Almost everyone can say that they’ve had a headache at one time or another, but when headaches are a regular theme in your life, it can be a real drain, affecting your energy, mood and concentration. In this article we’ll run through the current biomedical understanding of tension headaches, what to look out for, and then finish with some ideas from traditional Chinese medicine along with current acupuncture research.
WHAT IS IT?
A tension headache is described a mild to moderate pressing or tightening pain affecting both sides of the head. For it to be classified as chronic, it must be recurring for 3 months or more, and if occurring on 15 or more days of every month, then it is considered chronic daily headache.
WHAT CAUSES IT?
The underlying causes are not well understood, however it is important to rule out certain identifiable causes such as inflammation or vessel damage (including stroke), infection (like meningitis), abnormal intracranial pressure, brain tumor, and traumatic brain injury (check out “when to see your doctor” below).
With the more serious potential causes of chronic headaches ruled out, you can start to look at some of the common triggers for what may be exacerbating your headaches:
Excessive muscle contraction in the neck, shoulders and/or face
Eye strain - exposure to light, excessive reading, prolonged screen time
Like a band tightening or pressing around the head
Occurring 15 or more days of the month, for 3 months or more to be classified as “chronic daily headaches”
WHEN TO SEE YOUR DOCTOR
It’s worth checking in with your doc if you experience any of the following:
You usually have more than 2 headaches every week
Most days you require pain relief medication
You need to take more than the recommended dose of pain relief medications to relieve your headaches
The pattern of your headache changes or the intensity increases
You are disabled by your headaches
And if you experience any of the following, it’s time to get checked out ASAP:
It comes on suddenly and severely
It is accompanied be a fever, stiff neck, confusion, seizure, double vision, weakness, numbness and/or difficulty speaking
Preceded by a head injury
Pain worsens despite rest and pain medication
HOW IS IT DIAGNOSED?
There is no specific test to diagnose tension headaches, typically your doctor will run through your symptoms, medical history and an examination to arrive at a conclusion. Other tests or imaging may be used to rule out more serious causes if suspected.
HOW IS IT TREATED?
First, lifestyle modification should be considered especially if headaches are chronic and frequent:
Avoid or limit headache triggers - keeping track of when your headaches occur can help you identify possible triggers to avoid or limit. See the list above for ideas.
Do not overuse medication - certain over the counter medications can cause headaches when overused. Please consult with your doctor or pharmacist if uncertain about dosage and frequency of use.
Get enough sleep - typically 7-8 hours is ideal.
Don’t skip meals, eat healthy and drink enough water - hunger and dehydration can contribute to headaches.
Exercise regularly - get moving to improve your physical and mental wellbeing. It can also help with the next point of stress reduction.
Reduce stress - techniques such as meditation, tai chi or yoga done on a regular basis may be of benefit.
Limit caffeine intake - if caffeine is a regular part of your life, it may be worth considering trialing a period without it as it has been linked to increased frequency of headaches.
Over the counter medications such as aspirin are often recommended for the management of pain. In other cases your doctor may prescribe antidepressants or stronger analgesics.
HOW DOES CHINESE MEDICINE APPROACH HEADACHES?
When we treat in the clinic we’re interested in treating you as a whole person and not just a sore head. Our goals are to figure out what might be driving your headaches from a Chinese medicine perspective, as well as how we can support your body’s natural ability to heal and recover so that your body can better look after you.
An example might be that we find muscular tension in the neck with tender points that refer pain into the head, we then figure out that this tension started with an old injury and has been exacerbated by desk work over the years. Upon further questioning we also discover sleep isn’t ideal, often waking around 3am with trouble falling back asleep, and then feeling groggy and unrested when the alarm goes off. Digestion seems a little off too with bloating and sensitivity to certain foods.
For us to do a good job with this example, we would aim at not only relieving the muscular tension contributing to the headaches, but also help to improve the body’s ability to effectively switch out of a fight or flight (sympathetic dominant) state into a rest, digest and recover (parasympathetic dominant) to restore deeper quality sleep and improved digestion. With improved muscle function in the neck there is less tension contributing to headaches, and with deeper, more restorative sleep along with improved digestion, the body is better able to heal and recover into the future.
Of course every case is unique and there are many different combinations of factors, which is why it’s important for us to access each person with headaches as an individual. In treatment we predominantly use acupuncture, along with Chinese herbal medicine and lifestyle advice where appropriate.
ACUPUNCTURE HEADACHE RESEARCH
In a Cochrane systematic review of current research concluded that acupuncture was “effective for treating frequent episodic or chronic tension‐type headaches”. In another summary of evidence, they concluded that there was a compelling case for the “potentially important role for acupuncture as part of a treatment plan for patients with migraine, tension-type headache, and several different types of chronic headache disorders”.
TRY ACUPUNCTURE FOR YOUR HEADACHES
The friendly team at Village Remedies in Balmain are here to help you. Please call or book online to schedule a time to see us. Your appointment will include a consult, assessment and acupuncture treatment. If we’re a good fit for you, then from there we can develop a plan to get you feeling better.
Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40. ncbi.nlm.nih.gov/pubmed/27411557