migraines

Treating The Four Most Common Types Of Headaches

/ Thomas Cohn, MD

headachesA headache can ruin your whole day, which is why it’s important to prevent headaches from developing and take some steps to treat them when you feel one coming on. However, not all headaches are the same, and you need to really understand what type of headache you are dealing with in order to pursue the optimal treatment. In today’s blog, we take a closer look at four of the most common types of headaches and how each is treated.

Common Types Of Headaches

There are more than four types of headaches, but these four tend to be much more common, which is why we are putting them under the spotlight:

Migraine – A migraine is the most common type of headache, and there are many different subsets of migraines. A migraine typically involves pain or a throbbing sensation on one side of the head or face. A number of different issues can contribute to or directly cause a migraine headache, including dehydration, stress, hormonal changes, lack of sleep or sensory triggers like flashing lights or loud sounds. Treatment involves pinpointing the underlying cause of the migraine and working to target the issue. For example, improving your sleep habits, finding healthy outlets for stress and staying hydrated can all help to prevent and treat a migraine attack.

Tension Headache – A tension headache is likely the next most common type of headache, causing discomfort in the back of your head, temples and forehead. As the name implies, they are oftentimes the result of muscle tension or excessive strain on muscles that support your head and neck. Oftentimes they can develop as a result of poor posture and an unhealthy diet that doesn’t supply your body with nutrients that help muscles function property. Simple tweaks to your diet and really focusing on improving your posture can help to keep tension headaches at bay.

Cluster Headache – A cluster headache usually involves pain or discomfort on one side of the head, oftentimes in the eye region. Researchers believe they develop as a result of your body’s sudden release of histamine or serotonin, which means foods, allergens or sensory triggers can all lead to a cluster headache. Although they tend to be shorter in nature compared to migraine and tension headaches, they can still pack a punch. Avoiding allergens and potential triggers are a helpful step, and your doctor may talk to you about certain medications to help relieve a cluster headache should one develop.

Hypnic Headache – The final headache we’ll spotlight is called a hypnic headache, and it is a primary type of headache that typically occurs during sleep, which can make getting prolonged restful sleep difficult. They tend to occur in older individuals, and while their exact cause is unknown, researchers believe that brain activity and nerve relays during the REM cycle play a role in their onset. Interestingly, caffeine is oftentimes a recommended treatment, but if this also keeps you from falling asleep and staying asleep, your doctor may see if melatonin or similar medication can help you find relief.

If you need help overcoming chronic or infrequent headaches, or if you believe that your underlying pain condition is contributing to your headaches, reach out to Dr. Cohn and his team today at (952) 738-4580 for assistance.

Daith Piercings, The Vagus Nerve, and Migraines 

/ Thomas Cohn, MD

vagus nerveDaith piercings have been showing success in helping to control migraine headaches. Now there is new research that seems to shine more light on what has been thought to be the mechanism that contributes to the success of this treatment. Research into dementia has recently been done with stimulating the ear with a slight bit of external and intermittent vibration. The research suggests that this may help prevent dementia. The mechanism of action is thought to be by stimulating the ear, a branch of the vagus nerve is also being affected and this is what is producing the results. Similar to what we assumed was happening with the daith piercing, vagus nerve stimulation is the key factor at play.

The latest information on stimulating the ear and the vagus nerve comes from a study out of England and the University of Leeds (Bretherton et al, 2019, in Aging). Stimulating the outer ear for 15 minutes a day for two weeks with gentle electrical vibratory signals improved the relaxation signals and parasympathetic activity. The researchers determined that they were electrically stimulating a branch of the vagus nerve that is in the region of the tragus. In older people (55 years and older) they may have a high sympathetic outflow and this leads to stress, tension, depression and low energy. The transcutaneous electrical stimulation of the ear rebalanced the system and seemed to slow the effects of aging. The major caution was this was a small study so one does not know if these findings would be present in a large controlled study.

