new daily persistent headaches

New Daily Persistent Headaches (NPDH)

New Daily Persistent Headache is yet another type of chronic headache. How can you tell if you are experiencing New Daily Persistent Headache? Usually NPDH begins with a sudden onset – one day you are fine and the next you get a headache that never goes away. New Daily Persistent Headache is thought to occur in approximately 1.7% of the population among adults. NPDH also seems to appear more frequently in young patients, either children or women in their 20’s an 30’s, and men in their 50’s. This condition is very difficult to treat effectively and some people may endure constant headache for years despite treatment.

Here are the common symptoms:

• You have headaches more than fifteen times per month
• Your headaches develop over the course of three days or less
• Pain is typically felt on both sides of the head
• The sensation of pain is usually like that of a tension headache – a constant sensation of pressure
• The level of pain can range from mild to moderate
• The level of pain is not made worse by exercise or routine physical activity
• Other symptoms like mild nausea and sensitivity to light may also exist.
• There is no evidence that the pain is caused by physical abnormalities or another diagnosable condition.

However, these symptoms are not enough to diagnose NPDH. You must also have these symptoms daily, without any sign of improvement for three months or more. Additionally, one must not experience more than one of the following symptoms – mild nausea, sensitivity to light, or sensitivity to noise – not all three and the nausea must not be severe. Essentially, these requirements rule out people with a past history of chronic tension headaches or migraines.

What Triggers New Daily Persistent Headache?

No one knows for sure. Sometimes NPDH appears to be triggered by infections, extracranial surgery, or stress. There also appears to possibly be a link between NPDH and  hypothyroidism, hypertension, alcohol consumption, overusing pain medications, and caffeine. Children will frequently have NPDH triggered by extracranial surgery, febrile illness, or head trauma.

Of all triggers, infection such as that caused by the Epstein virus is thought to be the most significant. The root cause is thought to be the body’s response to infection or stress, not the infection itself.

Treating New Daily Persistent Headaches

Typically treatment for NPDH does not vary that much from typical migraine treatment protocols including abortive medication (medication that will stop a headache as it develops, not just mask pain.)

Some instances of NPDH will go away on their own after a period of time whereas other may require constant treatment.

Reference: “New Daily Persistent Headache in Children and Adults,” by Kenneth J. Mack MD, PhD Current Pain and Headache Reports 2009, 13: 47-51.

chronic daily headaches hemicrania continua

Chronic Daily Headaches – Hemicrania Continua

Do you have a headache nearly every single day? If you do, you are not alone. As many as 5% of the entire population is thought to experience chronic headaches. There are many types of chronic headache conditions including, migraines, chronic tension headaches, “new daily persistent headache” and “hemicrania continua.”

Hemicrania continua is a headache that:

• May occur in 2% of headache sufferers
• Is more frequent among women
• Occurs more than 15 times per month
• Causes pain on one side of the head
• During an attack the level of pain will fluctuate up and down
• Sometimes additional jabs of pain are felt
• Sometimes the pain can migrate from one side of the head to the other, or to the neck, shoulders, or face
• Symptoms are made worse by exercise
• Additional symptoms may be noticed on the same side of the head as the pain such as a runny nose, tearing eyes, swollen eyelid as well as nausea, and sensitivity to light

What Causes Hemicrania Continua?

The cause of hemicrania continua is still unknown as research is still limited. Some studies show a possible connection between hemicrania continua and brain stem lesions and strokes. However, other studies show that many people have perfectly normal brain scans. The only thing that’s known for sure is that more research is needed.

Treatments for Hemicrania Continua

Hemicrania continua headaches all share one common link – they can be treated by a powerful anti-inflamatory medication called indomethacin. A few doses of indomethacin has been known to resolve the symptoms of hemicrania continua – however many people are not able to take this medication over the long term due to very unpleasant digestive system side effects including -  pain, ulcers, and bleeding. The side effects of indomethacin are not limited strictly to the GI system – many people also experience fatigue, bruising, blurry vision, ringing in the ears, and constipation.

