Headaches. For most, they're a minor, temporary inconvenience. For some, headaches are frequent, debilitating episodes of agonizing pain that interfere with every aspect of life.
When headache strikes, many automatically reach for pain killers. In fact, $400 million is spent in the U.S. each year for aspirin and other over-the-counter headache remedies. But recently, more and more headache sufferers are seeking natural ways to ease the pain, including acupuncture, diet, biofeedback, herbs, and a variety of other modalities. Some are turning to alternative medicine because of inadequate relief or side effects from drugs. Others discover the very medications they once found helpful become the source of their problem, causing a rebound headache. Many find that by using complementary approaches, they can reduce, if not totally eliminate, the amount of medication they use.
Types of Headaches
Headaches vary greatly from person to person and there are a dozen categories of headache. The two major types, tension and migraine headaches, account for about 90 percent of all headaches.
Tension headaches are characterized by an occasional or chronic painful, band-like pressure around the head, often with muscle tension in the head and neck.
Migraine headaches are usually experienced as mild to severe throbbing, often on one side of the head and accompanied by nausea and hypersensitivity to light and sound. According to the American Council on Headache Education, as many as 23 million Americans (mostly women) suffer from migraines. Of those, half experience headaches so severe there is a disruption in their work and family life.
Less common types of headaches include sinus headaches, with deep, dull aches around the nose, forehead and ears; cluster headaches, which can be excruciating with stabbing pain on one side of the head often behind one eye; and rebound headaches (caused by chronic use of caffeine and pain killers) experienced as continuous dull pain around the front and back of the head. Many headache sufferers experience more than one type of headache.
Understanding Your Headache Triggers
No matter what the type of headache, most headache experts urge sufferers to begin their search for relief by keeping a detailed and accurate headache diary. A headache diary should include a daily timeline of events such as onset of headache and other symptoms; headache duration; foods and liquids consumed; exposure to environmental triggers (i.e., smells, weather); emotional stressors; physical activity; and for women, where they are in their menstrual cycle.
After keeping a diary for a week or more, noticeable patterns may emerge. Commonly, a particular food, dehydration, or emotional stress will be noted as headache triggers. Once a trigger is identified, it should be avoided if possible. The type of trigger may suggest the kind of alternative modalities to try. For example, those who note physical tension and stress as a trigger might first explore biofeedback, while diet should be the first approach for those with known food sensitivities.
Diet
Many dietary factors can influence headaches: low blood sugar, caffeine intake, dehydration, and various food sensitivities can all be triggers.
Hypoglycemia and De-hydration-To avoid low blood sugar and dehydration, Jan Mundo, Director of Headache Relief Services in Berkeley, California, advises patients to eat and drink water frequently-every two hours-and to avoid highly processed, sugary foods.
Mundo, who also leads headache relief seminars at Kaiser Permanente, worked with Joanne Richter, a retired librarian who suffered with migraines for over 15 years. She attributes her decrease in headaches to following Ms. Mundo's recommendations.
"By the time I took classes from Jan, I was at the end of the line. After 15 years of trying everything to help my migraines, including many drugs, I discovered that eating six to seven small, well-balanced meals a day and drinking eight to 10 glasses of water a day has reduced my headaches from four a week to two a month."
An ideal snack could include complex carbohydrates and a small amount of protein such as whole grain crackers and low-fat cheese.
Diabetic headache sufferers need to be particularly careful about avoiding hypoglycemia from too much medication or insulin. Diabetics who exercise should be sure to have a light snack 30 minutes before their workout to avoid dips in blood sugar. (Otherwise, exercise can be a very valuable headache relief tool).
Caffeine-While caffeine in small doses can sometimes be helpful to headache sufferers (a strong cup of coffee at the onset of a headache can sometimes stop it in its tracks), a coffee habit of as little as two and a half cups per day can result in rebound headaches if one tries to cut down or quit. Most headache specialists advise limiting caffeine to one cup of coffee or tea a day or to eliminate it all together.
Many soft drinks and headache remedies also contain caffeine, so it's important to check labels. Caffeine-induced headaches usually start between eight and 18 hours after the last dose of caffeine and peak three to six hours later.
Food Allergies-The role that true food allergies play in headache is controversial, but there is some evidence that food allergies may trigger migraines, especially in children. The most common food allergies are cow's milk, eggs, chocolate, oranges, and wheat. Researchers found children with migraines placed on a hypo-allergenic diet experienced fewer headaches. It's best to work with an allergist or dietitian experienced with elimination diets when trying to track down food allergies. Allergic reactions usually develop within four hours of ingestion but may take as long as 72 hours.
Tyramine-A naturally occurring substance in many protein-rich and aged foods, tyramine is a major culprit in triggering headaches. Foods rich in tyramine and related chemicals include chianti wine, sherry, chocolates, beer-aged cheese, sour cream, nuts, seeds, soy sauce, yeast extracts, miso, tempeh, and salted fish. Tyramine headaches may occur immediately or as long as 12 hours after eating.
Alcohol-Excessive drinking can result in a headache for almost everyone. But even small amounts of alcohol can be a trigger for some, especially those with cluster headaches.
Nitrites-Nitrites have been used for hundreds of years as a processed meat preservative. Foods that contain nitrites include bacon, bologna, corned beef, ham, hot dogs, sausage, and smoked fish. Nitrites typically cause a dull, aching pain, accompanied by facial flushing.
Aspartame-Many people report severe headaches immediately after consuming beverages, candy, gum, or other foods containing the sugar substitute aspartame.
