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Resilient Practice

What a Headache


“Your pain is the breaking of the shell that encloses your understanding”

– Khalil Gibran


Headache is one of the most common ailments of our modern society and one of the most frequent reasons for speaking to or seeing a doctor. The lifetime prevalence of headache is more than 90% and we imagine that most of you who are reading this have experienced it at some point. Whilst many people manage their headaches without intervention, they form the basis of approximately 20% of GP consultations. There are a myriad of causes from simple dehydration through to worse case scenarios such as a brain tumour.


As this is such a common problem we thought that we would share some of our expert knowledge and then explore some ways to help from various perspectives.


So, the science…


Primary headaches - these are stand-alone headaches that do not have an underlying cause, for example:

· Migraine

· Tension-type headache

· Cluster headaches

· Trigeminal Neuralgia

· Exercise induced headache


Secondary headaches - those caused as a result of another condition or problem such as:

· Trauma

· Vascular incident (stroke)

· Vasculitis (inflammation of the blood vessels)

· Sinusitis

· Ear infections

· Dental abscess

· Medication overuse

· Cancer

· Illicit drug use

· Alcohol

· Carbon monoxide poisoning

· Meningitis

· Withdrawal of caffeine

· Temporomandibular Joint Dysfunction

· Anxiety


This is a long list and as we said, some are simple and easy to remedy, others are much more serious. The most important thing to consider about a headache is the history.


Your GP would ask the following questions:


When did it start?


How long has it been going on?


Were there any triggers?


Where is the pain and does it radiate anywhere else?


What time of day does it occur?


What makes it better?


Does anything make it worse?


How is it affecting you?


….and the key question – what does it feel like? - the nature of the pain.


Tension type and Migraines.

Tension headaches are typically a pressure like feeling often described as a band around or across the head. They do not usually make you feel sick, and they are not made worse by moving around. They are often mild, or moderate but bright lights can make them worse. They can last several days, and some people get them almost every day.


Migraines have a pulsing, throbbing quality. People will often feel sick and just want to lay day and turn off the lights. They are often on one side of the head and many people get an aura before they occur. This may be an odd smell, flashing lights, dots or lines in the vision or pins and needles. Some can get neurological symptoms with the migraine such as weakness on one side or difficulty with speech. This is very frightening and should be considered an emergency.


Cluster headaches are a specific type of migraine that is centred around one eye. The eye may be red and watery and the nose on that side may run. They tend as the name suggests, to come in clusters with many episodes each day for several days and then nothing for a significant time.


If you suffer from headaches, it is important to talk to your GP to determine the cause.


Consider also the following:

  • Medication overuse. This is becoming a huge problem. Codeine based painkillers can often make headaches worse.

  • Make sure your boiler has been checked and get a carbon monoxide monitor.

  • Your diet. Are there things that might be contributing to your headaches such as spikes in blood glucose?

  • Stay hydrated

  • The physical activity that you do. Getting outside connecting with nature will help.


Treatments

Tension headaches

Check for sources of physical tension, common places are in the shoulders and neck.

Consult a physical therapist for a thorough assessment and treatment.

Acupuncture has also been shown to help.

Relaxation exercises are good, check in with your body, are there any areas of tension? If there are, take a moment to identify the tension and allow it to drain into the ground. Read our Yoga Nidra article and try the practical exercise.

Recognise if psychological tension is contributing to your headache and take steps to address this with talking therapies.

In terms of medication, simple painkillers can be useful as can low dose amitriptyline as a prevention.


Migraines

These do need medication. The first line is ibuprofen or aspirin. Paracetamol can help. Specific drugs called triptans were designed for migraine and these can be prescribed. An anti-sickness medication can also be helpful. If the migraines are frequent, again preventative medications are available.

Cluster headaches should be treated in conjunction with your doctor.


Red Flags:

We would urge anyone with the following symptoms to seek medical help:

· A new severe unexpected headache (described as a thunderclap)

· Headaches that are getting worse or change significantly in their frequency, duration and intensity

· Fever

· Visual disturbances

· Signs of a stroke – weakness, slurred speech

· An atypical or odd aura

· Excessive vomiting

· Dizziness

· Others affected similarly (suggests environmental causes)

· Triggered by coughing or sneezing

· Much worse on bending forward or standing up

· Much worse on laying down

· New onset over the age of 50


Now let's look at headaches applying the principles of consciousness that all our teaching is based on...

Try this:

If you begin to be troubled by headache, it is important to remember to stay calm.


No situation is ever improved by you engaging in anxiety about it and the same applies here.


Like all pain, a headache is a message from your body, signalling to you that something is out of balance. As difficult as it may be, try to foster some gratitude for that message and slow down, say ‘thank you’ and listen.


Stay present – avoid projecting your thoughts into a scary future. Take action in the present moment. Make an appointment. Take steps to alleviate your pain.


Breathe – engage in some deep belly breathing to down-regulate you fight/flight response and avoid panic.


Observe your responses – be aware of your thoughts, emotions, and behaviours. What are you telling yourself? Is there truth in it or is it a story rooted in fear? How does that line of thought make you feel? What are you doing and what is the result? Is it helping or making it worse? Can you reframe the narrative? Process the emotion? Choose positive behaviours? Can you break the negative cycle and engage in one that will carry you through in a positive way?


Follow the above advice and seek medical guidance from your GP but do remember that most causes of headache are not serious and once those causes are ruled out, there are many remedies for you to try both medical and complimentary.


There are more headache soothing practices than we have mentioned here. Once you have received medical advice, seek to formulate a plan to soothe your pain.


With your unrivalled knowledge of your own body and preferences, find a formula that perfectly fits for you.


For more insights and a host of tools and techniques for exploring the Self and improving your

human experience see our book:

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