Headaches - Yogic Management for Common Diseases

Headache is one of the most common symptoms a doctor is asked to treat. There are several types of headache, and the origin of pain is slightly different for each one. The brain itself is insensitive to pain, but many other structures both inside and outside of the skull have sensitive pain fibres. These include the arteries and venous sinuses of the brain, the dura mater or membrane surrounding the brain and the external scalp muscles.

Clinical features

There are some causes of headache which should be treated by a medical expert, such as tumours, meningitis or acute fevers. The types of headache described below also have a number of different causes. Therefore, in all cases of chronic headache a medical check up is essential.

• Vascular headaches are the typically throbbing type and are due to dilation of blood vessels. The headache which accompanies fever and systemic infections is typical. It is due to dilation of the intracranial blood vessels, as are throbbing headaches which occurs at high altitude or which follow a blow to the head, an epileptic fit or excessive consumption of alcohol.
• Migraine and hypertension headaches, on the other hand, are thought to be due to dilation of the extracranial arteries outside the skull.
• Muscle spasm is one of the most common causes of headache. The muscles of the scalp or the neck go into a spasm due to emotional tension. This produces persistent and continuous type of headache which varies in intensity from a feeling of tightness to a true pain. Cervical spondylitis and poor spinal posture in general are frequent causes.
• Referred headache from the eyes is also common. It often accompanies eyestrain and glaucoma. Similarly, inflammation or irritation of the sinuses and nasal passages often manifest as a headache.
• Psychogenic headache  is the term used to describe head-caused by emotional or mental tensions. It is often a vascular or tension headache, being experienced as a sense of pressure at the top of the head, or as a tight band around the scalp. Migraine belongs in this group.

The most common headaches

The two most common forms of headache are migraine and tension headaches.

Migraine: This severe form of headache occurs more commonly in woman than men. It is characterized by periodic headaches which are usually one-sided and are often accompanied by visual disturbances and vomiting. Migraine is thought  to be caused by swelling of the arteries outside the skull due to instability of the autonomic nervous system which controls the flow of blood into the head. Pain is caused by the stretching of pain nerve endings in the arterial wall.                                                                   

Migraine is found to have a family predisposition, with three in four migraine sufferers having close relatives who are similarly affected. It is uncertain whether this predisposition is genetic or is behaviourally inherited. Migraine usually starts after puberty and continues until late middle life. Acute attacks are often related to emotional stress, occasionally occurring during the period of relaxation when the stress appears to be over.                                                                                     
Attacks occur at interval varying from a few days to several months. The fist symptom of an attack is commonly a sensation of white or coloured lights, moving spots, wavy lines or visual defects. Loss of sensation or weakness of one half of the body may be experienced or there may be numbness of both hands and around the mouth. These symptoms may last up to half and hour. This period is known as the 'migrainous aura'.It is followed by the actual pain of the headache, which usually begins in one spot and subsequently involves the whole of one or occasionally both sides of the head. The pain is usually severe and throbbing in character, and is associated with vomiting, photophobia (aversion to light), pallor, sweating and prostration, which may cause severe loss of muscle tone and necessitate the patient taking to bed in a darkened room. The attack may last from a few hours to several days, leaving the patient weak and exhausted.        
                                                                                   
A migraine attack may be precipitated by many factors, but for each sufferer there is usually a characteristic one. It may be a response to a particular food, especially the tyramine rich foods, such as cheese, chocolate and red wine. It is not always easy to locate factors which precipitate the attack.                                                           

Similarly, there are many phases of migraine. Some people have migraine with the sun rising, and it gets better as the sun falls towards the horizon. They may be completely free of attack when conditions are cloudy. In other people, the incidence of migraine appears to be related to the lunar cycle. The site of migraine attack also varies. Some sufferers will experience the attack in only half of the head, while other sufferers experience the pain at the top or at the back of the head.

Tension Headaches:  

Tension headaches are related to migraine but manifest through through the somatic nervous system (which is part of the peripheral nervous system associated with skeletal muscle voluntary control of body movements) instead of through the autonomic nervous system (a division of the peripheral nervous system that influences the function of internal organs. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions such as the heart rate, digestion, respiratory, respiratory rate, pupillary response, urination and sexual arousal. This system is the primary mechanism in control of the fight-or-flight response and the freeze-and-dissociate response).

These headaches are produced by sustained contractions of the external scalp muscles. These headaches are usually constant and non-pulsatile and may be unilateral or bilateral. The sufferer often describes a feeling like a tight band around the head, or a feeling of the head being in a vice or under great pressure. Migraines usually last for a few hours, but may extend much longer. With prolonged headache, the muscles of the head, jaws, neck and upper back may become tender and tight and movement may be limited. In addition, hardened localized, painful areas in the scalp muscles commonly arise. Generally poor posture is a major factor.

Tension headaches commonly follow emotional stress, but sustained muscle contraction may also be a factor in the pain associated with vascular headaches, and with diseases of the eyes, ears, nose, teeth and sinuses. Similarly, the type of headache which is found to be associated with cervical arthiritis (spondylitis) or disc degeneration generally stems from muscular spasms.

Tension headaches and migraine often occur in the same person. Headache is also a common symptom of constipation and menstrual irregularity. These headaches disappear when the underlying condition is recognized and treated.

Medical Treatment of Headaches

Many headaches disappears when an underlying cause such as fever, eye disorders, or sinusitis has been removed. Others may respond well to osteopathic treatment or removal of allergenic foods. Otherwise the treatment is symptomatic, as conventional medical science has been unable to provide cure for psychogenic headaches such as migraine or tension headache.

Symptomatic treatment using various drugs which provide temporary relief is all that is currently prescribed in the first instance. Muscle tension headaches sometimes respond to aspirin or tranquilizers, psychotherapy, massage and heat. For migraine type vascular headaches the commonly prescribed drugs are derived from ergot alkaloids. These must be taken at the first sign of the attack if they are to be of any benefit. 

Rectal aspirin suppositories also help. In general, however, the medical management of chronic, persistent headache symptoms a the present time is fairly ineffective, and the conditions present a real problem for both the patient and the doctor.

Yogic Management

Yogic practices fill the gap in managing these types of headache which the medical science finds difficult to treat. Psychogenic headache, vascular headaches, including migraine, and muscle tension headache can often be eradicated completely through yogic practices alone.

Fundamental practices for migraine and tension headaches are the hatha yoga shatkarmas, kunjal and neti. If they are performed at the beginning of an attack of migraine, the sufferer gains immediate relief. These practices release the build-up of psycho-emotional tension which is precipitating the attack. In eradicating headaches these shatkarmas should be practiced daily each morning, in conjunction with the following program for two or three months.

1. Asana: Pawanmuktasan part 1, surya namaskara.
2. Pranayama: Bhramari, nadi shodhana, gentle bhastrika.
3. Shatkarma: Kunjal and neti daily. Laghoo shankhaprakshalana once a week. Shankhaprakshalana (full practice) should be undertaken in an ashram environment preferably before commencing the program.
4. Relaxation: Yoga nidra daily
5. Diet: A simple vegetarian diet is recommended. Avoid rich foods, especially cheese, chocolate and wine. Avoid overeating.
6. Fasting: Skipping a meal and relaxing for ten minutes in shavasana will often avert an impending headache if it is due to mental stress.