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Headaches

What is a headache?

Headaches are expressed as pain or an ache which affects areas of the head, neck and face. The different headaches which people suffer from vary in the type of pain experienced and also in the frequency they occur. The pain can be so intense that lifestyle and work are dramatically affected, or just irritating and constant but mild. The majority of the population of the UK will experience at least one headache this year and many of them will experience them on a regular basis, taking over the counter medicines to relieve them. The vast majority are mild to moderate and do not require investigations only a very small proportion will require examination and treatment.

Headaches can be affected by the environment in which we live or the food we consume. Both of which can cause symptoms which affect the nerves, muscles and blood vessels creating headaches. Therefore the cure sounds quite simple alter the food we eat and the environment in which we live and no more headaches, unfortunately it is not always that easy, but in some fortunate cases it is. There are many different triggers out there for some types of headaches and if you can find what it is and avoid it, then you will be cured, or at the very least be aware of what is causing your problem and have the choice to avoid it.

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Different type of headaches:

Vascular headaches:

These are characterised by the persistent throbbing nature of the pain in the blood vessels or the vascular system, there can be various causes of this pain.

Brain Aneurysm:

This is a condition where the wall of an artery inside the brain begins to balloon out, the tissue of the wall becomes very thin, this can be due to disease, injury or perhaps it has been present from birth. High blood pressure can play a significant part in this and the blood vessel can rupture or burst resulting in a stroke. If this burst aneurysm on the brain is between the layer of the skull and the middle membrane layer of the brain it is called a subarachnoid haemorrhage, whereas if the artery which bursts is inside the brain itself it is called a cerebral haemorrhage. Most aneurysms go unnoticed unless they burst or are causing problems like causing pain above and behind the eye, headaches and visual disturbances. Subarachnoid haemorrhages are often described as the worst headache you can imagine. It is very sudden in onset and is often accompanied by vomiting, double vision, a stiff neck and sometimes unconsciousness. MRI (magnetic resonance imaging) or computed tomography (CT or CAT scan), are used to identify aneurysms.

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Brain Tumours:

These include both brain tumours as a primary (which means this is where the tumour started) or tumours which are metastasis (sometimes called a secondary) of a tumour elsewhere in the body. These tumours are cells which have multiplied and these can be either malignant (cancerous) or benign (non-cancerous)   approximately 40% of all brain tumours are non cancerous. Symptoms can include headaches that do not throb but which are worse in the morning and come and go. The disease can progress to include seizures, difficulty with memory and intellect, concentration, temperament with personality changes and speech and communication problems.

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Head injury:

These can be due to trauma of one kind or another, either falls, assaults or road traffic accidents. In the UK approximately 150,000 peoples are admitted to A&E departments with head injuries, and they are the commonest cause of death of young men. A head injury should be investigated further if you continue to have a headache or it gets worse, five hours after the initial injury and if drowsiness continues after a couple of hours. If you get additional symptoms like becoming confused, have slurred speech, become irritable, have visual disturbances like double vision, or experience a seizure (fit) you will need to return to the hospital immediately.

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Meningitis:

This is the inflammation of the meninges (the membrane layers protecting the brain and spinal chord) it can be caused by bacteria, viruses, fungi, and amoeba (single celled organisms) the early symptoms can be similar to flu and include severe headache, a high temperature and  vomiting. This then progresses to, a blotchy skin rash, a stiff neck, muscular pains, a dislike of bright lights, confusion and drowsiness. Not all these symptoms are necessarily present at the same time. The symptoms can develop slowly but the disease can progress rapidly and can be life threatening. If the person has a high temperature with a rash that does not fade when the side of a glass is pressed against it, they need to go to hospital immediately.

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Migraine:

Researchers agree that the blood flow to the brain is affected with migraine headaches and it is caused by sometimes obscure triggers factors which are present at different times; however the exact cause is unknown. Spasm and the release of serotonin (a chemical which when released into the blood stream constricts blood vessels) in the arteries disrupt the supply blood to the head, and all contribute to the sever headaches of migraines.  

