1) Eat regularly and don’t skip any meals.
2) Maintain a regular sleep schedule.
3) Get frequent and consistent exercise.
4) Recognize what triggers migraines (examples may include stress or overexertion) and try to avoid those triggers.
5) Identify any foods that may trigger a migraine. Common examples are chocolate, caffeine, cheese and processed meats.
6) Talk to your child’s pediatrician about medication if migraines can’t be controlled by other methods.

While I can agree with all these I would add another tip before number 6. Unfortunately this list suffers from the all too familiar discounting of the role muscle tension in the face, jaw and shoulders plays in triggering migraine headaches. If you have a child who is prone to headaches, watch their forehead and between their eyes. Do they squint regularly? Do they furrow their brow when worried? Do they clench their teeth? If you say yes to any of these, reminding your child to relax those tight muscles before a headache starts (or as it is starting) can avoid many, many headaches. The same advice goes for adults. Getting rid of the muscular triggers that stimulate migraine headaches will stop the majority of migraines from even getting started.

Kids do worry and kids do carry tension in the muscles of the face and neck. The good news is that kids can get rid of the tension much easier than adults. As a parent you have the opportunity to train your child to learn how to detect and then relax muscle tension in their face and jaw and shoulders. By doing this very simple training you could save them countless hours of pain and misery.

In her experience biofeedback is extensively used in rehabilitation treatment settings but not in acute treatment settings. She said that in a rehab situation, doctors can’t use as much medicine and all the staff know that good progress can be made when you invest in changing behavior. It does take time and effort whereas in acute treatment settings (emergency rooms, doctors offices, etc.) the staff are looking for quick fixes and don’t really think of treatment options that may take a little time and effort. They rely on drugs.

She went on to say that when she worked in acute settings, she saw a paradox where staff focuses on easy treatments like meds that don’t demand much effort from the patients and avoid treatments like biofeedback that could effectively solve problems over time. The concern is not losing patients but ensuring that they continue to be seen for treatment over many sessions.

Now, I am not easily shocked but this actually shocked me. Here is a medical professional that has worked with doctors and physical therapists in acute hospital settings and doctors offices essentially saying that she has observed other health professionals more interested in repeat business than curing patients. This, of course, was one of the central debating points for the national health legislation that is winding it’s way through the US Congress; the perception that the fee for service pricing structure drives up costs.

How widespread these practices are I don’t know, but if even a small percentage of health care professionals are thinking about repeat business rather than curing patients it is pretty scary. Particularly if that patient is you! What happens when you, with your terribly painful and upsetting headaches, end up with a doctor who likes repeated drug trials instead of more effective behavioral or biofeedback therapy?

This is one of the best arguments I know for taking charge of your own health and recovery. While it may be more time consuming to take charge of your health and learn alternative ways  to get rid of your headaches, you are responsible for yourself rather than having somebody else’s secondary gain determine your treatment options.

Don’t be afraid to ask your doctor for treatment options. Don’t be afraid to do research. If you have chronic headaches, do ask about biofeedback therapy for your headaches and look for information on how to treat your headaches by changing your behavior; you just might save yourself a lot of time, angst and money. And unfortunately trained biofeedback therapists are not available in every community in the US which is why we created our online Headache Free Blueprint training.

And, given all the training and practice I have had, I am still often surprised at the stages I encounter during the process of relaxing. The first, most obvious, aspect to this story is that relaxing is not intellectual. Knowing how to relax, knowing about relaxing, etc. doesn’t make any difference at all. Only doing it makes a difference. (This, of course, is the first problem but stay tuned because there are others.)

So I sit down to relax and I feel my body start to let go. I feel my body becoming less tense and softening. I feel my breathing deepen and slow down and my body fairly quickly responding. This is good and this is what is expected.

But, guess what? This process is repeated and repeated and repeated time after time as I sit there. What does this mean? It means that I keep relaxing and then I relax some more and then I relax some more. It almost feels like I break through layer upon layer of tension. To use an active metaphor, it feels like I am busting through layer after layer of tension. And I probably am doing exactly that.

But, golly, I relax regularly. I relax often during the day mentally and take a mental inventory of tension in my body off and on all day long. How could it be that I find myself busting through layer upon layer of tension when I sit down and really DO my relaxation exercises?