The initial research at the University of Leeds in England was done in 2015 and was done in healthy young people.  Stimulating the ear with transcutaneous electrical stimulation at the vagus nerve improved autonomic function. Normalizing autonomic function means decreasing sympathetic tone, stress, tension and most likely vascular tone.  This would also mean blood vessels would not constrict and could impact the occurrence of migraine headaches.

What It Means For Migraines  

Vagus nerve stimulation has a history that is long standing.  Vagus nerve stimulation devices were implanted after 2005 for treatment of major depression. They also have been used for gastro-intestinal disorders, epilepsy, and some inflammatory disorders. Now there is an FDA-approved device (GammaCore) to stimulate the vagus nerve through the skin to relieve migraine headaches.

Daith piercings we now know are not placebo treatments for migraine headaches. It is pretty clear they work through stimulating the auricular branch of the vagus nerve in the region of the tragus in the ear. Stimulating the vagus nerve will increase parasympathetic activity and decrease excessive sympathetic tone. This would likely decrease the vascular events that surround migraine headaches. Furthermore it may reduce overall personal stress and anxiety that may be migraine triggers. The piercing would cause physical stimulation of the vagus system and thus rebalance the autonomic nervous system in the body. If piercing is not an option, then using a transcutaneous nerve stimulator (TENs) unit with a very light current to the tragus unit would likely do the same. The good news is that science is validating the practice of this piercing.

As a side note, research is underway specifically on the daith piercing.  Studies are being done in England and elsewhere in Europe with regards to the effectiveness of this technique. Whether the daith piercing will work for any one individual is unknown. Since migraines may have a number of triggering causes, the effectiveness of the daith piercing is likely dependent on whether a component of the migraine is related to autonomic balance in the body and if it can be corrected with vagus nerve stimulation. Hopefully we continue to learn more about vagus nerve stimulation and how to best treat these types of migraines in the near future.

The Link Between Chronic Migraines and Dementia

/ Thomas Cohn, MD

migrainesNew research published in the Journal of Alzheimer’s Disease found a link between chronic migraines and the eventual onset of dementia, especially in women.

For the study, researchers examined 7,400 study participants between the ages of 60 and 80. Half of the group said they suffered from regular migraines, while the other half were migraine free. The goal of the study was to see if a migraine diagnosis could impact a person’s likelihood of developing dementia within 10 years of the migraine diagnosis, independent of any other medical issues the individual had.

At the conclusion of the 10-year period, researchers uncovered that over five percent of individuals with migraines had been diagnosed with dementia, while just over 3.5 percent of those without migraines received the same diagnosis. Moreover, when examined by sexes, nearly six percent of women who suffered from migraines went on to develop dementia within 10 years.

“Our results indicate that elderly people with migraine headaches should be regularly screened for cognitive decline and dementia,” researchers concluded. “Furthermore, offering adequate treatment and management to migraine patients is important, as it may help prevent the subsequent development of dementia.”

Not only does there appear to be a link between migraines and dementia, but previous studies have found an increased risk of heart attacks, strokes and cardiovascular issues in women that suffer from migraines, so proactive treatment is important.

Migraine Treatment

Migraines and headaches are two conditions that we help treat, and we recommend seeking professional help if you suffer from chronic headaches because every case is different. We’ll provide you with a comprehensive diagnosis and then walk you through some treatment options. If a treatment isn’t providing relief, we’ll move on to different techniques until we find one that works for you. Some common treatment options that have helped patients find relief include:

  • Exercise
  • Weight loss
  • Relaxation Therapy
  • Diet Changes
  • Monitoring and Adjusting Caffeine or Beverage Consumption
  • Acupressure
  • Daith Piercing
  • Muscle relaxers
  • Other Medications

We won’t stop until we find a solution that works for you. For many individuals, their migraines may also be linked to a chronic pain condition, which we can also help treat. Pain is a complex issue that is best handled through a team approach, so do right by your body and contact Dr. Cohn and his team today.