This condition is three times more likely to affect you if you are young and female and if either of your parents suffered from migraines, then it notches up your chances again. They can be linked to many triggers but are more common with menstrual periods. If your migraines are linked to your menstrual cycle or pregnancy they can become worse if you take the pill or HRT (hormone replacement therapy).

The migraine headache itself varies dramatically from person to person in duration it can be four hours or up to three days, and you may suffer these weekly, monthly or only occasionally.

Warning of migraines takes different forms some people have prodromal warnings which is a symptom before the onset of the headache. Being consciously aware of these factors can mean that medication may be taken prior to the migraine attack. These prodomes can occur from a day to hours before the headache comes on, these can be varied:

  1. Hankering for all things chocolate or sweet
  2. Abnormal thirst
  3. Inexplicable euphoria
  4. Sleep disturbance
  5. lethargy
  6. Feeling stressed
  7. Frustration and irritabilit

Some people have “auras” which are forewarning of the headache to come, they usually occur up to half an hour before the onset of the migraine. Again if this warning is heeded medication can be taken to ward off or reduce the intensity of the migraine.
People who have these can experience:

  • Visual disturbances such as
    • Flashing lights
    • Blind spots
    • Sparkling lights
    • Crisscross lines across your vision
    • Heat wave visual sensation

Symptoms of Migraine can include some or all of these:-

  1. Moderate pain on one side of the head
    1. Some people experience pain on both sides
  2. Throbbing or pulsating pain
  3. Pain that interferes with work or  lifestyle activities
  4. Sensitivity to light
  5. Noise intolerance
  6. Speech difficulty and confusion
  7. A tingling feeling on the hands or side of the face
  8. Irritability
  9. Nausea and  or vomiting
  10. weakness of a limb i.e. arm or leg

Some migraine headaches are described more accurately as:

  • Migraine with aura – These are severe migraines which occur following a usually visual disturbance warning as described above usually accompanied by a number of the symptoms listed. Duration of the headache is usually between 4-72 hrs
  • Migraine without aura – This is usually a one sided throbbing moderate to severe headache accompanied by sickness, light and noise sensitivity, and lasts between 4-72 hrs .
  • Opthalmoplegic – These migraines are connected to visual disturbances, and usually begin in childhood. It can cause the temporary symptom of a drooping eyelid (ptosis), and double vision, repeated attacks may leave the sufferer with a slight ptosis. Theories of compression of nerves and swelling of arteries have not been supported by arteriograms (an X-ray detectable liquid is injected into the blood stream and x-rays taken which show up abnormalities) the sufferer experiences the same symptoms of conventional migraine with vomiting and light sensitivity( photophobia). It equally effects both men and women it is rare to suffer from this in adulthood if you have not experienced an episode as a child.
  • Retinal Also known as ophthalmic migraines, anterior visual pathway migraines, or ocular migraines – This is where the sufferer is blinded temporarily in the one eye for approximately 10 – 20 minutes and is accompanied by a severe one sided headache. The visual disturbance varies in that it can be a black, grey or white area and can come on slowly or instantaneously.
  • Basilar artery Migraine –This occurs when there is bilateral (both eyes) disturbance of vision, with the inability to co-ordinate muscle movement, dizziness, dysarthria (difficulty with speech), tinnitus (ringing/ noise in the ears) and face or limb tingling or pricking sensation. These symptoms are followed by severe throbbing headache.
  • Hemiplegic Migraine – This is a very rare and quite a frightening condition as the person may well believe they have suffered a stroke as one side of the body may become temporarily paralysed. There are two types of this condition Familial Hemiplegic migraine and Sporadic Hemiplegic migraine, both begin in childhood
  • Status Migrainosus –This condition is a rare but severe type of disabling migraine. The nature of its severity is that whilst it encompassed all the symptoms of a migraine the relentless nature means that is continues longer than for 72 hours and can cause extreme dehydration which means that the person will need  to be hospitalized for pain relief and rehydration.

