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Как да различим трите вида главоболиеГлавоболието може да се проявява като тъпа и пулсираща болка или рязка и концентрирана. Вече ви разказахме кои са най-често срещаните причини за неприятната болка в главата . Важно е обаче да се определи и какъв е видът на главоболието, за да се вземат правилните мерки. Има три основни вида главоболие: тензионно, мигренозно и клъстерно. Всеки от тях има свои причини и отличителни симптоми. Установяването на вида, от който страдате, помага за лечение на симптомите и предотвратяване на бъдещи пристъпи, смятат специалисти. Тензионно главоболие Тензионното главоболие е един от най-често срещаните видове. То се причинява от стягане на мускулите на врата и скалпа. Това свиване на мускулите може да бъде предизвикано от редица физически фактори - включително схващане на мускулите на раменете и врата поради неправилна поза при седене, стрес или недоспиване. Този вид главоболие води до слаба до умерена болка и натиск в главата, които могат да започнат от тила/врата и да продължат напред, или обратното. Главоболието обикновено се усеща от двете страни на главата и може да бъде придружено от болки във врата или раменете. Болките могат да продължат от половин час до няколко дни. Макар че причинява дискомфорт и дразни, тензионното главоболие обикновено не е опасно за Вашето здраве. Как да се справим с него? Най-често тензионното главоболие е резултат от стрес и напрежение в ежедневието, умора и прекалено психическо и физическо натоварване, безпокойство, безсъние, напрягане на мускулите в областта на главата и слепоочията. Ето защо масажът в областта на слепоочията е болезнен, но до известна степен облекчава болката. Единичните случаи на тензионно главоболие изискват да си дадете повече почивка и спокойствие. Ако работите в офис, то причината за вашето главоболие може да е и заради неправилната поза на седене. Сменете стола, ако е възможно. Може да опитате и с допълнителни възглавнички, които да поставите зад кръста си. Специалистите препоръчват и повече физическа активност. Източник: Thinkstock/Guliver Мигренозно главоболие Мигренозното главоболие се различава от тензионното по това, че болката обикновено е ограничена до едната страна на главата и се влошава с течение на времето. Болката зад очите и на тила е обичайна за мигрените. Мнозина страдащи от мигрена изпитват и чувствителност спрямо светлина и шум, гадене и повръщане. Някои пристъпи на мигрена се предшестват от визуална аура, която може да включва виждане на светлинни проблясъци или замъгляване на зрението. Мигренозното главоболие може да продължи от няколко часа до няколко дни с пристъпи веднъж – два пъти годишно при някои хора, до няколко пъти на месец при други. Известните причини за мигренозното главоболие са много и различни при различните хора. Всяка отделна причина обаче задейства един и същ път в мозъка, който води до абнормна неврологична дейност и умерена до силна болка. Как да се справим с него? Страдащите от този вид главоболие също имат огромна нужда от почивка. Срещу мигрена най-добре действа хубавият нощен сън. Но хората, които страдат от главоболие, често не могат и да спят вечер. По време на мигренозен пристъп се изисква пълен покой и отстраняване на всякакви дразнители - особено светлинни и звукови. Ако не можете да се справите сами, най-добре е да потърсите съвет от вашия личен лекар. Клъстерно главоболие Клъстерното главоболие е най-рядко срещаният вид главоболие, но може да се твърди, че е най-интензивно, като се среща повече при мъжете, отколкото при жените. Независимо че истинската причина за него не е известна, счита се, че клъстерното главоболие може да е свързано с анормално задействане на нерви в мозъка. „Клъстерът“ на клъстерното главоболие се отнася не до мястото на болката в главата, а по-скоро до групирането на пристъпите във времето. Това е основната разлика между клъстерното главоболие и тензионното или мигренозното главоболие – клъстерното главоболие се повтаря периодично през определени периоди от време. Възможно е хората да имат от един до три пристъпа на клъстерно главоболие на ден в продължение на няколко седмици или месеци (период на „клъстера“). След това пристъпите могат да спрат напълно, но се възобновяват отново по-късно. От трите вида главоболие клъстерното главоболие е причина за най-силни болки, обикновено описвани като мъчителни или изгарящи. Болката настъпва бързо от едната страна на главата, около и зад ухото, след това се влошава и може да продължи от 30 минути до два часа. Други симптоми включват подуване, сълзене и зачервяване на окото, запушен или течащ нос само откъм засегнатата страна на главата. Как да се справим с него? Най-честите провокиращи фактори на този тип главоболие са - алкохолни напитки и прекомерно тютюнопушене. Един от основните съвети на специалистите е да ги избягвате. Лечението може да включва лекарства с рецепта за предотвратяване на главоболието, кислородна терапия или, в редки случаи, хирургични процедури. За лечение се обърнете към лекар.
