About Headaches: Tension, Migraine and Cluster

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This is SCIENCE IN THE NEWS in VOA Special English.  I'm Barbara Klein. And I'm Steve Ember.  Today we tell about headaches, the head pain that strikes almost everyone at some time.

Do you ever get a headache?  If your answer is yes, you are among thousands of millions of people worldwide who develop the condition.  The National Headache Foundation says more than forty five million Americans suffer chronic headaches.  At first, they experience severe pain in the head.  The pain goes away, but returns later.

The most common headache is a tension headache.  Millions of people have a more painful headache, called a migraine.  By comparison, not many people develop cluster headaches.  The severity of cluster headaches usually requires treatment.

The National Headache Foundation says about one-tenth of all Americans suffer from migraines.  About seventy percent are women.  Some people experience this kind of pain as often as two weeks every month.  Some describe the pain as similar to a repeated beat like a heartbeat.  Others say it is like someone driving a sharp object into the head.

In addition to the suffering, there are economic results.  Migraines cause Americans to miss more than one hundred fifty million workdays each year.  A migraine can be mild.  But it also can be so severe that a person cannot live a normal life.

The Mayo Clinic in Rochester, Minnesota, provides information about migraines and other headaches.  The Mayo Clinic says several foods are suspected of causing migraines.  They include aged cheese and alcoholic drinks.  Food additives like nitrates and monosodium glutamate also are suspected causes.

So is caffeine, the substance in coffee that makes people feel more energetic.  Interestingly, doctors sometimes use caffeine to treat migraine headaches.

If you are developing a migraine headache, you may feel sick.  You may feel very tired, hot or cold.  You even may temporarily lose your sight.

Some people take medicine every day to prevent or ease migraines.  Others use medicine to control pain that has already developed.  Doctors treating migraine sufferers often order medicines from a group of drugs known as triptans.

Most migraines react at least partly to existing medicine.  Most people can use existing medicine without experiencing bad effects.

Some people continue to suffer with migraines, although they may try different medicines.  But the future may be better for these people.  Two kinds of devices are being tested on patients.  Both are based on the idea that electricity may stop or control migraine headaches.  But experts say more testing is needed.

One experimental treatment is called occipital nerve stimulation, or O.N.S.  It involves placing electrical devices under the skin in the back of the head.  Lead lines placed in the lower back send electrical signals to the patient's occipital nerves.  Shocks sent through the lines are thought to block pain signals from the nerves.

The United States Food and Drug Administration approved testing of O.N.S. at seven medical centers.  Six are in the United States.  The other is in Britain.

One of the centers is the Mayo Clinic in Arizona.  The Arizona center is an extension of the Mayo Clinic in Minnesota.  In April, researchers at the Arizona center reported on their testing.  They presented their findings at a meeting of the American Academy of Neurology.  The researchers said the treatment appeared safe and effective.

Another possible treatment is called transcranial magnetic stimulation, or T.M.S.  It is meant only for patients whose migraines begin with an aura.  They may see objects like bright stars and flashing lights.  The goal is to stop the migraine before it takes hold.

In T.M.S., a magnetic device is pressed against the back of the head.  The device produces signals.  They are thought to interfere with the brain activity that causes the pain.  Hundreds of people are taking part in tests of the device.

Doctor Yousef Mohammad works at the Ohio State University Medical Center.  His team performed a small study during two thousand four and two thousand five.  The results showed that most patients treated with the device had no headaches two hours after its use.  Or their headache pain was less severe.

Many more people suffer tension headaches than migraine headaches.  But most tension headaches are not as powerful.

Triggers are events or actions that can start a headache.  Tension headache triggers may include emotional pressure and the deeper than normal sadness called depression.  Other tension headaches start from something as tiredness or common changes in atmospheric conditions.

The Mayo Clinic says you may feel a tension headache as tightness in the part of your face over your eyes.  Or, you may feel pressure around your head.  Episodic tension headaches strike from time to time.  Chronic tension headaches happen more often.  A tension headache can last from a half hour to a whole week.

The Mayo Clinic says the pain may come very early in the day.  Other signs can include pain in the neck or the lower part of the head.  Scientists are not sure what causes tension headaches.  For years, researchers blamed muscle tension from contractions in the face, neck and the skin on top of the head.  They believed emotional tension caused these tightening movements.

But a test called an electromyogram has shown that muscle tension does not increase in people with a tension headache.  The test records electrical currents caused by muscle activity.

Some scientists now believe that tension headaches may result from changes among brain chemicals such as serotonin.  The changes may start sending pain messages to the brain.  These changes may interfere with brain activity that suppresses pain.

Medicines for tension headache can be as simple as a painkiller like aspirin or similar medicines.  But if your pain is too severe, you will need a doctor's advice.

A Web site called familydoctor.org  provides information from  the American Academy of Family Physicians.  The group suggests steps to ease or end a tension headache.

For example, it says putting heat or ice on your head or neck can help.  So can standing under hot water while you are getting washed.  The group also advises exercising often.  Another idea is taking a holiday from work.  But you had better ask your employer first.

Ask anyone with a cluster headache, and they will tell you that the pain is terrible.  The Cleveland Clinic Headache Center in Ohio says the cluster headache can be many times more intense than a migraine.  The pain of a cluster headache has sometimes been known to cause people to kill themselves.

Cluster headaches usually strike young people.  Smokers and persons who drink alcohol often get these headaches.  Men are about six times more likely than women to have them.  The Cleveland Clinic says this is especially true of younger men.  Doctors say cluster headaches often strike during changes of season.

Cluster headache patients describe the pain as burning or piercing.  The pain is almost always felt on one side of the face.  It can last for up to ninety minutes.  Then it stops.  But it often starts again later the same day.  Eighty to ninety percent of cluster headache patients have pain over a number of days to a whole year.  Pain-free periods separate these periods.

The Cleveland Clinic says the cause of cluster headaches is in a brain area known as a trigeminal-autonomic reflex pathway.  When the nerve is made active, it starts pain linked to cluster headaches.  The nerve starts a process that makes one eye watery and red.

Research has shown that activation of the trigeminal nerve may come from a deeper part of the brain called the hypothalamus.

The Cleveland Clinic says injections of the drug sumatriptan can help.  Many other drugs also could be used.  For example, doctors say breathing oxygen can help.  Thankfully, modern medicine has ways to treat almost all of our pains in the head.

This program was written by Jerilyn Watson and produced by Brianna Blake.  I'm Barbara Klein. And I'm Steve Ember.  Join us again next week for more news about science in Special English on the Voice of America.