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Temporal or Giant Cell Arteritis:

This is a condition that is characterised by pain when you are chewing food; you begin to feel a pain in the temple area that becomes so sore you stop eating. This type of headache is concentrated in the temple region, above your eye and towards the hair. It is usually sore when touched or pressed; and the swelling from the blood vessel can sometimes be seen above the eye. The artery wall begins to swell causing narrowing of the artery and a reduced blood supply to the optic nerve; it can damage your eyesight permanently if left untreated. It is important that you see your GP as soon as possible.

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Tension Headache also known as muscle contracture headaches:
 
This type of headache is the most common and is usually relatively short lived.  Muscle contraction headaches involve the involuntary tightening or tensing of facial and neck muscles, this tension can concentrate at the base of the neck or right at the front of the head above the eyes. It is often described as having a tight band of pain around the head or a constant dull ache. Sometimes symptoms similar to those of a migraine can be experienced but to a lesser degree and the headache does not incapacitate the sufferer they are still able to continue with daily living activities.

These tension headaches are often caused by emotional stressors such as anxiety either within the home environment or at work, anticipated conflicts with work colleagues or perceive unachievable goals can lead to apprehension, fear, and panic. This anxiety can develop into other disorders such as depression, if not alleviated and recurrent tension headaches are a clear indication of a problem which requires attention.

Other factors to be considered when dealing with tension headaches relate to environmental elements, such as poor posture, inappropriate seating at desks, bad lighting, and noisy or polluted air conditions.

Existing or organic disease processes can result in tension headaches, degenerative arthritis of the neck, osteoporosis (porous bone), slipped disc, scoliosis (curvature of the spine), or a trapped nerve. 

Another condition which can cause tension headaches is temporomandibular joint dysfunction, or TMD this is a disorder where the joint just in front of the ear and the lower jaw cause the bite to be a poor match and the jaw to click and creak. Gentle jaw exercises, ice packs, eating soft foods, rest, not over extending the jaw, pain relief and patience as it can take a while for this to mend.

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Morning Headaches:

The causes of these headaches are linked with tension headaches but are a specific group as they always occur in the morning or on waking. They are due to a variety of reasons:

  1. Sleep apnoea – this is where people stop breathing regularly throughout the night, this cause’s excess strain on the heart and repeated waking during the night to restart breathing, means that the person is always tired and often suffers a headache.
  2. Partners of sleep apnoea patients- often wake with headaches due to being disturbed continually by the noise of snoring throughout the night. The lack of continuous sleep and the associated anxiety is a major contributor to morning headaches.
  3. Teeth grinders- or bruxers as they are also known. This condition sometimes is only highlighted due to the headaches in the morning some people do not know that they are bruxers. The muscle spasm and the loss of tooth enamel cause the teeth to become abnormally worn. Your dentist will be able to tell if you grind your teeth and be able to fit a mouth guard to protect them and keep the teeth apart at night.
  4. Hypertension – These feel as if the sufferer is wearing a tight hair band and is due to raised blood pressure. This needs to be controlled with medication and lifestyle changes to prevent further complications.
  5. Hangover- These are due to the excesses of alcohol and if this is a repeated cause of morning headaches may require further examination
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Sinus Headache:

The main sinuses in your face lay in the middle of your forehead and slightly over your eyebrows and just underneath your eyes either side of your nose they are made of bony air filled cavities. These may become infected causing swelling and congestion this in turn leads to pain around the eyes, the pressure will be felt across the cheeks and forehead. You can also suffer from facial swelling and the pain can intensify if you lean forward with your head down. The discharge may well be green yellow or brown in colour and be thick in consistency. You will need to visit your Doctor and will probably be prescribed antibiotic treatment to clear the infection and pain relief for the throbbing pain. If the symptoms are consistent with an allergy, virus or fungal contaminant decongestants may be offered.

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Chemical Headaches:

Chemicals used in some foods are known to cause sensitivity in some people and those often suffer headaches one of these is Monosodium glutamate the other known to be a causative factor are the nitrates used in the preservation of some foods.