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Women’s health articles Natural relief from chronic headaches By Dr. Julie Schwartzbard, MD Over the years, I’ve come to understand that headaches are my body’s way of telling me something’s out of balance. In understanding this dynamic I now know my daily choices play an active role in preventing my headaches. This means I can act first, not just react after I get a headache. When I do my best at practicing what I preach — optimizing my diet, taking my core supplements consistently, drinking enough water, trying to sleep at least 8 hours a night, and exercising regularly — my headaches are almost nonexistent, even during my period. Having a healthy lifestyle that places a premium on nutrition and supports natural hormonal balance is the first step in any drug-free approach to preventing and treating frequent headaches. Most headaches have multifactorial roots, however, which means relieving them may require multiple strategies. The story of your headache There are many separate types of headaches, with a wide variation in triggers and differing components of the headaches themselves. What causes a headache depends on a woman’s individual situation — her nutrition, unique stress factors, body mechanics — and her medical history. But one thing is certain: in many cases, a headache is a symptom of something deeper going on in her life. As a headache sufferer myself, I understand well the need to treat the pain in that moment. But to truly resolve your chronic headaches, you may need to figure out what stressors lie at the root. Once you familiarize yourself with any pattern, you can often treat and — ultimately prevent — them from recurring. To be fair, I think it’s important to note that there is a component of genetic propensity, particularly with migraine headaches. Although there are lots of strategies a woman can employ to attempt to minimize her headaches, in some cases genetics reign, and she may get that headache no matter what. While I always recommend doing what you can to reduce the likelihood of getting headaches, I don’t want you to start blaming yourself for them, especially when you are trying to do “everything right.” That said, there are many helpful options to try. Let’s look at the most common types of headaches and then discuss strategies for prevention. Different types of headaches — a brief overview The two major categories into which most chronic headaches fall are tension headaches and migraine headaches. Let’s take each major type separately, and also touch on cluster and rebound headaches and the less common but serious form of headache known as temporal arteritis. There are many other subtypes — from caffeine withdrawal headaches to menstrual headaches, and the lines between many of these can be blurry. If you are unsure what type of headache you suffer from, it may be helpful to see your healthcare practitioner for a diagnosis. Please note that we are talking about most moderate headaches — if your headaches deviate from their normal presentation, change or worsen in any way that seems alarming, seek medical attention immediately. Tension headaches Tension headaches may be the most common type of headache women experience. They are typically described as a band-like vise that creates pressure and pain uniformly around the head, and may involve the neck as well. Tension headaches can occur episodically or chronically, depending on the individual and aggravating factors. They can even progress to include migraine-like sensitivity to light or sound, and even become a trigger for true migraines in some cases. There are many stressors that can make a woman prone to tension headaches and that may explain their prevalence. These include are poor head and neck alignment and other posture issues, prolonged computer work, more serious prior cervical spine strain (such as whiplash), poor jaw alignment and other dental issues like nocturnal teeth grinding (bruxism), need for eyeglasses, weather changes, stress at home or at work —the list is almost endless! Fortunately, these headaches often respond remarkably well to natural prevention techniques and occasional treatment when needed. When these interventions don’t work, there are medications that a neurologist can prescribe to alleviate these kinds of headaches. It is so important to remember you have a range of options when trying to find relief. When you’re partnering with a neurologist, you will want to first discuss all the benefits and risks of drug therapy. Migraine headaches Migraine headaches are characterized by a series of four phases that occur with some regularity but which vary widely among sufferers: prodrome, aura, headache and postdrome. The prodrome phase