And herein lies what looks to me to be the big Problem with Relaxation. Everyone, and I mean everyone, pretty much thinks they know what relaxation is and how to relax. But do they really go through the steps to sharply focus and dig deep and bring forth a strong relaxation response? I would bet that no, they don’t. We are trained to keep moving forward, keep doing and you will get ahead. But taking the time to sit down and really cultivate the relaxation response in our body? I suspect most everyone thinks it is not necessary. Heck, we all know how to relax. Right?

This whole issue is particularly pertinent for headache sufferers. People who have headaches more than once a month have built up layers and layers of tension in their bodies that pressure their nervous system into having headaches. If they never learn how to ‘bust through’ those layers of tension, they really don’t have a chance to get rid of their headaches. They think they are relaxing, they don’t think tension is the problem but they can’t know how to relax until they do it. And when they do finally learn how to relax and their headaches get less frequent and milder or go away entirely they are amazed. They are amazed that their headaches went away and they are also amazed that they were more tense, actually much more tense, than they thought they were.

So, what is the problem with relaxation? I would say that the problem with relaxation is that nobody learns how to relax and can’t get the benefits that relaxation brings unless they really learn how to relax. And because we get so used to being tense nobody can really feel how tense they are until they relax.

So, if you have headaches more than once a month I will ask you to take the Relaxation Challenge. Sit quietly for 15 minutes, look inside and cultivate a feeling of ‘letting go’ so that your muscles soften and your body gets heavy and you feel calmer. If you can’t sit for 10 minutes, then you have a problem. And this problem keeps your headaches in place. It is now your choice, do you want to keep your headaches or do you want to learn how to relax better and get rid of your headaches?

While this young woman identified this insight as a #blondmoment, I actually feel it is quite brilliant. This short post actually tells us quite a lot about the behavioral management of headaches. First, she has been suffering from a headache (hopefully mild) for some time and despite her suffering she didn’t really know what to do to stop her headache. Somehow she had the insight to ‘PAY ATTENTION’ and she noticed that her hair clip was causing mechanical problems resulting in persistent headaches. I suspect that her hair clip was pulling her scalp too tightly resulting in irritation and then headache.

Now, she might have noticed a slight irritation in her scalp when first using her hair clip but quickly got used to the irritation so it failed to register anymore. But, then the headaches started and she didn’t immediately connect the scalp irritation with her headaches.

While this is an unusual and very specific example, this type of event occurs all the time and headache sufferers are so far down the road from the time the initial irritation started that they have no recollection of the original events that cause or aggravate their headaches; all they know is that they have headache and they are getting worse over time.

So, what events am I talking about? Well, stress for one. I know, I know, stress has gotten to be a fairly meaningless word because it can be used to describe so many events inside and outside of us. But, the fact is that when we humans go through a stressful event our bodies do react and these reactions cause changes to occur that put pressure on our bodies and ourselves and which often end up in symptoms if the stressful reactions are not dealt with and stopped. So, it could be said that the tight hair clip is a ‘stressor’ and literally putting pressure on her scalp resulting in a headache. There are many other stressors that put pressure on our bodies and if we are prone to headache these stressors will make sure we get more headaches and after time if these stressors are not relieved you can be sure that more and more headaches will occur and they will become increasingly painful. What are some of these ‘other’ strssors? Well they are things like clenching our teeth or tightening our shoulder muscles or furrowing our eyebrows or pushing the tongue forward, etc. We humans are prone to all kinds of minor habits caused by stress that can and will cause headaches in someone prone to headaches.

That is why I think the post by @AhaShake3 was so brilliant. She was able to take a look at herself and see that a hair clip she was using regularly was causing her problems. And, for her the solution was pretty obvious. Unfortunately, after years of suffering from chronic headaches the solution is not this obvious for most. That is why we start our training program with awareness training. The body has a marvelous ability to push sensations outside of our awareness if these sensations occur regularly. This is great in most cases but if a person genetically prone to headaches is not aware that they carry muscle tension in any of the muscles of the face, head, jaw, neck or shoulders then they have no clue what to do to stop the pressure or the headaches.

This is important news, though I suspect that most chronic headache sufferers have already given up coffee and caffeinated drinks. When a person tries to control their headaches through diet, giving up caffeine is the first logical step.

