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HELP, HEADACHE!!

22/10/2014

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2014-10-22_-_headaches.pdf
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Headache is one of the most common and debilitating conditions around.  Any veteran of headaches will know that once it has properly kicked in, your entire system struggles to operate effectively.  While it is a much researched topic, many of the causes of headaches are still being debated upon.  Possibilities for the source of headaches are endless, ranging from tension to tumors, sport and sex.  Where do we start eliminating?

Below is a list of often-missed factors that may be responsible for the hammer pounding in your head. These can all be addressed by simple lifestyle alterations, which may just help for those headaches never to return again.

  • EYESIGHT  

Degenerating eyesight is a common culprit, especially with frequent computer work.  These headaches often appear as cluster- or migraine type headaches, which worstens towards the end of the day. The patient may occasionaly have a blurry vision and find it hard to focus. Experts recommend eye tests two-yearly for those who do not wear spectacles or contact lenses, and yearly check-ups for people with visual aids.


  • GRINDING YOUR TEETH

Night-time teeth grinders often wake up with a slight headache, which progresses as the day goes along.  Pain may be on either or both sides of the head, and are often located in the temples, behind the eyes, around the jaw or at the base of the skull.  A night of grinding may leave your jaw slightly numb in the morning.  Your dentist will be able to confirm whether you are a grinder by looking at the wearing pattern of the molar teeth.  A custom-made bite plate may provide a solution to eliminate the source of your headache.


  • MUSCLE SPASM AND/OR VERTEBRAL PAIN

Tight, painful muscles in the neck and shoulders are one of the big causes of tension headaches.  Often, previous spinal trauma leads to vertebral pain and stiffness, which will certainly increase the occurance of muscle spasm and headaches.  Other causes for muscle spasms may be stress, muscle overuse, faulty posture and ergonomics and a prolonged sedentary position (see below).  These headaches are often more intense to one side that the other, and may be located in well-localised patterns (for example, behind your eye, or a band-like pain around your head).  Your physiotherapist will be able to assist in relieving these symptoms and aid you to prevent reinjury by means of slight adaptations to posture and lifestyle.  Regular heat, stretches and stress management techniques can also help to keep you spasm-fee.


  • ERGONOMICS AND POSTURE

Sitting for prolonged periods may increase your risk for headaches, especially when maintaining a forward-head posture, rounded shoulders and drawn-up shoulder blades. Visit your physiotherapist and have a workstation evaluation done in order to optimise your office ergonomics. It may take as much as adjsuting your chair height or repositioning your keyboard to resolve the problem.


  • SINUSITIS

Sinusitis can occur due to acute infection or prolonged exposure to allergens. Often seasonal, certain allergies can lead to the irritation and inflammation of mucus membranes in the sinuses.  This can result in headache on either or both sides of the face, around the cheekbones and/or above the eyes. Headache often increases with head movement or when bending over.  Speak to your doctor or pharmacist about your symptoms and recommended medication.  Also make regular use of a saline nasal spray during the course of the day. Your physiotherapist can help to improve sinus drainage by means of electrotherapy and manual therapy treatment.


  • DIET

A change in diet may resolve your problem all together.  The best way to identify a food substance which may elicit your headache is by means of elimination.  Avoid the specific substance completely for two weeks WITHOUT changing the rest of your diet, and note whether or not your headaches recur at a different intensity and duration.  Food substances that may trigger headahces include:  

  1. Dairy products such as yoghurt, sour cream, ice cream and strong, matured cheeses;
  2. Certain meat products such as pork, seafood or chicken livers and processed meat (such as polony and sausage)
  3. Fatty or fried foods
  4. Chocolate and nuts
  5. Caffeine-containing drinks
  6. Alcoholic drinks, specifically red wine.

  • WITHDRAWAL SYMPTOMS

Are you busy to quit smoking, decrease your coffee intake or discontinue chronic medication? Withdrawal may well be the cause of your headache.  Try to decrease your intake more gradually, and drink a lot of water to assist your body with detoxifying.  Most importantly, just hang in there! It will wear off sooner or later – and your body is going to thank you! (Remember never to discontinue chronic medication without your doctor’s input.)


  • HORMONES

Ladies, your headache is most probably hormone-related if you experience it in a regular pattern on a monthly basis, especially if it occurs close to your menstrual period.  If you have recently started on new contraceptive or hormone replacement medication, this too can be the cause of headache.  Speak to your gynaecologist if symptoms persist.


  • DEHYDRATION

Headache can occur simply due to you not taking in enough fluids.  When a headache hits, have a glass of water and monitor your symptoms for the following 20 minutes.  If the headache is due to dehydration, it should subside.  Be sure to take in at least 2 litres of fluid (preferably water) per day, and up to 3 litres on warmer days, especially if you spend a lot of time outdoors.

SO WHEN SHOULD I WORRY ABOUT MY HEADACHE?

The following are pointers that may indicate a more serious reason behind your headache.  Seek medical help if any of these occur:

  • Intense headache with neck stiffness, light sensitivity, nausea, fever and/or flu-like symptoms;
  • Any weakness or loss of sensation to any of your limbs or other body parts;
  • Sudden visual disturbances;
  • Loss of consciousness, disorientation or personality change;
  • “Thunderclap” headache – rapid time between onset and peak of headace (about 5 seconds);
  • Longstanding headache not reacting to any medical treatment

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    Author

    Marissa Fourie is a physiotherapist in Stellenbosch with a special interest in musculoskeletal conditions, pediatrics and post/prenatal health.

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