may take place anywhere from a few hours to days before onset of a migraine headache, with symptoms that can include mood changes, fatigue, and cravings for certain foods that may themselves be migraine triggers. Some migraine sufferers also experience an aura, with sensations of flashing lights, numbness and tingling, or altered vision before or during onset of the severe head pain. This aura experience is generally short-lived (usually about 20 minutes) and considered part of the classic migraine sequence, but the majority of migraine sufferers do not experience an aura. The aura phase can occur on its own, with no subsequent headache pain, which is known as optical migraine or acephalalgic migraine. But most migraines occur without any aura, and are known simply as common migraine. Pain during the headache phase is generally described as severe throbbing or a pulsating sensation that occurs on one side of the head or temple. Migraines can last anywhere from two hours to several days. This type of headache is usually associated with sensitivity to light (photophobia), sound (phonophobia), or smells (osmophobia) and is frequently accompanied by lightheadedness, nausea, gastric upset and vomiting. It is important to remember that pain is not necessary to define a headache as a migraine, and the severity of the pain accompanying the headache isn’t migraine specific either. Instead a migraine is defined by the features that go along with it: nausea, throbbing, photophobia, phonophobia, and photopsias (flashes of light). By the postdrome phase, the pain has usually subsided, but sufferers are typically left feeling tired and worn out. Some also report experiencing negative psychological effects such as slower thinking or feeling “flat” after a migraine, and in some cases these after-effects can last several days. Women may also experience migraines at the onset of their monthly cycle, with these hormone-related headaches often referred to as menstrual migraines. Approximately 70% of migraine sufferers are women, and there’s no doubt that chronic migraines can have a significant impact on a woman’s quality of life. The higher incidence of migraines in women may be related to our hormonal fluctuations, or the way we respond to stress in our lives — but as we know, these two are interlaced. Migraine theories Historically, many experts considered migraines to be a vascular disorder caused by constriction, then sudden dilation of the blood vessels to the neck, brain and scalp. Then the throbbing pain of migraine was thought to be brought on by an abnormal release of the neurotransmitter serotonin, bringing about additional constriction of the arteries supplying blood to the brain. This theory has been debunked by modern neurology, and we now understand more about migraines thanks to improved imaging of the brain. The new migraine theory proposes that migraines start with electrical “hyperexcitability” in an area of the brain, meaning migraine sufferers may simply have a hypersensitive nervous system that makes them prone to these headaches. A lifestyle or environmental trigger such as hormonal fluctuation or exposure to a certain food or chemical can provoke an attack. In any event, migraine pain is best prevented and treated — both conventionally and naturally — at its onset. While debate continues about the biochemical basis of migraine headache, it’s important to recognize that with a little detective work you can learn to recognize your personal triggers, and, in many cases, abort a migraine before it turns painful. The key part of treating an active migraine is doing it quickly. If you wait too long to intervene, it is often too late to achieve quick relief. Cluster headaches This type of headache seems to affect men more than women. Patients describe the pain of a cluster headache as severe, usually one-sided, and often associated with symptoms such as nasal congestion, a bloodshot or tearing eye, or facial perspiration. The pain of a cluster headache is intense, often prompting restless, pacing behavior. It often begins during sleep, and may be present for several days in a row, but a series of cluster headaches can also recur months or years apart. People often mistake the name “cluster” to mean multiple headaches in a short time period. But actually, “cluster” refers to the tendency of the headaches to cluster around the same time of year. They can then spontaneously resolve until the next year or for many years. Some people have chronic cluster headaches which do not remit spontaneously. Others can have a “cluster-migraine” variant which involves symptoms of both headache types and doesn’t fit neatly into one definition or the other. Oxygen therapy with deep breathing can be an effective abortive therapy for cluster headaches. Also, some of the medications which are used to abort migraine headaches often work with