What Causes a Headache?

Not everyone suffers from headaches, but those that do often wonder why.  Twenty-eight million people in the United States suffer from various forms of headaches, according to doctors at St. John Chronic Headache and Migraine Institute.  Although a headache may seem like a simple ailment—pain in any region of the head, including sinuses, muscles, and blood vessels—the actual causes can be varied and often preventable.

 

Stress and Physical Causes

 Any type of stress can cause tightening of the muscle systems, which may lead to frequent headaches and migraines. Physicians at Virginia Hopkins have found that mind and body relationships are often disturbed by stressful situations, thereby disrupting sleep and causing headaches. For example, people under stress tend to grind their teeth during sleep, which places pressure on small mandibular joints just in front of the ear.  Sometimes it is just stress, but sometimes it can be due to dental problems. If one’s jaw or teeth are misaligned, one side of the jaw receives more pressure causing head pain.

 Drugs and Diet

           

Both prescription and over-the-counter medications are known to cause frequent headaches. This includes caffeine, alcohol, nicotine, and even medication given to patients for the treatment of headaches. The National Headache Foundation (NHF) suggests that it is often better to use a simple pain killer and wait out the headache, rather than inundating oneself with multi-symptom medicines.

Any type of substance abuse can cause not only frequent headaches, but also serious injury. Anti-depressants, sleeping pills, decongestants, and various beta-blockers can all cause painful headaches if overused.  Additionally, withdrawal from stimulants is a common culprit and is treated  by easing off the stimulant rather than stopping entirely.

Genetics

           

Genetic predisposition is often overlooked in cases of frequent headaches. Migraines tend to occur in early adulthood, accompanied by a sense of vertigo, and can often last for days. 

Headaches are more common in women than in men, suggesting a hormonal connection,  according to the American Headache Society. An increase in estrogen is known to cause vascular dilation and thus increase chances for recurring migraines. Frequent headaches in this category may be treated with progesterone cream to restore vascular tone and counteract the estrogen dominance. Many women and young adults suffering from these frequent headaches have found relief in the form of acupuncture, acupressure, meditation, and even simple relaxation techniques.

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A1614

http://www.mayoclinic.com/health/headache/MY00407/DSECTION=causes

http://www.headaches.org/educational_modules/completeguide/differenttypes.html

http://www.achenet.org/education/patients/typesofheadaches.asp

http://www.virginiahopkinstestkits.com/headachecause.html

Medicine, an excuse for living.

Medicine: An Excuse from Living

This article was immensely interesting to me and helped me rethink my decision for medicine. To me, balance is the most important thing in this life and finding that balance is also the trickiest thing one can do in life. As the article states: “as your practice grows, you will find your balance professionally…in your personal life.” The article was very positive and helped me to see what is actually important. It is difficult to see the war when you are fighting the daily battles on the front lines. The idea of this article is not to get too caught up in the heat of the battle and pay attention to the tides of the war. It also said that “some physicians will use their indispensability to patients as a way of life and the loved one can be made to feel guilty about taking the doctor away from a sick patient. It’s a rare family that will have the assertiveness to place their needs above the life or well-being of a patient.” The exploitation of guilt is merely a scape goat, a way to put off goals and aspiration and the needs of other members of the family. This is a serious problem and one I hope I will never fall into doing. One can very easily neglect the most important things and give excuses without realizing it. Family comes first as the saying goes, and we must always remember that. When I get into medicine, I promise never to neglect what is important, and although I will work hard to provide for my family, I cannot forget why I am working hard, and that is to make my family and myself happy. If my family is not happy I cannot be happy, and my family cannot be happy if I neglect them at the cost of my patients. It is something that is vitally important to the success of our society and our country, and ourselves. This article is all about family and deoting time and energy to the development of mature interpersonal relationships, regardless of recognition or rewards.

