CHRONIC BENIGN HEADACHE

Headache is one of the most common complaints brought to primary care physician’s offices.  The diagnosis of Chronic Benign Headache (CBH) is defined by chronicity and stability.  The workup of headache can be extensive.  Medical education teaches best medical practices for most conditions.  These practices do not require testing (like an MRI) for every person with headache.  The physician makes an informed and educated judgement on whether to order objective investigations after having performed a complete history and physical examination.  The advice that follows assumes that your physician is satisfied that serious causes of your headache have been excluded.  With this understanding, empiric therapies like those that follow may be employed.

The knowledge that your headache is not a serious condition or that it does not require medical intervention may improve the pain.

Like many other common innocuous symptoms, the cause of CBH is not understood.  If it interferes with your life, it is still an illness.  Head pain that prevents you from living your life, even if benign, can be treated.

There are many treatments for CBH.  This is often the case when no single cure works most of the time.  Medicines, cognitive/behavioral therapy, and physical therapy are commonly prescribed approaches to this problem.  People who suffer from headache often experiment with a number of different therapies before finding the ones that work.  This is to be expected.

I have several suggestions that may sound unusual but are effective.  This list of potential cures does not require a physician’s actions or prescription.  If done carefully, there is no harm from the following.

Stretch your neck.  Sit or stand straight.  Slowly turn your head to the right as far as it will comfortably go.  Hold for 2 seconds.  Do 5 repetitions.   Turn to the left 5 times.  Lift up your chin 5 times.  Lower your chin 5 times.

Stretch your spine.  Lie on the floor in a push-up position.  Lift your head up slowly, arching your back.  Support yourself with your hands.  Go only so far as is comfortable.  Hold 15-30 seconds.  Lower your head slowly.  Once down, turn your head to the side for about 5 seconds.

Stand with your feet about shoulder length apart, toes pointing forward.  Move your left hand down the inside of your left leg toward the ankle.  Raise your right hand to the ceiling.  Elbows and knees are held straight.  It should not hurt.  Hold each position 30 seconds.  Relax a few moments after the stretch.  Then, with your knees a little bent, lean forward gently at the waist.

Teach yourself to maintain an upright posture while sitting, standing, and walking.  Remind yourself to put a slight arch in your lower back while lifting up your chest and head.  This is a never-ending process for some.

Learn to meditate.  It’s about focusing your mind on one thought or sound.  As you do this, practice minimizing distractions.  Push out thoughts as they enter your brain.  There are books and tapes and videos and classes to help you.

Even if you do not have a diagnosis or symptoms of Temporomandibular Joint Syndrome (TMJ), your headache may still benefit from wearing a mouthguard.  Get an inexpensive universal version and try it for 2 weeks.

Curcumin, 300 mg. orally twice a day, helps with many pains.

Sip on dilute apple cider vinegar throughout the day.  Make a solution of 4 tablespoons of the vinegar in 1 pint of water.  Expect at least some benefit within 2 weeks.

L-Arginine, 700 mg. to 3500 mg., taken as a single dose in the morning helps many with headache.  It may cause sleeping problems.  Watch for this as a sign you are taking too much.

5-hydroxytryptophan (5-HTP) (400-800 mg.) at bedtime helps with sleep, tension, anxiety, and headache.  You will have to experiment with the dose.  If you are groggy in the morning, you are taking too much.

Experiment with pillows.  They come in many shapes and degrees of firmness. 

Oral magnesium supplements reduce muscle tension.  You may have to try different salts to find the best for you.  Magnesium glycinate or magnesium oxide have been the most effective.  Take it at bedtime.  It may make you sleepy.  The improvement for headache may require a month to prove itself.

Massaging certain areas help with headache.  One of these pressure points are at the base of the thumbs.  Another is the prominent muscle between the thumb and the forefinger.  This is called the thenar eminence.  Press hard enough that it hurts a little.  Massage for 15 seconds.

Another pressure point for headaches is the temporal areas above and in front the tops of the ears.  You will have to find the spot on yourself.  Some relief should be apparent immediately.

Treat sinus inflammation.  This is especially important if you have any chronic or intermittent sinus symptoms.  Many people without any sinus problems still benefit from this advice.  Use saline nasal rinse daily for 2 weeks to evaluate the effect on your headache.

Make your bedroom dust-mite free.  Store away papers, clothes, books, and other dust collectors in drawers or closed closets.  Remove carpeting if reasonably possible.  Wet-mop floor to ceiling weekly.  Prevent pets from ever coming in your bedroom.  Remove plants and upholstered furniture from the bedroom.  Wrap pillows, mattresses, and comforters in dust covers.

Reduce inflammation in general.  Digestive enzymes, omega 3 fatty acids, reduced fat diet, and the Mediterranean Diet have benefitted some people with chronic benign headache.    

Chamomile tea at bedtime has helped some wake with less headache.

Which will work for you?  Should you try a combination of several?  How long should any given therapy be tried?  You will have to experiment.  Listen to your body for a response.  Good luck.