There is a paradox here though, and that is that many medications for headaches contain caffeine. Migraine headaches, in particular, are thought to have a vascular component and it is well known that caffeine constricts blood vessels. So, if migraine headaches are caused by the dilation of blood vessels it makes sense that constricting blood vessels by taking a dose of caffeine as the headache begins will be beneficial. And, it is also well known that if a person drinks caffeinated drinks regularly it is almost inevitable that they will suffer caffeine withdrawal headaches if they stop drinking roughly the same amount of caffeine each day; these are known as caffeine withdrawal headaches.

Unfortunately the researchers who did this study don’t know why drinking increased amounts of caffeine increase the potential to suffer more headaches, even so this study is helpful by suggesting that anyone prone to headaches should approach caffeine intake with caution.

Read the review by Science Digest

So, what do I mean when I say that obtaining relief from chronic headaches is as simple as training for a sport? How can this be? Let me explain.

As I have mentioned elsewhere, I am a student and teacher of T’ai Chi. When you strip away the mystical jargon, T’ai Chi is basically a sport. It is a sport that combines patterned movements with meditation and it is ultimately a marital art. And training for any martial art involves seriously training your body’s muscle memory. Muscle memory allows your body to perform an action quickly and without thought. This is very important in a martial situation because thinking is much slower than physical reflexes; so much so that if a martial artist takes time to think they have lost the fight. They have to have previously trained their reflexes in patterned movements which can be relied upon to emerge and be useful in the midst of a crisis, without thought. This does not mean there is no thought at all, but thinking is not necessary to produce the movement. The unification of the mind and body in spontaneous purposeful activity is an exhilarating experience and explains much of the pleasure martial artists experience while training and performing.

So, how does this relate to chronic headaches? Well, one major cause of chronic headaches is negatively patterned muscle memory. This is muscle memory that was previously trained unconsciously during times of crisis or by bad habits over a lifetime. We learn bad muscular habits which have a negative impact on our headache patterns unconsciously. These habits may start out as comforting actions during times of stress (like clenching the teeth) or during times of mild anxiety and we don’t recognize the significant impact these habits have on our headaches. So, we inadvertently train ourselves to make our headaches worse because we don’t really understand that when we do anything that makes the muscles of the head, jaw, neck or shoulders more tense it actually makes our headaches worse in the long run.

I have obviously known this for years, since changing the patterns of muscle activity in the face, jaw, head and neck forms the basis of the online training program I teach to decrease the severity and frequency of chronic headaches. But I was reminded again of this entire dynamic this morning while practicing a new martial art I have decided to study. This martial art is called Bagua Chan and it is related to T’ai Chi in many ways so I don’t have to start from scratch. But is is substantially different in that it emphasizes walking in a circle with quick turns. One walking pattern is called Mud Walking where the stepping pattern is toe to heel rather than heel to toe which is my normal walking pattern. After walking the circle using the Mud Step for about 45 minutes I came back into the house and I found myself easily using the Mud Step to walk around the house. It was easy and it was natural. Now, this was very unusual for me. I NEVER walk using this stepping pattern so to find myself easily and naturally walking this way after just a small amount of practice was new and pleasing (I now see new patterns being trained for my muscles). And this is exactly what happens in our online training program, Headache Freedom Blueprint. Students learn how to train new patterns of muscle activity for their face, jaw, head and shoulders and these new patterns take the pressure off so muscle tension stops generating new headaches. If you think I was pleased just to see myself change my walking pattern, image how our students feel when they get relief from the painful condition of chronic headaches.

Have you had similar experiences? Does this ring a bell in anyway? Please leave a comment below

1) Eat regularly and don’t skip any meals.
2) Maintain a regular sleep schedule.
3) Get frequent and consistent exercise.
4) Recognize what triggers migraines (examples may include stress or overexertion) and try to avoid those triggers.
5) Identify any foods that may trigger a migraine. Common examples are chocolate, caffeine, cheese and processed meats.
6) Talk to your child’s pediatrician about medication if migraines can’t be controlled by other methods.

While I can agree with all these I would add another tip before number 6. Unfortunately this list suffers from the all too familiar discounting of the role muscle tension in the face, jaw and shoulders plays in triggering migraine headaches. If you have a child who is prone to headaches, watch their forehead and between their eyes. Do they squint regularly? Do they furrow their brow when worried? Do they clench their teeth? If you say yes to any of these, reminding your child to relax those tight muscles before a headache starts (or as it is starting) can avoid many, many headaches. The same advice goes for adults. Getting rid of the muscular triggers that stimulate migraine headaches will stop the majority of migraines from even getting started.