cluster headaches as well. Rebound headaches Another common type of headache is the rebound headache, often referred to as medication overuse headaches. Many people don’t realize that regular overuse of prescription and non-prescription headache medications is a very common cause of chronic daily headaches. The brain becomes dependent on the substance that once helped relieve the headaches. Weaning off the overused product is the only way to break the cycle, though this process can be difficult because the sufferer is stuck with headache pain and must slowly taper off the meds. If you do not detoxify from your daily analgesic regimen, then all other interventions, both natural and/or prescribed, will not work! There are, of course, alternative measures that can help alleviate symptoms of withdrawal from these meds, such as acupuncture. I encourage anyone with rebound headaches to see a headache specialist or neurologist for consultation. Working together from here, you can develop a plan to really support your body through the withdrawal and stabilization periods. Temporal arteritis One rare type of headache that you should be aware of is temporal arteritis. Temporal arteritis, also known as giant cell arteritis, is an inflammatory condition affecting the medium-sized blood vessels that supply the head, eyes and optic nerves. It is an uncommon affliction, but women are approximately four times more likely to suffer from temporal arteritis than men, and it occurs most often after the age It should be ruled out in women over 60 who experience unusual headaches with localized temple or scalp tenderness and affected vision in one eye (eventually in both). Temporal arteritis can include other associated symptoms, including fever, nausea or jaw discomfort. There is a risk of permanent vision loss if left unidentified and untreated with corticosteroids in the acute stages. If you experience an unusual headache or a headache with symptoms matching these, seek medical evaluation promptly from a specialist or an emergency room physician. A simple blood test can often confirm or rule out this condition. Headache treatments: the conventional approach As a headache sufferer, woman, and healthcare practitioner, I am a big believer in pain relief. While my colleagues and I want to prevent headaches as effectively and naturally as possible, we also accept the reality that once a headache has taken hold, a woman may need help with the pain. Women need to work and be able to function for themselves and their families, so turning to the medicine cabinet once in a while may be their best recourse. There are plenty of headache medications, or “rescue treatments,” available. But just as important is recognizing that headaches are your body’s way of getting your attention and highlighting an imbalance that needs to be addressed. Simply treating the pain without addressing the underlying imbalance will leave you vulnerable to further headaches and can lead to other, more substantial issues over time. And while there are effective natural headache remedies, the best place to begin is with natural prevention. Natural prevention — start with a headache diary Most chronic tension headaches can be relieved by dietary and lifestyle changes. Migraine headaches are somewhat different as they may stem from other issues, but they also usually respond well to natural measures. A headache diary is one of the most useful tools available for this purpose. Over time, tracking your headaches, their quality, quantity and duration, allows you to spot your personal triggers. You can keep a daily record of your eating, sleeping, drinking, and exercise habits, along with the time and place you begin to feel a headache coming on. You can also mark down where you are in your menstrual cycle, if and when you take medication or HRT, and how these factors may relate to your headaches. When in doubt, write notes on behavior and events. All of this information can reveal surprising patterns when recorded consistently for two to three weeks. Premenopausal women should log a headache diary through at least one menstrual cycle, ideally two. Some of my patients who began headache diaries found that their headaches were directly related to previously undiagnosed food or environmental sensitivities, underlying muscle tension, teeth grinding (a major culprit in TMJ headaches) — even sleeping on a bad mattress! One of my friends consistently developed a migraine the day after visiting her mother-in-law — a trigger she was unaware of until she began keeping a record of her daily activities. Assessing the support you give yourself in relation to the demands and difficulties in your life is absolutely the first step in determining how to help yourself. Once you have a broad idea of your habits and the kind of headaches you suffer from, you can choose to adopt a few or all of the following