Solvents used in day to day working environments can be known to causes headaches although risk assessment and COSHH -Control of Substances Hazardous to Health 2002 should cover and protect all employees. If you feel that your environment is causing you to suffer frequent headaches you can ask your employer to do a risk assessment to identify what may be the cause and then provide you with protective equipment. Solvents, like benzene, are found in turpentine, spray adhesives, rubber cement, and inks and are a known cause of headaches.

One of the most common causes of chemical headaches is due to poorly maintained gas central heating systems which cause carbon monoxide poisoning which initially can cause just headaches but if left uncorrected can lead to fatalities. The problem with this toxic gas is that it is colourless, odourless and tasteless. If the entire family are complaining of headaches by the end of the evening it is a good idea to have the central heating system serviced.

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Hormonal Headache:

Hormonal headaches cause a lot of controversy amongst GPs who treat them, the ladies who suffer from them and the researchers. It seems that this headache is often categorised as a migraine and treated as such. Advice regarding the contraceptive pill and HRT with the fluctuating levels of progesterone and oestrogen as the contributing factor are not as yet conclusive, some doctors maintain there are direct links others do not support the theory. Advice seems to indicate that if your headache becomes severe as to be categorised as a migraine and that it changes from migraine without aura to migraine with; it may be associated with your pill or HRT and that situation  needs to be addressed, and either discontinued or altered.

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Rebound Headache:

These headaches are not a type of headache they are a response to medication which is taken for headaches and that can be over the counter medicines or prescription. The condition arises when the sufferer gets involved in a vicious circle of medication for a type of headache whether it is migraine or tension. The headaches begin to not be relieved and therefore you take more medication more frequently, with no or little effect.

This cycle needs to stop, and that involves discussions with your healthcare provider, you may need to gradually reduce the medication you have been taking over a period of time or just stop them immediately, either way this needs to be in consultation with your doctor. Both ways may lead to side effects of withdrawal and the sufferer may experience worse headaches on a short term basis. The time period over which this happens can vary with the amount of medication being taken and the method of stopping.

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Cluster:

This is a rare form of headache which generally affects men more than women, between the ages of 20 – 50 the headaches. They get there name as they arrive in groups lasting for differing periods of time. i.e. daily for three weeks then gone for x amount of time. The trigeminal nerve which is one of the facial nerves becomes aggravated causing the most excruciating stabbing pain around the eye area spreading back towards the ear. The headache comes on very rapidly and can leave equally as fast. The duration of the pain can be from 30 minutes to three hours, and can occur many times in one day. Often symptoms of a watery red eye with nasal congestion on the affected side are also present, other symptoms can include a drooping or swollen eyelid, facial sweating and flushing.

The pain is cyclical in nature which means that it occurs often at a similar time, often at night and for specific time duration. The pain has been described as unbearable leaving the sufferer, pacing, rocking and even banging their head against walls and doors for relief. The side and eye which is affected remains the same throughout the duration of the cluster cycle but can alter to the other side when the next group of cluster headaches arrives. The time between the cycles of headaches varies from one sufferer to the next, to some it is seasonal, and others it can go into remission and not reappear for years. Whilst there is no cure for these headaches managing the pain to reduce the impact and duration is always the goal. Research has indicated that breathing pure oxygen at the onset of the headache can give instant relief for a large proportion of sufferers.

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Headache diary / record:

If you are suffering from regular headaches which are troublesome and interfering with your life style and daily activities, it might be helpful to keep a diary to record accurate details at the time and circumstances which may be the relevant to your headaches. You may find a pattern developing which can help you isolate your triggers and eliminate them or be able to go armed with this accurate information to seek help from your doctor.
Information you might like to include could consist of:

  • Time and date
  • Did you experience any visual disturbance?
  • Where were you when it came on?
  • The duration of the headache
  • What the pain was like i.e. stabbing ,throbbing, a tight band
  • Where the pain is i.e. front of head, all around  one sided
  • On a pain scale of 1-10 the level of pain
  • Were you sick?
  • What medication did you take?
  • What dose?
  • Was the medication effective?
  • When your headache went was it sudden or gradual?
  • Did anything else you did help?