Kids do worry and kids do carry tension in the muscles of the face and neck. The good news is that kids can get rid of the tension much easier than adults. As a parent you have the opportunity to train your child to learn how to detect and then relax muscle tension in their face and jaw and shoulders. By doing this very simple training you could save them countless hours of pain and misery.

This is great news for chronic headache sufferers, especially those with migraines. We have long been advocates for the importance of reducing chronic tension in the muscles of the jaw, face, head, neck and shoulders as a way to reduce or eliminate chronic headaches. Since botox works by paralyzing muscles (this is why wrinkles are smoothed when botox is used cosmetically) why in the world would botox help anyone with chronic migraine headaches unless tight muscles were triggers for migraines? If muscles are not involved in triggering migraines paralyzing them with botox would have no effect at tall. According to Richard B. Lipton, MD (lead author of one study and Director of the Montefiore Headache Center in New York City) the results of using botox were “highly statistically significant and reflects clinically meaningful improvements in functioning and vitality, and a decrease in psychological distress.”

For so many years prevailing wisdom has been that muscle tightness has nothing to do with triggering migraine headaches and that migraine headaches were entirely a vascular (blood vessels in the head) event. But recently, studies like these are showing the importance that muscular triggers play in the triggering of migraine headaches. We think the results of these studies are great news because they help make the picture clearer. Getting rid of the myth that tight muscles are not involved in headaches is important. We have long advocated that headache sufferers (migraine, tension, mixed migraine/tension and persistent daily headaches) learn how to relax the muscle of the head and neck. Botox can’t be used to paralyze muscles that are necessary for chewing or turning the neck or lifting the arm but relaxation training works just fine to reduce and eliminate tension in any and all the muscles that trigger headaches. In over 30 years of teaching patients how to relax the muscles of their head, neck and shoulders with biofeedback we have seen 98% of those who eliminate chronic tension significantly reduce their headache frequency and severity. We also can truly say, just like Dr. Lipton, that those who learn how to reduce their muscle tension experience “meaningful improvements in functioning and vitality, and a decrease in psychological distress.”

If you suffer from frequent headaches start to pay attention to whether or not you can feel tension any muscle of your face, head, neck or shoulders. Unfortunately, this tension may be hard to feel at first but keep looking. Over time you will be able to tell when your muscles are tight and that is when you can start to do something about it.

Check out the details at:
http://www.medicalnewstoday.com/articles/164027.php

“Botulinum neurotoxin type A for treatment of chronic migraine: PREEMPT 1 trial double-blind phase”
Aurora SK et al
“Botulinum neurotoxin type A for treatment of chronic migraine: PREEMPT 2 trial double-blind phase”
Dodick DW et al
“Botulinum neurotoxin type A for treatment of chronic migraine: analysis of the PREEMPT chronic migraine subgroup with baseline acute headache medication overuse,” Silberstein SD et al.
“Botulinum neurotoxin type A treatment improves health-related quality of life and reduces the impact of chronic migraine: results from the double-blind phase of the PREEMPT clinical program,” Lipton RB et al.

It is astonishing that this training is not taught at the beginning when anyone begins a cycle of chronic headaches and after a medical exam has ruled out neuropathology. In over 30 years of practice as a biofeedback therapist my most frequent referral was for chronic headaches. And, 99% of patients referred showed chronic levels of tension in one or more muscles of the jaw, neck, head or shoulders and saw a dramatic reduction in chronic headaches when this muscular tension was eliminated. Most of these patients had suffered with severe, chronic headaches for decades and were shocked to find themselves headache free so easily. And notably, this relief occurred whether or not the headache pattern was labeled as tension headaches, migraine headaches, mixed headaches or persistent daily headaches.

Couldn’t decades of suffering and expense have been avoided? We think so. If the attending physician or neurologist had simply told their patient that relaxing the muscles of the jaw, head, neck and shoulders was important in the beginning, the patient would have been empowered to start working on relaxing, noticing tension and muscular habits and would have been able to change the course of their treatment sooner instead of later. Unfortunately, without this knowledge an important dynamic driving their headache cycle remains invisible and the muscular habits fueling their headaches have a chance to become worse; more severe, more entrenched and more difficult to change.

We would like to hear from you so please leave a comment below about your personal story with headaches and what you have gone through in seeking relief.