natural measures. You may want to consider trying our programs, with one-on-one guidance by telephone with our Nurse–Educators. Either way, you are treating your headaches from the ground up, not just at the surface and it may take a little time. But if you’re prepared to stick with it and tune in to the elements creating your core imbalance, these measures can often provide full relief from chronic headaches. Ten ways to eliminate headaches naturally Focus on diet and optimal nutrition. Headache sufferers should take a close look at their diets. For many people, sugar and alcohol are headache triggers. While it may not be possible for you to eliminate them from your diet, gradually reducing your intake may decrease the frequency of your headaches. Ensuring that your body has all the essential vitamins and minerals it needs to work efficiently will also help reduce headache frequency and intensity. A balanced diet rich in all the food groups that focuses on whole, natural foods forms a solid base. We recommend women take a top quality daily multivitamin that includes calcium, magnesium and essential fatty acids in addition to a healthy diet. A note about caffeine: Caffeine itself isn’t really a headache trigger. It’s the caffeine withdrawal that triggers a headache. Caffeine can actually be effective in aborting migraines and so quitting caffeine may need to be done gradually to avoid headaches. Consider testing for food and environmental allergies and sensitivities. Many women get a lot of information from blood testing for food and environmental allergies and sensitivities. Headache-aggravating foods worth investigating include alcohol (wine especially), dairy, aged and fermented foods, and highly processed food products. Substances in foods of greatest concern to headache sufferers include tyramine, nitrites, chocolate, MSG, sulfites, histamines, tannins, prostaglandins, artificial colorants, preservatives, and sweeteners such as aspartame (NutraSweet). Since, depending on your unique physiology, a headache could be triggered by just about any substance, get a handle on what’s affecting you by being tested. And don’t forget examining your environment: mold, scented candles, air fresheners, cosmetics, cleaning products — even soap — are all suspect. Some find NAET (Nambudripad’s Allergy Elimination Techniques) successful at diagnosing and clearing both food and environmental issues. Reduce inflammation with regular detoxification. Much of the inflammation in your system fans out from inflammation of the gut. Good digestion and regular daily bowel movements are signs of efficient detoxification. One of the first signs of sensitivity to a toxin is a headache, and chronic headaches may indicate that your body is trying to process a heavier toxic load. Magnesium at bedtime and a daily dose of probiotics can really help. Consider a biannual detox and colon cleanse if you have any issues with IBS or constipation. Adopt stress management and relaxation techniques. Once people start tracking their headaches, they may conclude that mild to moderate headache sufferers always feel better when they’re on vacation. Why? The answer is simple — stress reduction. An interesting phenomenon often seen in migraines is the concept of the “let-down” headache. This phenomenon has been well studied in the medical literature and it seems that many migraine sufferers will develop a migraine after a stressor. For example, the headache often comes on the weekend, on vacation or after a big exam or presentation at work. Sort of the opposite of you might think when linking stress to headaches. We cannot escape stress, but we can develop better coping strategies for daily challenges — at home, where we actually tend to feel the most stress, and at work. This takes attention, self-care, and awareness. Begin with the small steps you’re most sure about to ease your stress, or manage individual stressors. These will help you build momentum toward a greater shift. Sometimes a therapist, behavioral counselor or life coach can help you explore your emotional roots so you can get past any behaviors that no longer serve you. Don’t forget the possible triggers of physical stress — poor ergonomics at work, staring at a screen or too much driving — even carrying a heavy purse or wearing an ill-fitting bra can cause muscle tension that leads to headache. Many women use yoga, meditation and deep breathing exercises to reduce tension. Others prefer more active antidotes to stress like running or swimming. And still others find peace from a new hobby or artistic technique. With a little experimentation and an open mind, you can find what soothes and relaxes you and then do it more consistently. Try building “mini-vacations” into each day — little respites for breathing deeply, enjoying nature or just unwinding and being still. Counselors, doctors, books, and