This was originally published on Think Better Life blog but is reprinted on Sleep and Health Journal
CHRONIC DAILY HEADACHES (CDH): MAYO CLINIC CONSIDERS CDH THE MOST DISABLING OF HEADACHES
How your headaches are defined may prevent you from having effective treatment. View patient testimonials at the bottom of this post.
Living with headaches is a fact of life for many headache survivors. According to Mayo Clinic “chronic daily headaches occur 15 days or more a month, for at least three months. True (primary) chronic daily headaches aren’t caused by another condition.” This definition will artificially separate similar headaches into different diagnostic groupings.
Hear a testimonial of a patient that a Mayo Clinic Physician was hopeless. She is now doing very well.
Chronic daily headache is not a specific type of headache but rather a disabling pattern of headache occurrence.
Johns Hopkins describes Chronic Daily Headache as “A patient who has headaches as many days as not — at least 15 days a month — is said to have chronic daily headache (CDH). CDH is not a specific type of headache, but rather a descriptive term applied to any number of headache types. The two most common types of primary headache are Migraine and Tension-Type Headache. Rebound headache or medication overuse headache is a frequent occurrence in patients with CDH. The treatment actually becomes the disease.
The typical treatment offered by headache specialists and neurologists is a prescription medication. When the first is not effective the patient is often taken thru a series of single medication trial followed by trials of multiple medications. This is similar to what happens to patients who utilize OTC medications moving from drug to drug often mixing prescription and non-prescription medications.
Tension-type headaches are the most common type headache but theuy are often dismissed as being relatively mild and tolerable. These headaches often progress to Rebound headaches and/or migraine. Tension-type headaches should be considered to be muscle contraction headaches. According to Cleveland Clinic “They used to be commonly referred to as muscle contraction headaches or stress headaches, but these old terms have been abandoned.”
90 – 95% of all headaches are actually partially or completely muscle contraction headaches. There are Vascular/ Neurogenic components to all headaches as well.
According to the NHLBI of the NIH patients who receive a diagnosis of TMJ have a 60-90% chance of experiencing satisfactory resolution of symptoms but patients diagnosed with other types of headaches will probably be condemmed to live in pain.
Tension-type headaches or muscle contraction headaches re considered episodic if they occur less than 15 days/month and chronic if they occur more than 15 days/month. They may las for 30 minutes to several hours or continue for days at a time. Because they are a type of headache referred from muscles they tend to have slow onset and are achy in nature. Patients often describe them as a taut band, pressure headaches, and usually they are bilateral and generalized in location. What is important to understand is that Tension –Type headaches can be part of a ongoing process that triggers migraines and other more severe headaches. Tension headaches can be as severe or even more severe than migraine headaches. Tension-Type headaches are considered a Primary headache but referred headaches from the neck muscles (cervical headaches or cervicalgia) and/or the TMJ (Tempormandibular Joints) and masticatory muscles are considered secondary headaches..
These secondary headaches are examples of muscle contraction headache as are headaches related to trigger points and taut bands in Fibromyalgia and Myofascial Pain and Dysfunction.
According to John Hopkins the following is a list of causes of tension-type headaches. If you read the list it is almost like saying a normal life is the cause of headaches. What all of these have in common is that they all provoke muscle contractions secondary to stress.
• “Inadequate rest
• Poor posture
• Emotional or mental stress, including depression
Tension-type headaches can be triggered by some type of environmental or internal stress. This stress may be known (overt) or unknown (covert) to the patient and their family. The most common sources of stress include family, social relationships, friends, work, and school. Examples of stressors include :
• Having problems at home
• Having a new child
• Having no close friends
• Returning to school or training; preparing for tests or exams
• Going on a vacation
• Starting a new job
• Losing a job
• Being overweight
• Deadlines at work
• Competing in sports or other activities
• Being a perfectionist
• Not getting enough sleep
• Being over-extended; involved in too many activities/organizations”
According to the National Heart Lung and Blood Institute of the National Institute of Health TMD Disorders :
“TMD has been used to characterize a wide range of conditions diversely presented as pain in the face or jaw joint area, masticatory muscle pain, headaches, earaches, dizziness, limited mouth opening due to soft or hard tissue obstruction, TMJ clicking or popping sounds, excessive tooth wear and other complaints.
TMD remains to be classified in the larger context of other muscle and joint disorders or in the category of pain disorders (NIH Technology Assessment Conference, 1996). About half of all cases are attributed to conditions linked to the muscles of mastication” and “Pain linked to the TMJ and/or muscles of mastication constitutes the essential criterion for case assignment. It often qualifies as “aching”, “throbbing”, “tiring” and exhausting.
These are the same symptoms found in tension headaches and both are associated with similar proportions of female to male patients. These disorders are also associated with sleep disturbances that tie them to a wide variety of other disorders.
The National Institute of Health and PubMed.gov provide the largest database in the world of headache publications. These publications universally agree that regardless of the type of headache a patient has almost 100% are caused or mediated by the Trigeminal Nervous system. The Trigeminal Nerve is often called the Dentist’s Nerve because it innervated the teeth,the periodontal ligament and gums, the jaw muscles, the jaw joints and many associated structures. The Trigeminal Nerve also controls the blood flow to the anterior two thirds of the meninges of the brain.
Why do TMJ patients do better than other headache patients? Only dentistry treats headaches by changing input to the brain. While migraines are often thought to be caused by chemical imbalances within the brain only dentistry attempts to correct these chemical inbalances by eliminating noxious input to the Trigeminal Nervous System.
Neuromuscular Dentistry is probably the single most effective method of controlling noxious (nociceptive) input to the brain.