This information can all give the GP a very good indication of how often your life is being affected by you headaches. If you wanted to do some investigative work for yourself and help your doctor more you could extend your diary to include the last 24 hours the more details you can remember will help with patterns and ultimately diagnosis and treatment, aspects like:

  • Did you experience any difficulty with speaking or balance
  • Did you notice any numbness or tingling on your body
  • How long did you sleep
  • What were you doing i.e. working -if so description of the environment, recreational at the cinema etc.
  • Did you experience any light or sound sensitivity
  • What you ate and quantity? breakfast ,lunch, supper- Chinese takeaway, fruit,
  • What you drank? How many cups of coffee, tea, fizzy drinks etc
  • What the weather is like
  • How do you feel emotionally i.e. euphoric, miserable, irritated ,happy
  • For women where in your menstrual cycle are you?
  • Have you been doing any activities like exercising, dancing, trampolining etc?
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Triggers:
These are the many varied and different things that we come into contact with which are a contributory factor to bringing on a headache. These triggers are in two groups the environment we live in and the food we consume.

Dietary Triggers:

There are many different foods which can cause headaches these are just a few of the more common. Long time sufferers try elimination diets to see if the food they suspect is a causative agent in their headaches is, it can be a lengthy process but hugely beneficial in the end as it is possible to isolate your trigger. Another method of seeing if environmental or food stuffs have a specific effect on your headaches is to keep a headache diary.
Common dietary triggers include:

  1. Wine usually red
  2. Alcohol, beer and spirits, brandy
  3. Caffeine, coffee, tea, carbonated drinks
  4. The chemical additive monosodium glutamate (MSG) which can be found in processed foods stuffs and Chinese takeaways, dry roasted nuts, crisps, frozen foods, sauces, and  mayonnaise .
  5. Some of the aged cheeses
  6. Yeast products
  7. Diary products, yogurt and sour cream
  8. Vinegar
  9. Food containing Nitrates as preservatives, smoked fish, bacon sausages, pepperoni and corned beef.
  10. Missing meals, can cause an imbalance in your body chemistry causing headache
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Environmental triggers include:
  1. Flying due to the high altitude
  2. Travel and time zone changes
  3. Weather pressure alterations
  4. Strong smells, creosote, petrol, perfumes, paint fumes
  5. Bright sunlight
  6. Cigarette smoke
  7. Stress
  8. Hormonal changes in women , the pill, HRT, menstrual cycle
  9. Visual stressors such as computer use
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Diagnosis:

When you go to your doctor to seek help you will probably have already experienced quite a few headaches. Your doctor will ask you relevant questions to facilitate the diagnosis the more accurate you can be will help. If you have a diary of your headaches it would be useful to take it along to help answer more precisely the questions your doctor will be putting to you. A person may have different types of headaches, and just because you suffer from migraines does not mean that you won’t have the odd tension headache thrown in for good measure.
If the doctor assesses your condition and decides it is necessary, they might send you for tests like:

Blood tests may be done to screen for thyroid disease, anaemia, or infections which might cause a headache.

MRI - Magnetic Resonance Imaging - This system uses powerful magnets and a radio-frequency to create images which are processed though computers. This is a commonly used technique to see inside the body and can show muscles, joints, ligaments, blood vessels, nerves and other soft tissue structures. It is often used to look at the brain and structures within, it is harmless to people although some do become anxious about going into the tube like structure of the machine. It can be loud when the scanner is processing the images but you will be given ear protectors for the duration of the test.

CT scan or CAT scan-Computed Tomography – This is a form of imaging whereby x-rays are used to obtain information of by scanning thin slices of the body structures and soft tissues with a narrow x ray beam which moves in rotation around the body, it then produces an image of each slice as a cross section of the body almost like slices of bread. The information is interpreted by computers and a two dimensional image is produced. Sometimes a contrast medium( x-ray detectable dye) is used to help show up the structures more clearly.

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When do I need to see a doctor for my headache?