classes are good places to start — I often recommend the book The Relaxation Response by Herbert Benson. Get enough sleep. Sleeping soundly for a good amount of time can help headache sufferers in many ways. Most of us thrive on seven to nine hours per night, with less in summer, more in winter for some. If you have trouble falling asleep or wake in the night, take a look at what you do before going to bed. Set the stage for a better night’s rest by making a few simple adjustments. Some women need a small bedtime snack to keep their blood sugar stable. Other women do well with extra adrenal or serotonin support that can shift their physiology into a deeper, more restful sleep cycle. You might consider a short-term course of phosphorylated serine or 5-HTP for these purposes. Additionally, some women benefit from taking melatonin to help normalize their sleep cycles. If hormonal fluctuations are contributing to restless sleep, these may be influencing your headaches as well. Most women find that calm, relaxing activities during the two hours before bedtime translate to more peaceful sleep. No More Sleepless Nights is a good resource that details successful sleep hygiene techniques and has proven to help my patients sleep. Stay well hydrated. Many of my patients’ headaches experience dramatic relief once they focus on drinking more water daily. Most have no idea they are dehydrated! Increase water consumption slowly, working up to 8–10 glasses a day by increasing one cup per day every three days. Sipping throughout the day is better for you than guzzling large quantities of water in one sitting, but we encourage you to experiment and do whatever works best for you and maintains good results. Many people are convinced they don’t need so much hydration, but if you suffer chronic headaches, nothing is easier than drinking more water. Evaluate body mechanics and alignment. Posture and head and neck alignment are huge factors in nearly all types of headaches. Many of us are unaware how significantly our body architecture affects our joints until we have pain. Chronic headaches may be your body’s telltale sign that something is misaligned and not working for you. It is critical to make sure your desk and overall work environment are ergonomically correct for your body’s dimensions and activities — especially with repetitive or computer tasks. Consider strength and alignment training with a certified yoga or Pilates trainer and pay attention to how you move through life every day. Are you sleeping in a healthy position? Cradling the phone between your head and shoulder? Driving and gripping the wheel? Carrying your purse? All of these activities can add up to major physical stress and lead to head and neck pain over time. Talk with your dentist about your bite and whether or not you grind your teeth. Ask if you might benefit from an occlusal adjustment — a process that realigns the way the surfaces of your teeth strike each other when you bite down. Get regular exercise and stretch daily. We all need exercise for its many benefits — to the heart, circulation, muscle tone, and stress reduction. Most tension headache sufferers find immense relief with the addition of exercise — and there is the added advantage of deeper breathing and better oxygenation. Just remember to pace yourself if you are beginning a new routine, and to support your workout with good nutrition and plenty of water. Explore alternative therapies like massage and acupuncture. Many headache sufferers respond well to massage therapy and acupuncture. In fact, many forms of bodywork or physical therapy can help reduce stress and may release endorphins into the blood that help relieve pain. If you pursue Traditional Chinese Medicine and acupuncture, find a licensed practitioner. If these methods work to alleviate your headaches, I would try to integrate them into your monthly routines. You may want to explore biofeedback as well, which has been shown in some studies to decrease headache frequency by 50%. Support with supplements. In addition to a full-spectrum multivitamin and Omega-3, we recommend some specific supplements to reduce headaches. Research — and our own medical experience — indicates that magnesium, probiotics, fiber and vitamin D can all be helpful. Regular use of herbal products containing standardized, purified extracts of butterbur (Petasites hybridus) and feverfew (Tanacetum parthenium) can help prevent migraines. A custom homeopathic or flower essence formula is also worth consideration, as both are very safe and yield good results — especially in combination with the above measures — in our natural approach to headache relief for women. Most women can definitely find the headache relief they need, and in the process, they’ll find other benefits as well. Related to this article: Further reading on chronic headaches Last Modified Date: 07/22/2014