Other Food Additives- Various other food additives may cause headaches in sensitive people. One of the most common is MSG (monosodium glutamate), a flavor enhancer, which often is added to Chinese food, soups, frozen entrees, sauces, and other processed foods. MSG may be listed on ingredient labels as hydrolyzed vegetable protein, hydrolyzed plant protein, and natural flavoring. MSG-induced headache usually comes with facial pressure and burning in the torso 15 to 25 minutes after ingestion.
Sulfites found in red wine and dried fruit; tartrazine, a yellow food dye (FD and yellow #5); and sodium benzoate, a preservative; are triggers for some migraine sufferers.
Biofeedback
Many body conditions and functions previously believed to be unchangeable can to some degree be brought under our control, given proper feedback information. Electronic instruments can convey our body's internal information through audio and visual signals such as tones, lights, and numbers that can be easily understood by the user. This technique, known as biofeedback, has been used successfully in the treatment of chronic headache and is offered at many headache clinics throughout the country.
Kathy Smith, Marriage, Family, and Child Counselor and Certified Biofeedback Therapist at the San Francisco Headache Clinic, has worked with headache sufferers for 10 years. She describes five common types of biofeedback which are used in helping headache patients:
Electromyographic (EMG) Biofeedback-provides information on muscle tension.
Thermal Biofeedback-measures the temperature of the skin and is useful in teaching hand warming, an effective tool for those with headache.
Electrodermal Biofeedback- (also referred to as Galvanic Skin Response) measures sweat activity too small to feel on the skin and can help to measure stress levels.
Finger Pulse-records heart rate and force.
Respiration Feedback-which indicates the rate, volume, rhythm, and location of each breath.
Smith sees patients after they have been medically evaluated and works both with those who choose to use medication and those who are seeking a totally drug-free approach. But biofeedback is not an instant cure. "It often takes three to four sessions for people to learn biofeedback and to begin to see results. A full treatment program typically takes six to 10 sessions, but that varies," says Smith.
Biofeedback is helpful to headache sufferers in preventing headaches, for shortening the duration and intensity of a headache in progress, and for alleviating some of the stress that may be contributing to the headache in the first place. Perhaps most importantly, it helps people regain a sense of personal power. "It's so gratifying to see people who felt so out of control gain a sense of control ... learning to work with the body rather than being victimized by it."
According to Smith, biofeedback in the treatment of headaches or migraine, is enhanced when used in conjunction with other methods of treatment such as psychotherapy. "Psychotherapy along with awareness of the body is important to help with whatever is fueling the tension that promotes the headache," Smith adds.
Herbs
In England, the herb feverfew is widely used in the treatment of migraines. The dried leaves of this plant in the chrysanthemum family (Tanacetum parthenium) are thought to work due to its anti-inflammatory properties. A double-blind crossover study conducted in Nottingham Hospital in England, revealed a 24 percent decrease in the number of migraines experienced in the 59 subjects studied. Patients received 82 mg. of dried powdered leaves daily. Because herbs vary in potency, it may be necessary to try several brands of the herb to determine if it will be helpful.
Feverfew has been a very successful remedy for Lory Reyes, a 44 year-old coordinator for a newspaper in Plantation, Florida. "I was going through a bottle of 100 aspirin per week. My headaches started when I was 15 but they really got bad a few years ago. I was prescribed various drugs which helped, but I decided I didn't want to be on medication. So I started taking feverfew along with 400 mg. of magnesium daily. Compared to 12 months ago, I'm 95 percent better."
Tia Yoshiwara, a 49 year-old marketing director in Chicago, suffered from severe headaches since childhood. She found a variety of herbal baths help with her headaches. "For headache with pressure, I like to take a bath with a few drops of eucalyptus essential oil (it can be used as a steam inhale if you have sensitive skin) as well as my usual lavender-it relaxes me but tends to make me drowsy, and rosemary which keeps me alert though relaxed. For stress headaches, I rub diluted lavender and rosemary essential oil on my temples and lie down. My sister has had good luck using this technique for migraines. She's also found feverfew capsules to be very effective for her menstrual migraines."
In David Hoffmann's The Holistic Herbal, marjoram and peppermint are suggested along with lavender and rosemary as effective herbal rubs.
Acupuncture
Daniel Jiao, L. Ac., an Asso-ciate Professor of the American College of Traditional Chinese Medicine in San Francisco, has been treating people with headaches for over 12 years. "In Chinese medicine," Dr. Jiao explains, "each patient is treated differently even if the headache symptoms are similar. We first ask the patients many questions: what time of day they get headaches, what makes it better or worse-like weather, PMS, menopause, music, or a hot shower. We then find out about diet, lifestyle, and occupation. Checking the tongue and pulse are used for diagnosis, along with a medical history. Then we are ready to do the acupuncture and prescribe Chinese herbs. It usually takes about six to 10 sessions, but it's different for each person."
After experiencing terrible migraines for 10 years, Jackie Hirtz, a freelance writer, found acupuncture helped her more than anything. "It was by accident. I was seeing an acupuncturist for stomach and back pain. When I told her I was taking injections for migraines, she began working on me for that problem, too. After 12 sessions, I was much better and I rarely get headaches now. I haven't had one for six months." Hirtz advises, "It's really important to follow your gut. I had tried acupuncture before without success. The acupuncturist I use now is a true healer and I have a lot of trust in her."
Finding What Works
When it comes to headaches, each person has a unique profile. For some, food is a key trigger; others may find odors or stress provoke their pain. The key is taking the time to do the detective work necessary to thoroughly understand the patterns and then try to avoid whatever aggravates the condition. Finding a health professional experienced with headaches can be very valuable in helping you to track your triggers, but it's important to find someone you trust.
There is no magic drug or drug-free bullet, but by eating a healthy plant-based diet, drinking water regularly and exploring various natural approaches, most will have success in reducing symptoms and gaining some control over chronic headache.
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