Interesting Article reviews

Asthma, Airway Inflammation and Treatment in Elite Athletes
Sports Med 2009: 35 (7)
Iikka Helenius, Aki Lumme, and Tari Haahtela

This article discussed how highly trained athletes are exposed to cold air during winter training and other allergens all throughout the year and that one should switch to less irritating environments whenever possible. The point was strongly made that it is difficult to change the natural course of asthma in athletes by anti-inflammatory treatment. I found it very interesting that the type of exercise and training can cause specific type of bronchial symptoms, bronchial hyperresponsiveness and asthma in most elite athletes. They listed the most common endurance athletes as cross country skiers, swimmers, long-distance runners, all of which experience mild asthma at some point. Apparently, the risk of asthma is closely associated with atopy. Atopy is basically when a hypersensitivity reaction such as asthma occurs in a part of the body not in contact with the allergen.
They discussed various forms of medical treatment in use of various antiasthma drugs to treat exercise-induced bronchial symptoms. In one study, they found that 17% of 253 Finnish elite summer-sport athletes used asthma medication in some form of inhalation. The funny thing is that despite widespread use of antiasthma drugs by athletes, few controlled studies have been conducted on the effects of inhalers, bronchial responsiveness, and airway inflammation. The article then discussed various forms of studies that have actually taken place such as the use of inhaled b2-agonists and leukotriene antagonists. They also discussed the increase use of fish oils and fatty acids with fighting inflammation. Some common environmental risk factors for allergic athletes include pollen season, cold ambient air, cold air and pollutants in indoor ice arenas, swimming halls, and dust/allergens indoor arenas for track and field.


Eating Disorders in the Male Athletes
Sports Med 2006; 36 (1)
Antonia Baum

This article discussed eating disorders in male athletes in addition to how this involvement in athletics fosters this disorder. Apparently they are less prominent than in female athletes, and therefore in danger of being missed. The article then discuss how to treat these disorders and what could be done. I learned a good new word: aetiology. They said that the participation in sports could contribute to the aetiology of eating disorder, but the opposite could also be true. The article then discussed different cases, in this following order: psychoeducation of athletes, their families, coaches and trainers, and other essential cases. I found it interesting that counseling an athlete to pursue a sport appropriate to his body type or to leave a sport behind altogether can be an important treatment. The point was also made that treatment can be structured using a biopyschosocial approach, and all appropriate modalities of therapy, including individual, family and group, as well as psychopharmacotherapy, which I do not exactly understand, but seems like a big word and important.
This article stated that eating disorders are an underrecognised problem in male athletes. There are some sports with particular vulnerability, including sports with an emphasis on asthetics, sports where low body fat is advantageous, and sports where you have to make weight for competition. Apparently, anabolic steroids also make a big difference in the disordered body image of male athletes. It seems that the best treatment is the biopsychosocial approach, where you involve friends, family, coaches, trainers, etc. The article concluded that future research was required to more firmly establish the reason and solution for eating disorders and behaviors. A delineation of sex differences in eating disorders is needed in both athletes and non-athletes. Interesting read, but never came to any great conclusion.



Wilderness Medicine
David A. Townes
Division of Emergency Medicine, University of Washington School of Medicine



The contents of this paper dealt with strategies for provision of medical support for adventure racing. I was previously not aware of such activities, but this article claims it is growing more popular. The idea is that in this multisporting, or adventure racing, athletes tend to perform multiple disciplines over a course in wilderness terrain. These can include hiking, trail running, mountain biking, cave spelunking, boating, and mountaineering. These races can apparently last up to 6 hours. The point of this paper is that presently there are no formal guidelines and small amount of literature to help with medical support plans during these events. This is probably due to lack of popularity, but that does not mean it should not be taken care of. The article provides an introduction to methods in providing provisions and medical support for these so called adventure races, since during these activities, it is necessary to address a wide variety of illnesses, and injuries. They stated that foot-related problems are the most common reasons for athletes to require medical attention during these events.
Since these races require utter rigor and rigid bodies, this paper also talked about the controversies involved in the provision for medical support during these events. Obviously, you don’t want your doctor to win the race, and if you are offered assistance, perhaps some form of a penalty should be addressed. The paper offered various penalities. Penalities included removal of the athlete from the event for medical reasons, and they also expounded the logistics of medical support communication, and liabilities. I at first was unclear as to the purpose of this and how useful it would prove, but as I read the article I realized that the information would be useful to medical directors of future adventure events. Event medicine is a new area that should always be addressed and discussed, especially when winning is involved.