The severe side effects of indomethacin have pushed researches to look for safer alternatives. Currently two known alternative treatments include melatonin and topiramate.

Melatonin is an herbal supplement that one can buy in any health food store. Melatonin is known to be chemically similar to indomethacin but in form that naturally occurs in the body. Be sure to notify your doctor before trying this supplement as some people have been known to experience significant side effects.

Topiramate is a prescription drug used to treat seizure-related conditions such as epilepsy.  While some people have experience relief with this medication, it is not without significant side effects. Topiramate is known to impair one’s ability to think and concentrate, increase the risks of kideney stones and osteoporosis, and impair one’s natural ability to sweat.

migraine botox

Migraine Botox

Most people only know botox as a treatment for facial wrinkles but recently, there has been a lot of press regarding botox as an alternative treatment for migraines. What is botox? Boxtox is a diluted and chemically refined substance derived from botulinum toxin A – a bacteria that many fear for its paralyzing effects when ingested. Botox is then injected into the muscles of the face that need relaxing – creating a smoother, less wrinkled appearance.

Can Botox Help Migraines?

Like many medication that are now prescribed for migraines (antidepressants, anti-seizure medications, etc) doctors noticed that patients suffering from migraines experienced a reduction in migraine attacks after botox treatments for wrinkles. This was not an official study by any means but simply observation of patients after treatment. Once the trend was noticed, word quickly spread among migraine sufferers.

Unfortunately, as there has not been a formal study of botox’s migraine preventative capabilities, it is still unknown why botox reduces migraines and if it will work for everyone. For now, botox as a migraine treatment is strictly an “off-label” use for medication – meaning, botox is not FDA approved for migraine treatment.

How Does Botox Treat Migraines?

If you are interested in trying botox treatment with the permission of your doctor – this is how many migraine sufferers are receiving treatment:

Botox is injected into one’s forehead, eye area, sides of the head, and back of the head.

Treatments must reoccur as botox will wear off after four to six months (this is no different than typical botox treatment to keep wrinkles at bay.)

Are There Side Effects to Treating Migraines With Botox?

Essentially, the potential side effects for treating migraines with botox are the same as treating wrinkles with botox – there is always some risk that a person will experience either an allergic reaction or certain symptom of botulism such as trouble moving normally, visual disturbances, trouble breathing, speaking, or swallowing. Less severe side effects include discomfort or irritation at injection sites, and mild reactions like dry mouth/eyes, feeling tired, and headaches.

what is headache

What is Headache?

When a person says they have a headache, typically they are  experiencing a certain kind of pain in their head or neck. Headaches are actually incredibly common. Nearly 70% of all people will experience a headache at some point within a year. A smaller, yet still significant number will suffer from reoccurring migraines, or even daily chronic headache pain.

Headache pain can vary from incident to incident and from person to person. Headache pain can be widespread across the entire head, parts of the face, and neck or very localized – occurring only on one side of your head, just around the eyes or sinuses, or perhaps just at the back of the head. Many people report feeling anything from dull, pressing pain, to sharp stabbing pain, to throbbing or pulsing sensations. Certain individuals will experience side effects from their headaches including nausea, dizziness, and sensitivity to light.

How do you know what kind of headache you are experiencing?

Tension headaches tend to cause pain that goes all the way around the head (and sometimes neck.) The sensation of pain is usually constant, not throbbing, and can feel light tight muscles or pressure. In the past, it was believed that tension headaches were caused by stress  (hence the name) or poor posture. Recent research is starting to indicate that tension headaches may in fact have a neurological component that was previously not known.

Migraines are among the most dreaded of headaches. The pain of a migraine is usually quite intense and can last anywhere from hours to days. Unlike tension headaches, migraine pain is usually felt as a throbbing sensation. Many migraine sufferers also experience symptoms like nausea and a sensitivity to light. A smaller component will also experience aura symptoms before the onset of headache pain – such as visual distortions. Migraines are known to be caused by conditions in the brain not by stress or psychological factors as many people are led to mistakenly believe.

