These processes actually are involuntary but can be manipulated and controlled at will. Biofeedback therapy is used to treat conditions such as migraine headache, tension headache, urinary incontinence, high blood pressure, chronic pain, etc.

The concept behind biofeedback training is very interesting. It utilizes the power of the mind to become aware of what is happening within the body. This awareness helps a person to gain more control over bodily functions, involuntary ones too. This therapy works wonders on people experiencing stress. Stress can cause fluctuations in blood pressure and biofeedback therapy aids in relaxation.

Electrodes are attached to the patient's skin, which sends information to the monitor. Based on the monitor reading, the therapist understands the mental activities of the patient. The parameters that are monitored include blood pressure, sweating, breathing rate, and muscle activity. If a patient is experiencing stress at a particular moment the above mentioned parameters may alter. Understanding this alteration can help understand which part of the body needs to relax.

Depending on the severity of the issue, the number of sessions may vary. A session may typically last from 30 minutes to one hour. Biofeedback therapy does not have any side effects or pose any risk and is a non-invasive procedure. To undertake a session in biofeedback therapy, it is advisable to work with a health care professional trained in biofeedback.

Biofeedback therapy uses

Biofeedback therapy can be used to treat:

Chronic pain: Helps in identifying tight muscles and relaxing them, relieves lower back pain, abdominal pain, etc. This therapy benefits people across all age groups.

Anxiety: Anxiety relief is one huge area wherein biofeedback therapy can be very helpful. The therapy helps understand the body's responses when a person is stressed and anxious. By understanding this, one can control body response using biofeedback therapy.

Urinary incontinence: People may have trouble in controlling the urge to urinate. This therapy, particularly in women helps in tightening the pelvic floor muscles that control the urge/feeling to urinate. It is helpful in treating kids who bed wet.

Headache: Stress and muscle tension can cause headaches like migraine and other types of headache. This therapy can help relax the muscles and reduce frequency as well as severity of the headache.

Other conditions that can be cured using biofeedback therapy include ADHD (Attention Deficit Hyperactivity Disorder), asthma, constipation, rheumatoid arthritis, COPD (Chronic Obstructive Pulmonary Disease), high blood pressure, etc. Different relaxation exercises used in biofeedback therapy:

• Deep breathing
  
  
• Guided imagery: Concentrating on a specific image and focusing on the image to make the person feel relaxed.
  
  
• Progressive muscle relaxation: Alternately tightening and relaxing various muscle groups.
  
  
• Mindfulness meditation: Focusing thoughts to let go of negative emotions.

Biofeedback therapy types

Neuro feedback: Used to measure brain wave feedback. Used to treat epilepsy and other seizure disorders.

Thermal biofeedback: Used to measure skin temperature. Used to treat headache and Raynaud's disease.

Electromyography: Used to measure muscle activity and tension. Used to treat conditions such as headaches, back pain, anxiety disorder, incontinence, muscle retraining after injury.

Electrodermal activity: Used to measure sweating and can be used in pain and anxiety.