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HEADACHE

A lecture by Francis Sunagawa M.D.

WHAT IS HEADACHE
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck.

WHAT IS HEADACHE
The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Nine areas of the head and neck have these painsensitive structures, which are the cranium (the periosteum of the skull), muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinuses and mucous membranes.

WHAT IS PAIN
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (International Association for the Study of Pain) Pain motivates the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Pain is the most common reason for physician consultation

WHAT IS PAIN

Types of pain: Nociceptive, Neuropathic, Phantom, Incident, Referred, Psychogenic, etc

WHAT IS PSYCHOGENIC PAIN


Psychogenic pain, also called psychalgia or somatoform pain, is pain caused, increased, or prolonged by mental, emotional, or behavioral factors. Headache, back pain, and stomach pain are sometimes diagnosed as psychogenic. Sufferers are often stigmatized, because both medical professionals and the general public tend to think that pain from a psychological source is not "real". However, specialists consider that it is no less actual or hurtful than pain from any other source

HOW DO WE MEASURE PAIN


In pain science, thresholds are measured by gradually increasing the intensity of a stimulus such as electric current or heat applied to the body. The pain perception threshold is the point at which the stimulus begins to hurt, and the pain tolerance threshold is reached when the subject acts to stop the pain

DIFFERENCES IN PAIN THRESHOLD


Differences in pain perception and tolerance thresholds are associated with, among other factors, ethnicity, genetics, and sex. People of Mediterranean origin report as painful some radiant heat intensities that northern Europeans describe as nonpainful, and Italian women tolerate less intense electric shock than Jewish or Native American women.

DIFFERENCES IN PAIN THRESHOLD


Some individuals in all cultures have significantly higher than normal pain perception and tolerance thresholds. For instance, patients who experience painless heart attacks have higher pain thresholds for electric shock, muscle cramp and heat. Women have lower pain perception and tolerance thresholds than men, and this sex difference appears to apply to all ages, including newborn infants

DO YOU FEEL LIKE THIS?

Headaches have now become my work mates. I wonder why they never occur when I am relaxing at home but only when I have 10 reports to file, angry boss to answer or my all important presentation.

SOME HEADACHE STATS


The average worker missed 1-3 days of work per month because of headache. Each year, it is estimated that time lost from work due to headache costs the nation(US) up to $17 billion dollars in absenteeism, lost productivity and medical expenses (National Headaches Federation of US) In the U.K. headaches cause 890,000 missed days of work every year, costing employers nearly 100 million one in five people will have limited work ability due to a headache.

TYPES OF HEADACHE
The most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to get tension headaches if you work too much, don't get enough sleep, miss meals, or use alcohol. Other common types of headaches include migraines, cluster headaches, and sinus headaches.

USUAL CAUSES OF HEADACHE


Stress: When there is little time but so many things to do and targets to fulfill, we tend to stress out and here comes the headache. For some, the cause can be a fight at work, tension with the boss or fear of failure. Not only these but good reasons like new job, additional responsibility can also cause stress. Lack of sleep: Headaches are a signal for the body that it needs rest. So continuous lack of adequate or sound sleep or changing shifts that can lead to disruptions of bodily cycles can cause headaches.

USUAL CAUSES OF HEADACHE


Coffee: Too much coffee can increase the tension and anxiety again causing headaches. Another reason is coffee withdrawal i.e. headache due to lack of coffee if the body has got dependent on coffee. Foods: There are certain foods that trigger headaches in some. The common ones are chocolate, caffeine, red wines, cheeses, citrus fruits, beans, freshly baked bread, artificial sweeteners, preservatives, etc. If you notice that you get the headaches after you eat the same food stuff then that might be the cause.

USUAL CAUSES OF HEADACHE


Lighting: Sometimes it is the improper lighting at work that is to blame for the headaches. It could be due to glare on computer screens from any overhead lighting or glare from overhead incandescent lighting or flicker from fluorescent lighting. Try to examine the lighting at your workplace to prevent headache. Posture: A simple thing like bad posture can cause you many problems and headaches are one of them. You might find yourself to be hunching your shoulders, using a chair with no back support or staring at a monitor that is too low then just a little readjustment might relieve the headaches.

USUAL CAUSES OF HEADACHE


Hunger: With a pile load of work to do, lunch takes a back seat. For some this can be a cause of headache as the blood sugar goes down and we are robbed of energy. Cell phones: A recent study conducted in Sweden and Norway shows that mobile phones can cause headaches. They studied 17,000 people who used cell phones at work and found that among symptoms like feeling of warmth around the ear, and burning sensations on the face; one prominent problem was headaches, which began either during or after a call.

USUAL CAUSES OF HEADACHE


Sunlight: Some people get headaches after being in sun. Exposure of sun makes your head nerves and tissues change their mode, affecting the nerve endings causing pain on either sides or the front of the head. Wear caps or carry umbrellas to protect yourself. Also try to avoid going out between 10-2 pm if possible. Colds: Colds and flu are always accompanied with headaches as the sinuses are congested and filled with mucus.

WAYS OF PREVENTING HEADACHES

The best way to deal with headaches is to prevent them from happening and one way of doing it is to detect the causes

WAYS TO PREVENT HEADACHES

Stress at work is a given, but there are ways to deal with it so that it doesnt affect you physically

Take frequent breaks Switch off your cell phone when at home, if that is impossible- at least restrict the calls you attend Be organized, it reduces stress Dont procrastinate things- they always haunt you afterwards Breathe- When nothing else works and the boss is breathing down your neck just take 5 deep breaths and release the tension.

WAYS TO PREVENT HEADACHES


Dont skip meals, it makes you irritable and gives you headache. At least munch on some peanuts or a fruit but dont starve. If smoke is a problem, sit away from those who smoke and if you are the one smoking, headache is another reason to quit! Bad Posture is easy to rectify with good swivel chairs where you can adjust the height, back rest and arm rest. For people who suffer from headaches due to the use of cell phones, try to alternate between the sides, not talk as long, and use hands-free.

WAYS TO PREVENT HEADACHES


Avoid foods that cause headaches, studies show foods that contain omega 3 fatty acids also help in preventing headache. Maintain a headache diary and note down the type of headache, possible cause and duration. It might indicate the exact factor causing headache. Exercise, any physical activity really helps to prevent headaches and keeps you healthy and moving. If nothing helps, then go for medication but try to avoid consuming them regularly as it can cause acidity and increases the dependency of medicines.

LAST BUT NOT THE LEAST

Headaches are annoying; some people are regular victims of it and still work with it. But headaches are also good indicators of deeper problems like lack of exercise, lack of sleep, poor nutrition and bad habits. Headaches also tell us how we handle stress.