Cluster headaches are relatively uncommon and not widely known about. Cluster headaches get their name from the frequency with which they reoccur (say every hour for a certain number of days, every other day for a number of week, etc.) Cluster headaches can cause the most severe pain of all headaches. Usually what will happen is severe pain in the eye area will come on suddenly without warning, last anywhere from a few minutes to an hour, and then disappear. During an attack there may be other noticable symptoms on the side of the head where pain is experienced including visible veins, redness, sweating, swollen eye lids, tearing in the eye, and nasal dripping. Cluster headache sufferers are also known for being unable to lie down when in the middle of an attack.

sharp head pain

Sharp Head Pain – Is it Cluster Headaches?

Cluster headaches are named for the pattern in which they appear – frequently over the course of hours/days/weeks and then not again for an extended period of time (from weeks, to months to years) – although some people can have daily cluster headaches. Usually the headache strikes at the same time(s) ever day when one is experiencing a period of attacks. The average cluster headache attack can last from a few minutes to a few hours. The pain of the cluster headache is known to be the worst of all headaches – more severe than even migraines.

The pain of a cluster headache is usually single sided and frequently located around the eye area. Unlike a migraine, there are seldom any warning symptoms and usually the pain comes on suddenly all at once. The pain is usually described as having a spike driven into ones head (sharp, burning, and very severe), as opposed to the throbbing pain of a migraine. Cluster headaches are also known for driving the sufferer to move around restlessly or even bang one’s head against the wall. While experiencing an attack you may notice other symptoms on the same side as your pain such as a runny nose, tearing or blood-shot eye, dropping eyelid, or sweating. A cluster headache usually ends as instantly as it begins and seldom do any symptoms linger – other than exhaustion.

The cause of cluster headaches is still unknown but current research indicates that the hypothalamus may be responsible.Why? Interestingly enough the hypothalamus regulates the body’s biological clock. As cluster headaches reoccur with such startling regularity, abnormalities in the hypothalamus are suspected. Other factors that may contribute to developing cluster headaches include hormones (primarily melatonin and cortisol) and neurotransmitters (serotonin, etc.)

Cluster headaches are experienced by men ten times as frequently as women. People who suffer from cluster headaches may also have a tendency to drink or smoke or use nitroglycerin.

If you do not have a past history of cluster headaches,make sure that you visit your doctor to rule other other more serious problems.

Cluster headaches can be especially difficult to treat as the pain is known to come on suddenly without warning. This type of behavior makes relying on over the counter medications impossible as the effects of such medications can take 40 minutes to develop.

The most effective treatment for cluster headaches is believed to be breathing pure oxygen. People who choose to try this treatment would need to keep an oxygen cylinder and regulator with them. Some people are able to get this same effect from very vigorous exercise. Unlike migraines, cluster headaches are not thought to be caused by exposure to environmental triggers like certain foods, etc – however once a period of attacks begin, many people notice that drinking alcohol can act as a trigger.  Some people have found relief by treating their cluster headaches with an injectable form of sumatriptan (the same family of triptans used to treat migraines) or a nasal spray form of zolmitriptam – Imitrex and Zomig.

Newer treatments in development call for the surgical insertion of devices that will stimulate the occipital nerve or the hypothalamus itself.

back of head pain

Do Headaches or Pain in the Back of the Head Make it Hard for You to Sleep, Work, or Relax?

Do Your Headaches and Pain Refuse to Go Away No Matter What You Do?

If so, what you are doing to treat your headaches and pain isn’t working. At best – you are suffering needlessly, worst – what you are doing to try to treat your pain could actually be making your problem worse. You need REAL help for your headaches and pain in the back of the head. Read on to discover how to identify and Treat the Real Cause – Not Just the Symptoms and End the Pain.

