If you’ve ever had a headache, especially a migraine, you are most certainly aware of how debilitating they can be. Sensitivity to light, sound, possibly nausea and vomiting, that constant throbbing that won’t go away – can make it impossible to get out of bed some days, let alone be productive.
It has been estimated that about 38% of the human population is in pain at a given time. In fact, according to the National Headache Foundation, approximately 45 million people in the U.S. suffer from chronic, recurring headaches each year, leading to about $50 million dollars lost due to employee absenteeism and medical expenses. Unfortunately, even those who seek conventional medical care for their headaches often find themselves alternating between medications, trying new ones to see if they might work, without ever really finding long-term relief.
This is why I love working with patients suffering from headaches. They are often at the end of their rope, barely able to continue functioning, and we find that even small changes can help shift the pain, so that they are able to sleep a bit better, require less medication, can take the sunglasses off, and begin to take their day back.
During a headache, there is constriction of intra-cranial (inside the skull) blood vessels, followed by dilation or expanding of the extra-cranial (outside the skull) blood vessels. This can put pressure on the small nerves around the skull, signalling pain back to the brain. Additionally, it has been found that impaired energy production by mitochondria can contribute to the chronic nature of headaches. But, there are a few simple things that can help break the cycle!
Personally, I find one of the largest contributors to headaches can be hydration status. It is absolutely essential, in my opinion, to consume at least 1500-2000 milliliters of water per day (about 6-8 250 ml measuring cups). Water is involved in hundreds of processes in our body, but most importantly, ensures adequate blood volume, so that important nutrients like oxygen, glucose, vitamins, and minerals, can be carried to each tissue and cell of our body. The next time you’ve got a killer headache, or feel one coming on, try taking down a tall glass of water and see if that doesn’t do the trick. If you happen to wake up in the morning with a headache, be sure to get at least 500-1000 ml of water in before any juice, tea, or coffee.
The importance of physical assessment, and correcting structural and functional abnormalities of soft tissue, in my opinion, is another factor of headache management that goes severely unnoticed. In the vast majority of cases (about 90% of all headaches), muscle tension and contraction on blood vessels and sensory nerves, especially in the shoulders, neck, base of the skull, and jaw (from clenching your teeth during your sleep, or during times of stress), can easily lead to headache symptoms. In fact, about 30% of people who see a doctor for pain will find that it is due to ‘trigger points’ in their muscles. In order to find relief from a headache, and reduce the frequency and severity of recurring headaches, it is important to receive physical therapy (such as soft tissue massage, active release stretching, and myofascial trigger point release – all of which are performed in our clinic) on a regular basis, in addition to home stretches. The next time you’re feeling a headache coming, try some simple stretches to the muscles at the back of the neck (such as pushing your head back against the seat of your car while stopped at a traffic light, or down into your pillow when lying in bed) to help reduce tension and decrease pain signaling pathways.
There are a few key nutrients with evidence for reducing the frequency and intensity of headaches, both as prevention as treatment measures.
– Magnesium – found to be deficient in people suffering from migraines. Magnesium helps prevent spasms and constriction of blood vessels, relaxes skeletal muscle, and regulates cell membrane function. An appropriate dose is usually about 600mg per day, but you may need to go higher for acute treatment.
– B vitamins – specifically B2 (riboflavin), B3 (niacin), and B12 (cobalamin), are crucial for mitochondrial metabolism and energy production. They are also found to be deficient in some people who take anti-inflammatory drugs (NSAIDs), which are commonly prescribed for headaches. These deficiencies, in addition to leading to free radical production, can trigger the headache pathway. Vitamin B12 helps reduce the free radicals, while niacin (B3) helps dilate those intra-cranial blood vessels that become constricted. A good dose would be about 400 mg of B2, 500 mg of B3, and 1000-2000 mg of B12.
– Coenzyme Q10 – also helps improve mitochondrial energy production and is important to take for long-term prevention of headaches. A good dose is about 200-300 mg per day.
All of the above nutrients are available at our clinic in professional-grade form. I personally find that, for best acute headache relief, the vitamins and minerals should be given intravenously (IV) as what’s called a modified Myer’s cocktail.
As with many illnesses, nutritional supplements and physical therapy will only go so far – you need to do some work yourself in terms of diet and lifestyle. It is important to avoid any dietary triggers of your headaches – common ones include coffee (although this can also help many people), tea, chocolate, and certain medications that contain caffeine. If you’re not sure what you might be sensitive too, it is a great idea to keep a ‘diary’ or chart of your headaches – each day record when you had a headache, the intensity, the foods you ate that day, your water intake, and whether you needed to take any medication for the headache. This is also great information to provide your health care practitioner, as it helps us assess whether the treatments we are giving or recommending are being effective.
Finally, as with any medical condition or illness, it is important to seek the advice of a qualified health professional who can perform an adequate neurological examination. Less than 1% of headaches are due to emergency conditions such as stroke or intracranial bleeding, however it is important to know when additional testing, such as a CT scan or MRI, may be indicated.