Borgman, D. (1991). Headaches. S. Hamilton, MA: Center for Youth Studies.

OVERVIEW

Informally, one may refer to any annoyance as "a headache." The dictionary defines headache as a pain in the head. The Merck Manual sees headaches as "one of the most common of all symptoms (which) may occur either in the absence of organic pathology or as a manifestation of serious disease. Most headaches are transient but a few are chronic, recurring frequently over a period of months or years." (Eleventh ed., p. 997)

Headaches are usually caused by tension. But they may, according to the Manual, be (in certain severe cases) "a manifestation of acute systemic infections; intracranial tumors and infections; head injuries; cerebral arteriosclerosis; severe hypertension; cerebral hypoxia; and chronic or acute diseases of the eye, nose, throat, and ear. However, all these conditions account for only a few patients who consult a physician because of headaches."

PREVALENCE

Millions around the world are afflicted with headache pain. A 1989 study of 10,000 people in Maryland found 76% of women and 57% of men had suffered from headaches in the past month. It is estimated that between 15 and 25 million U.S. citizens (one of every ten) have frequent, severe headaches.

NATURE AND CAUSES OF HEADACHES

Researchers are now rejecting the notion that the dreaded migraine is different from headaches. It is now considered an extremely painful, debilitating headache. Although specialists have never been sure of the etiology or cause of headaches, they now look more to the chemistry of the brain rather than in the muscles, blood vessels, or emotions. They see "the common denominator of headaches in a change or abnormality or in the brain’s nerve signals, perhaps involving the chemicals serotonin and norepinephrine that nerve cells release to ‘talk’ to one another" (Lehman, B. [1991, February 18]. Better to avert a headache than to treat one. Boston Globe). Lehman continues:

People who get only occasional headaches may be having the same chemical changes as people who are headache-prone, just less often. Or the chemical swings may be happening just as often in occasional sufferers, but they’re less sensitive to them. No one knows for sure.

But many of the things that can trigger a headache, both in people who are headache-prone and those who aren’t, are by now well known. Emotions, foods, medications, alcohol, illness, and hormone shifts, among many others, all can do it.

TREATMENT

A new trend is to focus on prevention rather than on painkillers. Painkillers may be fine if taken occasionally, but, when taken too often and in large doses, they may disturb the brain’s chemistry and create conditions that make the next headache sooner and more severe. (Researcher Joel Saper treated one man who took 55 Excedrin pills daily and drank three quarts of a mild antacid to soothe his stomach.)

The headache "rebound effect" is more likely with Tylenol and combination remedies like Excedrin and Vanquish (according to Saper). Plain aspirin and ibuprofen (as in Advil) are less likely to facilitate a return headache. A doctor should always be consulted in persistent pain.

Lehman concludes:

(Some) physicians are using blood pressure medications, such as beta blockers and calcium channel blockers, as well as antidepressants and epilepsy drugs, to ward off chronic headaches. They are also instructing patients to identify and avoid the things that trigger their particular headaches. They can include caffeine, tyramine (a chemical abundant in cheeses, chocolate and red wine) and the sweetener aspartame (Nutrasweet). Some patients are being urged to use stress-reduction techniques, including biofeedback, meditation, and physical exercise.

IMPLICATIONS

1. The increase of stress and toxins in the world has increased the risk of disease and pain.
2. Medical science has done much to understand and reduce pain.
3. A holistic understanding of the human body and psyche and a return, where possible, to a simpler way of living and more natural foods, is a general preventive posture in the face of rising stress.
4. There is a need for sensitivity to others who suffer pain and an understanding and nurture of one’s own body and psyche. Peace and well-being are contagious in family and working situations.