Introduction

Having a constant or reoccurring pain in the back of the head, neck, or shoulders is incredibly annoying AND frustrating. Despite the fact that headache or pain in the back of the head or neck is incredibly common, it seems no one knows what to do to treat the problem. I know that for me, the first time I visited a doctor it was recommended that I spend thirty minutes per day practicing “conscious relaxation” lying on the floor with a towel rolled under my neck. I simply could not believe this was the best advice the doctor could give me! Future visits to physical therapists had me spending hours per day doing neck stretches that did not seem to relieve my constant pain and tightness in my neck and back of the head. Frustration with finding a workable solution is what led me to research the problem on my own.

Fact #1: Doctors Want to Find Physical Evidence of Your Pain in the Back of the Head

This is not inherently a bad thing. Anytime you experience unusual or ongoing pain you should visit the doctor to rule out other serious problems – especially if you have recently (within the last year and a half) been injured or in an accident of any kind. When you experience pain in the back of the head or neck it is always possible the source of your pain is a structural problem or misalignment which can be diagnosed by xrays and other types of medical imaging.

There are many physical causes of pain or headaches in the back of the head or neck including:

Cervicogenic Headaches, which are caused by problems with the top two or three levels of the cervical spine.

Cranial or Occipital neuralgia, a source of nerve pain which can cause ongoing pain (of an “electroshock-type” sensation) in the back of the head, neck or shoulders.

The problem?

When xrayed, lots and lots of people will show signs of spinal misalignment, structural deviations, arthritis, etc – and yet, the vast majority will be completely unaware as they will not be experiencing any pain. As much as we would like to logically pair physical conditions with pain, these two do not necessarily go together for many people. If you have been diagnosed with a physical cause of your pain but you are not feeling relief – keep reading as there is help out there.

Fact #2: People Think Headaches and Pain in the Back of the Head Is Caused by Poor Posture and Can be Fixed Through Stretching, Relaxation, Massage, and Ergonomic Adjustments

Okay, I am not going to say this is not possible. It totally is! If fixing your poor posture and spending thousands of dollars on treatments and special equipment works for you – that is fantastic. I know I have gone down this path and easily spent thousands chasing “cure” after “cure” only to be left with exactly the same pain.

If you haven’t ever examined your posture, read on as I will explain what to look for and some easy and FREE exercises you can do at home! (And if you know this doesn’t apply to you feel free to skip this section.)

Is it Poor Posture?

Sometimes poor posture or a poorly designed work space can cause pain in the back of your head, neck, and shoulders. This type of posture is known as “head forward posture.” Head forward posture can be identified by looking at one’s posture from a profile angle (from the side.) If at all possible, have someone take a picture of you from the side. This would work much better than trying to analyze one’s own posture in the mirror.

Look at how you stand. Is your head a straight line up from your neck or does it appear to angle forward? Ears should be directly in line with one’s shoulder. If instead your head appears to jut forward when viewed from the side, poor posture could be causing some of the pain in the back of your head and neck.

Why is this? Forward head posture places too much stress on one’s muscles at the base of the skull (the suboccipitals) and the muscles in the back of one’s neck (cervical extensors.) This kind of pain can manifest as stiffness from the back of your shoulders to the top of your head and can lead to a headache located in the back of your head.

Here is another test – do you have full range of motion in your neck? Can you look all the way to each side? Can you allow your head to fall forward until your chin hits your chest? Without pain?

So what can you do if you suspect this is your problem? Essentially you will need to stretch the tight muscles and strengthen the weak ones. The most effective exercises are the following:

Chin retractions

45 degree Neck Stretch

Fact #3: Everyone says, “You Look Really Tense, Are You Sure its Not Just a Tension Headache?”

Little do they know, you are actually tense because you haven’t been pain free or had full neck mobility in months or years! Anyways…so how do you know if you are experiencing tension headaches?

Tension headaches are the most common type of headaches affecting anywhere from 30-78% of all people. Originally tension headaches were believed to be caused by tension, hence their name, but more modern research is uncovering evidence that the source of pain is actually neurological in nature.

