Sunday, March 4, 2012

Managing Headaches

Headaches are often under-rated or ignored despite being an often debilitating condition. In the list of leading causes of disabling conditions, a headache was ranked 12th for women and 19th for men, according to recent research by the World Health Organisation.

Calling it a migraine or headache is of no help in making a diagnosis or finding the correct treatment. As Dr. Elliot Shevel, Chairman of the South African Headache Society, published in the South African Medical Journal, they are part of a continuum; each one has components of the other. Determining which structures are causing the pain and generating the pain signals is the real million dollar question.

The pain primarily comes from one or more of three structures, namely the arteries supplying the head and scalp (not inside the brain), the muscles of the head and neck and jaw, and nerves that supply theses areas. One also needs to understand the difference between a trigger and a cause. A trigger is an external factor outside of the body, for example chocolate, which contains a chemical called phenylethylamine, thought to trigger a headache by affecting the arteries. Other triggers are sunlight, stress, fatigue, low blood sugar and dehydration. Causes are a variety of physical structures inside the body, including muscles, nerves, arteries, brain, sinuses, eyes, teeth, the jaw and even skin, which need to be assessed in a single comprehensive diagnosis in order to determine exactly what is causing the pain.

Dr. Shevel says “The latest research shows that muscle tension headaches are the most common form and generally stem from the craniomandibular (connecting the head to the jaw) and craniocervical (connecting the head to the neck and shoulders) muscles. Be aware of your posture when driving or sitting at your desk and use a good chair that supports your back, as this can result in a tension headache.”

 Michelle Das Neves, a Gauteng based biokineticist who works with The Headache Clinic's team of specialists says “One of the reasons why you present with a headache is due to incorrect alignment of the neck and shoulders. This in turn creates imbalances in the muscles attached to these areas that leads to neck pain, headaches, shoulder pain, incorrect posture, muscular fatigue, stiffness and tension”.

To alleviate this a biokineticist will prescribe exercises to create movement, work the overactive muscles, relax the tight muscles and provide relief, which should be done in a quiet area where you can concentrate and relax.

Exercising should be done daily if possible, with a days break for six weeks, with a minimum of three weeks.

“It is important to be diligent and consistent about the exercises. Results can vary with relief after three weeks to two months”, says Das Neves.

Dr Shevel explains that dietary headaches are another common affliction and are usually triggered by foods that assist with energy. “Having too much sugar, like refined carbohydrates where the body produces too much insulin, causes the body's blood glucose level to drop. Your diet should consist of slow digesting, fibre-containing food sources”.

Slow-digesting foods: Grains and seeds, (barley, wheat, oats, millet, semolina) beans (lentils), whole meal flour, unpolished rice etc. (called complex carbohydrates)

Fibre-containing foods: bran sources, (whole wheat, grains, seeds) vegetables, (green beans, peas, marrow, mealies, spinach) and other herbs (iron-rich beetroot leaves), fruit with skin, dried fruit, especially dried apricots, figs and prunes, almonds, etc.

The foods eaten should be well-balanced, containing foods from each food group, i.e. fruits, vegetables, protein, bread/cereals and dairy products

Dehydration can also trigger headaches, so be sure to remain properly hydrated

Skipping meals is a surefire trigger for headaches, but eat in moderation

Top tips to avoid a dietary headache:
Avoid the following foods:
Fried and fatty foods
Foods containing too much sugar
Drinking excessive amounts of alcohol

Eat and drink the following:
Dates (excellent source of sugar, fibre, carbohydrates, potassium and magnesium)
Almonds (rich in protein and fibre with low fat)
Bananas (good source of potassium, magnesium and carbohydrates)
Drink plain water, as many carbonated soft drinks contain substances that can trigger headaches

It is important that headache patients and sufferers understand that headache pain is a real neurobiological disease that can be treated following proper diagnosis. People who suffer from headache symptoms are urged to seek treatment so that they don't have to live with this debilitating condition” concludes Dr Shevel.

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