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Constant mild headaches: Headaches: Treatment depends on your diagnosis and symptoms


Headaches: Treatment depends on your diagnosis and symptoms

Headaches: Treatment depends on your diagnosis and symptoms

Do you take aspirin or acetaminophen for all your headaches? For some types of headaches, that’s not the best approach. Here’s why.

By Mayo Clinic Staff

Your head hurts. Again. The first step in foiling your frequent headaches is determining what type of headache you have. Sometimes headaches are a symptom of another disease or condition; sometimes there’s no clear cause.

Take a close look at your headache signs and symptoms. Keeping a headache diary might help determine your headache type. Note when your headaches occur, your symptoms, and potential triggers, such as food, stress or changes in sleep.

There are many types and sub-types of headaches. Chronic daily headaches, which occur 15 days or more a month, are one sub-type. Tension-type headaches and migraines are also common sub-types of headaches. They can both be chronic, though they aren’t always. Other types of chronic daily headaches include:

  • Hemicrania continua, a one-sided headache that can feel like a migraine
  • Primary stabbing headaches, which last for a few seconds and can occur several times throughout the day
  • Primary exertional headaches, caused by exercise
  • Chronic paroxysmal hemicranias, sharp, one-sided headaches that can cause tearing or a congested nose
  • Medication overuse headaches, which occur from overusing pain medications for headaches for at least three months. These headaches occur at least 15 days out of the month.

Other headache types include:

  • Cluster headaches, which cause severe pain on one side of the head and occur off and on for weeks over the course of a few months. Cluster headaches are associated with one or more signs and symptoms, such as tearing, nasal congestion and nasal discharge. These occur on the same side as the pain.

Tension-type headaches

Tension-type headaches, the most common variety of headaches:

  • Might be felt as a tight band of pain around your head, a dull ache or pressure
  • Might cause mild to moderate pain on both sides of the head
  • Vary widely in frequency
    • Can be occasional
    • May occur more than 15 days a month (chronic)
  • Last from 30 minutes to a week

Most occasional tension-type headaches are easily treated with over-the-counter medications, including:

  • Aspirin
  • Ibuprofen (Advil, Motrin IB, others)
  • Acetaminophen (Tylenol, others)

Daily prescription medications, including tricyclic antidepressants, might manage chronic tension-type headaches. Alternative therapies aimed at stress reduction might help. They include:

  • Cognitive behavioral therapy
  • Biofeedback
  • Massage therapy
  • Acupuncture


Migraines are another common type of headache. They affect three times more women than men. Migraines typically:

  • Cause pain that is moderate to severe
  • Pulsate
  • Cause nausea, vomiting, or increased sensitivity to light or sound
  • Affect only one side of your head, but can affect both sides
  • Worsen with activity such as climbing steps
  • Last from four to 72 hours without treatment

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. If you know what triggers your migraines, avoiding those triggers and learning how to manage them can help prevent migraines or lessen the pain. Treatment might include:

  • Rest in a quiet, dark room
  • Hot or cold compresses to your head or neck
  • Massage and small amounts of caffeine
  • Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) and aspirin
  • Prescription medications including triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig)
  • Preventive medications such as metoprolol (Lopressor), propranolol (Innopran, Inderal, others), amitriptyline, divalproex (Depakote), topiramate (Qudexy XR, Trokendi XR ,Topamax) or erenumab-aooe (Aimovig)

Recognize emergency symptoms

Seek emergency care if you have:

  • A very severe, sudden headache
  • Headache after a head injury or fall
  • Fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking
  • Pain that worsens despite treatment

These symptoms suggest a more serious condition, so it’s important to get a prompt diagnosis and treatment.

Take control

Almost everyone gets headaches, and many are nothing to worry about. But if headaches are disrupting your activities, work or personal life, it’s time to see your doctor. Headaches can’t always be prevented, but your doctor can help you manage the symptoms.

May 10, 2019

Show references

  1. Headache information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Accessed June 26, 2018.
  2. Headache diary: Keeping a diary can help your doctor help you. National Headache Foundation. https://headaches.org/resources/headache-diary-keeping-a-diary-can-help-your-doctor-help-you/. Accessed June 26, 2018.
  3. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018;38:1.
  4. Bajwa ZH, et al. Evaluation of headache in adults. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  5. Kasper DL, et al., eds. Headache. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: The McGraw-Hill Companies; 2015. https://www.accessmedicine.mhmedical.com. Accessed June 26, 2018.
  6. Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  7. Tension-type headache. American Migraine Foundation. https://americanmigrainefoundation.org/understanding-migraine/tension-type-headache/. Accessed June 26, 2018.
  8. May A. Cluster headache: Treatment and prognosis. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  9. May A. Cluster headache: Epidemiology, clinical features, and diagnosis. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  10. Headache: Hope through research. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research. Accessed June 26, 2018.

See more In-depth


Tension Headaches | Michigan Medicine

Topic Overview

Is this topic for you?

This topic is about tension headaches in adults. If you are looking for information about migraine headaches, see Migraine Headaches.

What is a tension headache?

Most headaches are tension headaches. These headaches tend to happen again and again, especially if you are under stress. They are not usually a sign of something serious. But they can be very painful and hard to live with.

Tension headaches can last from 30 minutes to 7 days.

If you have a headache on 15 or more days each month over a 3-month period, you may have chronic tension headaches. This type of headache can lead to stress and depression, which in turn can lead to more headaches.

Tension headaches are very common. Symptoms can start in childhood, but they are more likely to occur during middle age.

Some people have both tension headaches and migraine headaches.

What causes tension headaches?

Doctors don’t know for sure what causes tension headaches. Experts once thought that tension or spasms in the muscles of the neck, face, and head played a role. Now they think that a change in brain chemicals also may be a cause.