Situation where you should seek urgent medical attention would include if your headache:

  • Comes on  instantaneously  and abruptly
  • Is severe with a stiff neck
  • Associated with pain in the eye or ear
  • Follows a blow to the head or a fall
  • Accompanied by  mental confusion or loss of consciousness
  • Accompanied by limb weakness, numbness or trouble with speaking
  • Is associated with severe pain in or around the eye
  • Accompanies a seizure (fit)
  • Accompanied by a high temperature.
     
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Treatment:

If headaches are persistent and affecting your lifestyle, work life and daily activities it needs to be discussed with your doctor. It may mean that you need to reduce your stress levels or change the environment in which you work; but by taking control of the situation and doing something positive to improve your health you will feel more in control of the headaches, rather than your life revolving around your headaches.
Schwartz et al. “Lost workdays and decreased work effectiveness associated with headache in the workplace”. J Occ Envir Med 1997 -stated that over 13,000 respondents to the survey gave self-reports of work missed through headache. 57% of 10,000 lost workdays due to migraine. That is a huge proportion of the workforce who is suffering from headaches of one kind or another, the impact of lost hours and financial loss for the sufferer’s means that it is important to seek  and receive treatment.

Treatment may consist of two main approaches specifically relating to migraine sufferers:

Abortive therapy- which is to stop a headache once it has kicked in

Preventative Therapy – This is where you take medication or take action which will prevent the headache coming on.

The medications which are available for the treatment of headaches vary dependant on the type of headache you are suffering from. Over the counter medicines such as Paracetamol, Ibuprofen and Aspirin have all traditionally been taken for the relief of tension headaches however it should be remembered that any medication taken should be at the lowest dose to be effective and with the least side effects. If you are regularly suffering from headaches and are taking increasing amounts of pain relief with little or no help then you need to consult your doctor to discuss your symptoms. Changes in medication may be appropriate or combining different types of therapies may be more suitable. Headaches are approached on an individual basis as no one cure fits all, lifestyle alterations may be all that is needed in some cases; to others it may mean identifying and avoiding specific food triggers.

Many people have more complicated scenarios which will require combinations of preventative and abortive medications which will have to be trialed by the individual and their effectiveness measured. If you are in this position the more precise you can be about how beneficial the medication was, if  it was effective and how long  it took to act, will mean the doctor can alter dosage or change the medication to fine tune it to your specific headache pain relief requirements. People who suffer from nausea may find they are unable to take medication orally and therefore need to be prescribed rectal suppositories.

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Self Help:

Eating a well balanced healthy diet, keeping fit and avoiding triggers foods, is obviously sound advice. However sometimes that isn’t enough all sorts of other triggers such as stress and the environmental factors are not so easy to avoid. Examine your work load are you over worked and tired  If you know that stress is a trigger factor for you there are a variety of options available to you.

  1. Biofeedback – This is a form of training which gives people the tools with which to help themselves by measuring and monitoring their body’s response to external stressors. The feedback is informing the person of their responses and helping them to learn how to control them. People learn how to consciously relax and how to modify their body’s responds to stress. The body may react to the stress by  causing pain in the form of a headache, by learning to recognise when the tension is building and with conscious thoughts of being in control and able to handle the situation give the person much more control, thus reducing the incidence of headaches.
  2. Counselling – This is where the client and counsellor explore difficulties or distressing situations which may be resulting in the headaches that are being experienced. By talking through and looking at these problems from different views it will give the client different options or courses of action that they might choose to take. Counsellors do not tell clients what to do, they do not judge and do not make decisions for you , they help you on a journey of exploration for you to reach your own decisions.
  3. Relaxation therapy – This is a technique which is used to help people learn to relax to recognise when their body is stressed and provide ways to release physical and mental tension. Guided imagery is just one of the methods of relaxation.
  4. Cognitive therapy- This is a behavioural and thought process technique. The person talks about the “now” rather than “the past” as other therapies might. This therapy helps you to think about the way you see yourself, the world and the other people in it. It helps you to think about what you do and how it affects your thoughts and feeling. This behavioural response may help eliminate negative feelings and therefore improve how you respond to your stress and headaches.
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Practical help if the head ache has come on:

