"A headache is one of the most commonly shared causes of human misery".

Most people suffer headaches at some stage in their life. Thankfully, for most people they are few and far between, but others suffer on a more frequent basis with pain that lasts from minutes to days. Such pain ranges in intensity from being a slight inconvenience, causing little or no interruption to the daily routine, to being a dreadfully debilitating condition, ruining the life of the sufferer.

Many people who suffer quite severe headaches accept their lot with little complaint and often do not consider the possibility of treatment. Their suffering may not be inevitable as there are a variety of treatments that can reduce or eliminate headaches. Orthodox medicine has many successful medications particularly for the alleviation of the very severe pain of migraine. Osteopathy, Homeopathy and Acupuncture should also be considered as a primary treatment for headaches.

What causes headaches?

The causes of headaches are many and varied including muscle tension, migraine, sinus congestion, trauma, hypertension, pre-menstrual syndrome, and, very rarely, tumours or meningitis. The vast majority are due to muscle tension or migraine. A 28-year study found that 90% of patients complaining of head pain had either migraine or tension headaches or a combination of the two.

The pain sensitive structures of the head are the scalp, arteries, muscles, and mucous membranes of the sinuses, external and middle ear and the teeth. Interestingly the brain itself has little or no sensitivity to pain.

What are Sinus headaches?

In this case the sinus membranes swell up and block the channels from the sinuses to the nose. This causes pressure, which squeezes the sensitive facial nerves and may cause pain either side of the nose and between the eyes. (This pain can also be caused by infection).

What is a migraine headache?

Migraine is primarily a vascular headache sometimes preceded by a phase where there may be visual or sensory disturbance often described as flashing lights or blurred vision. Others may suffer from mood swings, nausea or just a feeling of 'strangeness'. However the majority of migraine sufferers do not have this initial phase.

The pain is generally one sided; pulsating or throbbing, usually made worse by movement and often of an intensity which prevents normal activity. The onset of pain is often accompanied by nausea and sensitivity to light and, in some cases, difficulty with speech. This variety of symptoms is due to an initial constriction of the blood vessels in the head that is later followed by an excessive expansion of the same blood vessels.

Migraine is not fully understood but certain patterns have been identified. Migraine occurs in about 8-12% of headache patients. It seems to occur more often in women than men, and many sufferers have a family history of this type of headache. (The hardworking perfectionist is the notable character type so stress may have a part to play).

Certain triggers have been identified. Foodstuffs such as chocolate, alcohol, caffeine and cheese have been linked as a causative factor, along with chemicals such as tyramine, found in beer, and monosodium glutamate along with sodium nitrate, which are found in many processed foods. American doctors often refer to the "Hot Dog" headache. The optimum age for a person to suffer their first migraine headache seems to be the 24 - 34 age group but it can strike at any time.

Why do some headaches seem to centre round just one eye?

Another type of headache is known as the "Cluster Headache". These can be very painful and are characterised by being located around one eye, often accompanied by redness, tears, a runny nose, sweating and sometimes a droopy eye lid. They usually last from 15 - 90 minutes and are often seasonal or associated with emotional stress and tension in the upper neck.

How does a tension headache differ from migraine?

Tension headaches are usually bilateral (both sides) and they are usually preceded by emotionally stressful situations, or by prolonged postural strain such as with excessive VDU usage. The headache often only comes on after the stressful period has actually passed. The pain is typically described as a constant, tight pressure at the front or back of the head like a tight hatband, which worsens as the day progresses. The pain of tension headaches varies in duration but can last for many days and often remains unchanged even with rest. The cause of the pain in this type is tightness of the muscles of the neck and of the scalp itself.

POSTURE in the office is especially important.

Should I consult my doctor?

For any persistent head pain that you are worried about, the doctor should be your first port of call, especially if your headache follows a blow to the head or appears suddenly and severely with visual disturbances. He will examine you and may take your blood pressure, as hypertension (high blood pressure) is a possible cause of headaches. He may also prescribe medication or in very rare cases send you for further investigation.

What can I do to help myself?

Your headache may be 'triggered' by food allergies, in which case keeping a headache diary may help to isolate a possible food or chemical culprit. We have to bear in mind here the varying absorption speed of different foods that result in different reaction times.

It will also be useful to your doctor if you can give him as much information as possible about the onset and duration of your headaches. Stress and emotional upset are well known causes of headache. In this case relaxation techniques or the identification of your personal stress factors will help. (Look for times when you 'catch yourself' clenching your fists or jaw, hunching your shoulders, or having a permanent frown).

How can the osteopath help?

The osteopath is well placed to help the patient suffering from head pain. Increased tensions in the musculo-skeletal system can be both a symptom and a cause of headaches.

Tense muscles are known to release chemicals that can be triggers for headaches and those of the head and neck are particularly implicated. The main nerves of the head responsible for pain are themselves closely related to the nerves that originate between the vertebrae of the neck.

Persistent tightness of the muscles of the neck will ultimately lead to compression of the joints of the neck, and so to dysfunction or increased degeneration and so pressure on these nerves.

The osteopath is able to identify the areas of dysfunction and treat that area. Such treatment may consist of massage to the muscles of the neck and upper spine or of gentle manipulation of the joints. The aim is to stretch the muscles and supporting ligaments of the neck, to relax muscle spasm and ensure free movement that will allow better drainage through the blood vessels. In this way many headache sufferers find their pain is helped and often completely relieved.