Migraine Headaches

Migraine sufferers are everywhere, and anyone can suffer from them. The pain that these people feel is often debilitating. Yet non-sufferers and even some medical professionals believe that it’s all their heads.

It is amazing just how much a true migraine headache can affect an individual. It can interfere with a person’s home life, work productivity and relationships with family and friends. It makes recreation and exercise very difficult, and can interfere with an individual’s ability to enjoy life. Many headache sufferers will try to treat themselves at first, and then will finally go to see a doctor. Yet often they can only get temporary relief. Chronic headache sufferers generally have a poorer quality of life compared with people with other disorders, such as arthritis.

About 28 million people in the United States suffer from severe migraine headaches. Approximately 25% have four or more attacks each month. 80% of migraine sufferers have some type of disability as a result of their migraines and some are unable to function in society at all. It is not unusual to meet people who are so disabled by their headaches. A migraine or tension headache is a debilitating disorder that can literally control a person’s life.

Causes of Headaches
We need to be able to differentiate between the cause of a headache and something that triggers a headache. Triggers for headaches can be environmental, foods, physical issues, emotional issues, medications or chemicals. Environmental factors that are common causes of headaches include: Changes in altitude, such as flying, flashing lights or strobe lights, loud noises (rap music), motion of a car, boat or airplane (accompanied by motion sickness), smoke from cigarettes, cigars or pipes, strong odors such as perfume, changes in the weather. Some typical foods that will trigger headaches in people include: chocolate, caffeine, alcohol (especially red wine), dairy products (milk, ice cream, cheese), pickled foods, food additives (MSG, sulfites, saccharin), meat containing nitrates (luncheon meats), and certain vegetables. Physical causes of headaches include: fatigue, hormonal changes (menstruation, pregnancy, birth control pill), hypoglycemia, stress, sex, exercise, smoking, neck strain/pain and vacations. Emotional triggers include: family problems, work related problems, school issues, emotional crisis, post emotional crisis, and anxiety. Medications and chemicals that can trigger headaches are: histamines, hormone supplementation, nitroglycerine, blood pressure medication, and anti-depressants.

The actual cause of a headache can include: eye problems, systemic or metabolic conditions, hypertension, thyroid disease, anemia, kidney failure, uremia, meningitis, encephalitis, head injury, trauma, a brain tumor, a fever or something of unknown etiology. The one thing that all headaches have in common is that they hurt. How and the degree to which they hurt varies. The International Headache Society has a list of about 130 various types of headaches. These differ in a variety of ways. They can be mild, moderate or extremely debilitating. They can vary in their intensity, length of duration and how often they show up. The worst type of headache is the one that is not always the most painful but often the one that causes the most distress in the patient. There are two basic groups of headaches: Primary Headaches and Secondary Headaches. Tension-type headaches are the most common type of Primary headache. They are experienced by about 80% of the population. The second most common headaches are migraines.

Headache Treatment
Not to long ago, the only drug available for a headache was a couple of aspirin. Today there are a number of drugs designed specifically for the treatment of migraine and other chronic headaches. Some of the drugs that are used to treat migraines were originally designed to treat other conditions such as high blood pressure and wrinkles. These drugs are divided into two categories, those that relieve pain after the headache has already begun, and those that prevent or decrease the symptoms of a migraine.

Neurologists will usually choose a treatment plan based on the frequency and severity of the headaches. Normally, those patients who suffer from two or more debilitating headaches per week, get no relieve from pain medication, or are using large quantities of pain relievers, are placed on a plan of preventative therapy. Unfortunately, many of the medications that are used can have serious side effects. Some are not used with children or with someone who is pregnant or breast-feeding.

Pain-relieving medications
These drugs are usually taken at the first sign of a headache. Nonsteroidal anti-inflammatory drugs (NSAIDs)- These are the common over the counter drugs like Ibuprofen (Advil, Motrin), Acetaminophen (Tylenol) or Naprosyn (Aleve), or Aspirin (Bufferin, Bayer).
Triptans- The very first drug developed specifically for migraine sufferers was Sumatriptan (Imitrex). Sumatriptan acts like the neurotransmitter serotonin, binding to those neurotransmitter receptors which results in constriction of the blood vessels in the head.
Ergots- Drugs such as ergotamine (Ergomar) and dihydroergotamine (D.H.E. 45) and dihydroergotamine nasal spray (Migranal) help relieve pain. These drugs may have more side effects than do tritons.

Preventive medications
Preventive medications can reduce the frequency, severity and length of migraines and may increase the effectiveness of pain-relieving medicines used during migraine attacks. In most cases, preventive medications don't eliminate headaches completely, and some can have serious side effects. For best results, take these medications as your doctor recommends:
Cardiovascular drugs- Beta-blockers — which are commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines. These drugs are considered among first-line treatment agents. Calcium channel blockers, another class of cardiovascular drugs, especially verapamil (Calan, Isoptin), also may be helpful. In addition, the antihypertensive medications lisinopril (Prinivil, Zestril) and candesartan (Atacand) are useful migraine prevention medications. Researchers don't understand exactly why all of these cardiovascular drugs prevent migraines. Side effects can include dizziness, drowsiness or lightheadedness.
Antidepressants- Certain antidepressants are good at helping prevent all types of headaches, including migraines. Most effective are tricyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and protriptyline (Vivactil). These medications are considered among first-line treatment agents and may reduce migraines by affecting the level of serotonin and other brain chemicals. Newer antidepressants, however, generally aren't as effective for migraine prevention. You don't have to have depression to benefit from these drugs.
Nonsteroidal anti-inflammatory drugs (NSAIDs-. Regularly taking over-the-counter NSAIDs such as ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve) may reduce the frequency of migraines. If these medications don't help, your doctor may suggest a stronger, prescription-only version of the same drug.
Anti-seizure drugs- Although the reason is unclear, some anti-seizure drugs, such as divalproex sodium (Depakote), valproic acid (Depakene) and topiramate (Topamax), which are used to treat epilepsy and bipolar disease, seem to prevent migraines.
Cyproheptadine This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
Neuromuscular Dentistry- Neuromuscular Dentistry is based upon the knowledge that for our jaws to function properly, our teeth, temporomandibular joints (TMJ) and the surrounding muscles must be in a state of balance. Our head rest upon our spine, and the lower jaw hangs below are head, held in place by a group of muscles. At some position in space there exists an ideal position of rest where the muscles are most comfortable. We call this position physiologic rest. There is also a position where our teeth will come together to maintain homeostasis between the teeth, TMJ and muscles to function. Neuromuscular dentistry is designed to find this optimal position using instrumentation, and restore the patient to that position. Neuromuscular dentistry uses computerized instrumentation to measure the patient's jaw movements. Combining both computerized mandibular scanning (CMS) or jaw motion analysis (JMA) with ultra-low frequency TENS the dentist is able to locate a "physiological rest" position as a starting reference position to find jaw relationship between the upper to lower jaw.
An orthotic appliance is made to this jaw position and the patient wears it for a period of time to see if the headaches improve. If they do, then more permanent treatment such as orthodontics, crowns, veneers, or surgery can take place to keep the jaws in this ideal position.