In fact, the very latest research shows that tension headaches, especially chronic daily pain, could actually be caused by low-level migraines – which is causing inflammation to the tissue around your head, neck, and even shoulders. Inflammation will actually cause the stiffness and “pops and snaps” that you may be dealing with. Unfortunately, this is a suggestion that your general practitioner is unlikely to suggest. Most family practice doctors are not as familiar with headaches and migraines (let alone the latest research!) as they would like you to believe.

In fact, as many as 50% of all patients are misdiagnosed with the wrong condition!

Most migraine sufferers are never even told there are treatment options available including new cutting-edge drugs and effective alternative therapies.

And this is a shame because migraine, while not a “curable” disease is chronic condition (much like arthritis – a condition you will have all your life) that can be managed.

The truth is, with proper treatment you can reduce the frequency and severity of your headaches and migraines! That’s right, you don’t have to keep suffering, missing work, canceling appointments, and missing out on the the things you really want to do in life!
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Together We Can Help Your Pain

Let me help you as I helped myself. While working to cure my own headaches and migraines I studied only the best and most current information. Each new source and theory brought a key to the puzzle but not the complete solution. Combining each approach took years of trial and error. Learn from my mistakes, gain from my experience.

What would you do if you didn’t have pain to hold you back?

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Discover how to treat headache conditions that men are uniquely predisposed to such as:

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sudden head pain

Sudden Head Pain – Is it Cluster Headaches?

Cluster headaches are named for the pattern in which they appear – frequently over the course of hours/days/weeks and then not again for an extended period of time (from weeks, to months to years) – although some people can have daily cluster headaches. Usually the headache strikes at the same time(s) ever day when one is experiencing a period of attacks. The average cluster headache attack can last from a few minutes to a few hours. The pain of the cluster headache is known to be the worst of all headaches – more severe than even migraines.

The pain of a cluster headache is usually single sided and frequently located around the eye area. Unlike a migraine, there are seldom any warning symptoms and usually the pain comes on suddenly all at once. The pain is usually described as having a spike driven into ones head (sharp, burning, and very severe), as opposed to the throbbing pain of a migraine. Cluster headaches are also known for driving the sufferer to move around restlessly or even bang one’s head against the wall. While experiencing an attack you may notice other symptoms on the same side as your pain such as a runny nose, tearing or blood-shot eye, dropping eyelid, or sweating. A cluster headache usually ends as instantly as it begins and seldom do any symptoms linger – other than exhaustion.

The cause of cluster headaches is still unknown but current research indicates that the hypothalamus may be responsible.Why? Interestingly enough the hypothalamus regulates the body’s biological clock. As cluster headaches reoccur with such startling regularity, abnormalities in the hypothalamus are suspected. Other factors that may contribute to developing cluster headaches include hormones (primarily melatonin and cortisol) and neurotransmitters (serotonin, etc.)

Cluster headaches are experienced by men ten times as frequently as women. People who suffer from cluster headaches may also have a tendency to drink or smoke or use nitroglycerin.

If you do not have a past history of cluster headaches,make sure that you visit your doctor to rule other other more serious problems.

Cluster headaches can be especially difficult to treat as the pain is known to come on suddenly without warning. This type of behavior makes relying on over the counter medications impossible as the effects of such medications can take 40 minutes to develop.

The most effective treatment for cluster headaches is believed to be breathing pure oxygen. People who choose to try this treatment would need to keep an oxygen cylinder and regulator with them. Some people are able to get this same effect from very vigorous exercise. Unlike migraines, cluster headaches are not thought to be caused by exposure to environmental triggers like certain foods, etc – however once a period of attacks begin, many people notice that drinking alcohol can act as a trigger.  Some people have found relief by treating their cluster headaches with an injectable form of sumatriptan (the same family of triptans used to treat migraines) or a nasal spray form of zolmitriptam – Imitrex and Zomig.

Newer treatments in development call for the surgical insertion of devices that will stimulate the occipital nerve or the hypothalamus itself.

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