Vijai P. Sharma, Ph.D
Headache is not considered a major problem by patients, families or their doctors unless it's one of those migraine headaches when a patient must stay in bed in total darkness for several days on end with a headband and (excuse me for the gory details) being sick and throwing up.
One in seven Americans suffers a headache every day of their lives and all of them are not migraine headaches. Of the many types of headaches, tension headache is the most common. In this article, the terms "stress headache" or "tension headache" are used interchangeably.
So, what is a tension headache? A tension headache is caused by prolonged contraction over a period of time of certain muscles located in the forehead in the forehead, face, neck and shoulders.
And, what causes the muscle contraction? Tension, or call it "stress" if you will.
Prolonged tension or stress causes prolonged contraction of the muscles mentioned above which can become painful.
To describe the pain, let's take an example of toothache. Toothache often causes a pulsating, throbbing type of pain. Tension headache often causes a non-pulsating, non-throbbing type of pain. The tension headache pain is felt like a tight band in one or both sides of the head and the forehead. The tightness and the pain of a tension headache gradually build up.
Migraine headache, on the other hand, is a severe episode caused by certain environmental or food "triggers." It produces a severe throbbing pain, occurring often on one side of the head accompanied with nausea and exaggerated sensitivity to light and sound.
Medical science, just in the last few years, developed highly effective treatment and medications for migraine headaches, but, unfortunately, it has had little to offer the tension headache sufferers.
Behavioral science, which studies the human behavior has a lot to offer for tension headaches and migraine sufferers. Migraines and tension headaches both cause inflammation. Inflammation is related to the sympathetic nervous system that governs our "fight or flight" reaction.
A simple explanation of the relationship between fight or flight response and the inflammation and pain at the physical level is this: Fight or flight signal from the brain releases adrenaline. Adrenaline creates energy in the muscles and nerves triggering other chemical reactions leading to inflammation and pain.
Here comes the psychological-emotional part: The fight or flight reaction can be triggered by actual or merely perceived challenges, dangers or invasions. This is the key to understanding how stress, which is mental or emotional in nature can lead to something so physical as the inflammation and pain.
Where one feels the pain varies from individual to individual based on their emotional and biomechanical patterns. Some may feel pain in the temples and others in the neck or forehead. But, to get a significant and lasting relief for migraine or tension headaches, the muscles in the shoulders and neck have to be released too, along with those of the head, face and the forehead.
It means that whether you have a migraine or a tension headache, you are likely to benefit from learning the skills of relaxation and stress management.
Teeth grinding, fist clenching, gum chewing, frowning, squinting and poor posture often increase under tension, excitement and negative emotions. These behaviors, through a complicated process, end up contributing to further inflammation and pain. Two thirds of tension headache sufferers report that clenching or grinding makes their headache worse.
Steady attention and practice of relaxing face, jaw, eyes and in fact the total body can be of benefit. Furthermore, efforts to keep the shoulders, face, neck and head relaxed, as far as possible, in spite of the pain, will reduce the chances of additional pain that can result from such "pain behaviors" as frowning, grinding and clinching.
It might appear that I am asking the impossible: How can one try to relax in the face of pain? My answer is that one should at least try to minimize the pain behaviors. And, we should also try to minimize such emotions as anger, sadness and fear as such emotions might convert into more pain.
The following techniques have been found helpful for migraines and tension headaches as well as for stress management: biofeedback; progressive muscle relaxation; counseling; anxiety management; stress management; yoga; Tai chi; aerobic exercises and deep breathing.
In many cases, use of such psychological techniques as emotional management, stress management, relaxation and personal resource development along with medical treatment is likely to be most beneficial.
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Copyright 2002, Mind Publications
Dr. Vijai Sharma
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