Treating Headaches — Frequently Asked Questions

A New Level of Medical Care For Serious Relief

By: Hal S. Blatman, MD

Headaches are categorized into different types according to their characteristics. They can vary in severity from mild, to severe and disabling. Some seem to start in the back of the head, and others feel like they come from the sinuses. They can last from a few moments to several days. Some people have a headache every day.

We are taught to believe that there are many kinds of headaches. Tension, sinus, cluster, migraine, and TMJ are among the most frequently diagnosed. For many years, the myofascial pain professional community has recognized that more than 90% of all these headaches occur because of an underlying myofascial pain condition.

Do Children get Headaches?

Children of all ages get headaches too. According to recent medical research, children are generally under-treated and their pain conditions are less likely to be taken seriously.

What are the Types of Headaches?

Migraine headaches usualy begin in childhood or young adult life. They affect about 10% of adults.

Tension headaches are among the most common of the recurrent and chronic headaches. They are often described as a feeling of pressure or a bandlike sensation about the head.

Sinus headaches often start suddenly and are associated with nasal discharge. Tension headaches often feel like sinus headaches, and this leads many people to self-treat with decongestants.

Temporomandibular Joint Dysfunction (TMJ) is a common and sometimes overlooked cause of chronic headache that does not respond to the usual treatments. It is often associated with jaw clenching and nighttime teeth grinding.

Cluster headache is more common in men than in women. More than 50% of people describe intense, non-throbbing, one sided headache “behind the eye” that is stabbing or burning.

What is Migraine?

A new theory has been proposed to explain the cause of migraine headache. This theory realizes that migraine headaches are not caused by blood vessel changes, but rather that the blood vessel changes are a result of changes in the brain that occur with the migraine. My experience is that myofascial pain underlies the brain changes that cause migraine. Keeping this myofascial pain below a certain threshold will stop unrelenting migraine, or prevent most migraines from occuring.

How can I tell what kind of Headache I have?

It is very difficult to tell what kind of headache we have. In my experience, whether the headache is caused by sinus, jaw problems, tension, stress, or trigger points in the neck and shoulders, it will feel the same to the person who has the headache. Most of the time it doesn't make much difference. Approximately 90% of headaches are caused initially my muscle.

How does Myofascial Pain Cause Headache?

Myofascial trigger points in the muscles of the scalp, jaw, neck, shoulders and upper back refer pain to the head and face. These illustrations are from Travell and Simons medical text book. The “x's” represent the locations of trigger points, and the red dots illustrate the locations of referred pain. This first diagram is of the sternocleidomastoid muscle. Notice that it causes pain in forehead, sinus, ear and back of the head areas.

Myofascial trigger points in the muscles under the back of the skull radiate pain to the back of the head, and around to the forehead. These trigger points cause tension headache and migraine headache.

Myofascial trigger points in other muscles in the back of the neck cause a slightly different pain pattern. Notice how these pain patterns overlap to some degree. The myofascial specialist understands this and will know these pain patterns and how to find your most active trigger points.

Myofascial trigger points in the muscles of the scalp and forehead cause pain in other areas of the head. Notice how these pain patterns also overlap to some degree.

What causes the Pain?

The pain is actually caused by the knots in the muscles that are called myofascial trigger points. We know this because when the knots are made smaller, the pain is less. When the knots are made to go away, the pain is gone.

How important is Nutrition?

Nutrition plays an important role in the treatment of headache. We get out of our bodies only the quality of what we put into them. "Whole foods" such as grain bread and brown rice are better for our bodies than processed food such as white flour and white rice. Refined sugar is perhaps the worst of the processed foods for us to eat. Many people feel better if they do not eat wheat or sugar.

In addition, there are dietary supplements that can help to reduce headache. A good multiple vitamin and magnesium are examples of dietary supplements that can be helpful. Various herbs may be also be helpful. Active allergic states can also cause headache pain to increase--so testing for food allergies can also be helpful.

How does STRESS affect Headaches?

There are central nervous system mechanisms that make muscles generate more pain when we are under more stress. Many people carry their stress in their neck and upper shoulders. Other people grind their teeth and their jaw muscles get very tight. We do not live in a stress free environment and we can often be helped by techniques that change how we respond to stress. A good night's sleep is also very important in healing our bodies.

How does Sleep affect headaches?

Sleep deprivation in normal people causes fatigue and diffuse pain patterns to occur. Lack of sleep aggravates the effect of stress on the human body. Medication that is not addictive may be prescribed to help restore normal sleep patterns. This often has a beneficial effect on the frequency and severity of headache symptoms.

Is there hope?

YES--Of course there is hope.

Many people with daily or severe disabling headaches have been everywhere and done everything in their search relief. For these people, everything they've tried may have provided little or only temporary relief.

After life threatening causes for the headache have been investigated by family physicians and neurologists, these patients need an individualized comprehensive holistic treatment program.

No single therapy has much chance for success. Simply medicating a headache is not enough. The health status of mind, body and spirit often needs to be improved. Lifestyle changes guided by expert nutritional advice, return to exercise, and reduction in toxic exposures often puts patients back on the path to wellness.

Individualized holistic treatment has been shown to be effective for many headache sufferers. Myofascial medicine has much to offer. Acupuncture, Healing Touch, Thought Field Therapy, Photon Therapy, Trigger Point Injections, Neural Therapy and Massage Therapy can all be helpful. The Blatman Pain Clinic offers people an opportunity for holistic education, treatment, and direction for getting better.

Research is helping doctors to understand more about body and nervous system mechanisms involved in causing headaches. New medications are being developed as a result of this research that will continue to improve the quality of life for the many people who suffer from this condition.

How are Headaches treated at the Blatman Pain Clinic?

The Blatman Pain Clinic treats adults and children using a holistic approach. Education is very important, so we teach people about their minds and bodies, also encouraging our patients to read and learn more on their own.

Treatment for pain usually includes various body work techniques. The most important of these are done daily at home. Others include Chiropractic, acupuncture, myofascial release and myofascial trigger point injections. Additional injection techniques include prolotherapy and neural therapy. Pain, stress, anxiety and tension can be treated with Thought Field Therapy, BioFeedback, and EEG BioFeedback. Other important modalities include Healing Touch, Lymphatic Drainage, Environmental Detoxification, Aroma Therapy, Herbal Therapy, Photon Therapy, and Massage Therapy.

Many women find that their headaches are related to their menstrual cycle. For these people, hormonal therapies may become important. There are safe and natural treatment options with Bio-identical hormones and herbs.

Nutritional changes are likely to be very important, and we provide one on one sessions under Dr. Blatman's direction to help our patients make these changes as easily as possible. In addition, food allergy testing can be added to the healing program for further reduction of bowel problems, headache, pain, fatigue and mental cloudiness.

How can Myofascial Medicine help?

Myofascial medicine refers to comprehensive care directed toward minimizing and eliminating pain from myofascial trigger points. Trigger points underly or are part of most headache conditions.

After evaluating the myofascial system for trigger points, an individualized treatment program is begun to reduce the activity of headache producing trigger points.

Perpetuating factors are considered in a holistic fashion. In addition to those already mentioned, Ergonomic factors can be important. Sometimes changes need to be made in how work and leisure activities are performed.

New Technologies

Within the past 20 years, the Europeans have developed Low Level Light Therapy, sometimes also called Low Level Laser Therapy, to treat headaches. The first FDA approved device to be used in the USA is called the Photonic Stimulator.

The Photonic Stimulator energizes body tissue without heat or danger, increasing the speed of healing and reducing pain. It also modulates the sympathetic nervous system that transmits much of the pain of muscle and fascial injury.