  1. Resting in a Darkened room
  2. Take you medication as prescribed
  3. Keep a headache diary
  4. Ice packs and heat packs alternated can help
  5. Warm showers on the back of the neck
  6. Gentle neck massage
  7. Acupressure –( a form of alternative therapy to apply pressure without needles to certain points to relieve pain)
  8. This one was sent in by Gill in Exeter- apparently you put your feet in a warm bowl of water and put an ice pack on the back of your neck.
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If you have any other practical self help tips on how to relieve you headaches please contact me so I can pass them on to other fellow sufferers. Click here to contact us

The food elimination process
:

If you believe that a certain food is one of the triggers for your headaches it may be worth trying to eliminate it from your diet for a period of time and see if your headaches improve. This method requires patience and endurance as the process can take sometime.
The process means identifying food stuffs in to groups and then eliminating all those foods form one of the categories from your diet for a period of a month. After a month reintroduce a variety of foods from that category for just the one day to see if you get a reaction over the next 48 hours. If you have a reaction and have a headache then you will need to by process of elimination again work through the elements in the food group which may be the culprit it may be more than one.

Suggested Food Groups:

Diary- milk, cheese, cream, yogurts
Corn – Corn flour, crisps, popcorn, cornflakes
Grains- oats, rye, barley,
Nuts- peanuts, cashew,
Soya – Soya milk, tofu,
Wheat- pasta, bread, cereals, beer, donuts, crackers, cakes
Sugar- chocolate, cakes, processed foods sweets
Nitrates- many processed meats - check the labels

Maintaining a healthy well balanced diet consisting of organic fresh produce, including fruit, vegetables, fish and chicken

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Help lines, Organisations, web links:

Brain Tumour UK

PO Box 27108
EDINBURGH
EH10 7WS
Tel: 0845 4500 386
Email: enquiries@braintumouruk.org.uk
www.braintumouruk.org.uk

Headway - the brain injury association

4 King Edward Court
King Edward Street
Nottingham
NG1 1EW
United Kingdom
Telephone: 0115 9240800
Helpline: 0808 800 2244
www.headway.org.uk
Fax: 0115 958 4446
Minicom: 0115 950 7825

 Meningitis Trust - Head Office

Fern House
Bath Road
Stroud
Gloucestershire
GL5 3TJ
United Kingdom
Tel: +44 (0)1453 768000
Fax: + 44 (0)1453 768001
e-mail: info@meningitis-trust.org
www.meningitis-trust.org

24-Hour Nurse-led Helplines:
UK: 0800 028 18 28
Republic of Ireland: 1800 523 196

Migraine Action Association
Unit 6 Oakley Hay Lodge Business Park
Great Folds Road
Great Oakley
Northamptonshire
NN18 9AS
Tel: 01536 461333
Fax: 01536 461444

Enquiries about Migraine
0870 050 5898
http://www.migraine.org.uk

Migraine Trust
The Migraine Trust
55-56 Russell Square
London
WC1B 4HP

Tele: 020 7436 1336
Fax:  020 7436 2880
Email: info@migrainetrust.org

Helpline: 020 7462 6601
Monday to Friday 10am to 5pm
http://www.migrainetrust.org

 British Snoring & Sleep Apnoea Association  
Castle Court 
41 London Road  
Reigate 
RH2 9RJ
Tel: 01737 245638    
Fax: 0870 052 9212
E-mail: info@britishsnoring.co.uk    
Web: www.britishsnoring.co.uk

The Sleep Apnoea Trust 
12a Bakers Piece
Kingston Blount
Oxon
OX39 4SW
United Kingdom
Tel :+44 (0)845 60 60 685
Fax: +44 (0)845 60 60 685
http://www.sleep-apnoea-trust.org/index.html

www.relieve-migraine-headache.com/diet-headache-migraine.html

 http://www.hse.gov.uk/coshh - Details on the regulations of chemicals in the workplace and the precautions which needs to be in place by the employer.

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