Tension headaches are one of the most common types of headaches. They can be brought on—or triggered—by things such as stress, depression, hunger, and muscle strain. Tension headaches may come on suddenly or slowly.

What are the symptoms?

Symptoms of tension headaches include:

  • A headache that is constant, not throbbing. You usually feel the pain or pressure on both sides of your head.
  • Pressure that makes you feel like your head is in a vise.
  • Aching pain at your temples or the back of your head and neck.

This is different than migraine headaches, which usually cause throbbing pain and start on one side of your head.

Tension headaches tend to come back, especially when you are under stress.

Pain from a tension headache is usually not severe and does not get in the way of your work or social life. But for some people, the pain is very bad or lasts a long time.

How are tension headaches diagnosed?

A doctor can usually diagnose tension headaches by asking you questions about your health and lifestyle and by examining you.

How are they treated?

Most people can treat their tension headaches with over-the-counter pain relievers like acetaminophen (such as Tylenol) or aspirin (such as Bayer).

But if you take these pain relievers more than 3 times a week, you may get rebound headaches. These are different from tension headaches. Rebound headaches usually start after pain medicine has worn off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine.

Your doctor may prescribe medicine if you get chronic tension headaches.

Can you prevent tension headaches?

Even with treatment, most people still have some headaches. But with treatment, you will probably have them less often. And when you do get them, they probably won’t be as bad.

Home treatment may help you avoid headaches. You can:

  • Try to reduce stress.
  • Make sure you sleep, exercise, and eat on a regular schedule.
  • Make sure you practice good posture. Stand and sit up straight.
  • Try not to strain your eyes when you use your computer.
  • Get treatment for depression or anxiety if you have those health problems.
  • Try using a headache diary. Every time you get a headache, write down the date, the time, and what you were doing and feeling before your headache started. This may help you and your doctor find out what is causing your headaches. Then your doctor can use the diary to plan your treatment.


The cause of tension headaches is not clear. In the past, doctors believed that tension or spasms of the muscles of the neck, face, jaw, head, or scalp played a role in causing these headaches. Now they think a change in brain chemistry may also help cause a tension headache.

Tension headaches are the most common type of headache. They can be brought on—or triggered—by things such as stress, depression, hunger, and muscle strain. Tension headaches may come on suddenly or slowly.

Chronic tension headaches often occur along with other health problems such as anxiety or depression.


Symptoms of tension headaches include:

  • A constant headache that does not throb or pulse. You usually feel the pain or pressure on both sides of your head.
  • Tightness around your forehead that may feel like a “vise grip.”
  • Aching pain at your temples or the back of your head and neck.

Unlike migraines, tension headaches usually don’t occur with nausea, vomiting, or feeling sensitive to both light and noise. But light or noise could make your headache worse. Tension headaches usually aren’t bad enough to keep you from doing your daily activities.

Tension headaches can last from 30 minutes to 7 days.

If you have a headache on 15 or more days each month over a 3-month period, you may have chronic tension headaches.

When to Call a Doctor

or other emergency services if:

  • You have symptoms of a stroke, such as:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

Call your doctor now or go to the emergency room if:

  • You have a fever and a stiff neck.
  • You have new nausea and vomiting, or you cannot keep food or liquids down.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your headache wakes you up at night.
  • Your headaches get worse or happen more often.
  • You start to have new symptoms.
  • You have any problems with your medicine.
  • Your headaches occur after physical exercise, sexual activity, coughing, or sneezing.
  • Your life is disrupted by your headaches (for example, you miss work or school regularly).

Watchful waiting

Watchful waiting is a wait-and-see approach. If your headache gets better on its own, you won’t need treatment. If it gets worse or you get headaches often, you and your doctor will decide what to do next.

Watchful waiting and using over-the-counter pain medicines work well if your tension headaches don’t keep you from doing the things you want to do. But if your headaches are disrupting your life, talk to your doctor about other treatments that you could try.

Who to see

Most health professionals can recognize and treat tension headaches. You may seek treatment from any of the following:

If you think that your headaches are caused by depression or anxiety, talk to your doctor. Treating these problems may help reduce how bad your headaches are and how often you get them.

Exams and Tests

Finding out the type of headache you have

A doctor can usually diagnose tension headaches by asking you questions about your health and lifestyle and by examining you.

It can be hard to know which type of headache you have, because different types can have the same symptoms. But the treatments may be different, so it’s important to find out which type you have.

Finding other possible causes

In very rare cases, headaches can be caused by more serious health problems (such as brain tumors or aneurysms). But most headaches aren’t caused by anything serious, so you probably won’t need to have tests.

Treatment Overview

You can treat most tension headaches with:

  • Over-the-counter pain medicines.
  • Prescription drugs if you have chronic or very bad headaches.
  • Avoiding things that trigger your headaches.
  • Meditation and other ways to lower your stress.

Over-the-counter medicines to stop headaches

Medicines can help you feel better. But they can also be dangerous, especially if you don’t take them the right way. Be safe with medicines. Read and follow all instructions on the label.

  • Try these drugs first. Most doctors recommend that you try over-the-counter drugs first if you have mild to moderate headaches. They may have fewer side effects than prescription drugs. These medicines include:

    • Acetaminophen, such as Tylenol.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (for example, Bayer) and ibuprofen (for example, Motrin).
    • Medicine that combines aspirin, acetaminophen, and caffeine, such as Excedrin.
  • Don’t take this medicine too often. Try not to take over-the-counter drugs more than 3 times a week, because you may get rebound headaches. These are different from tension headaches. They are usually triggered after pain medicine has worn off, prompting you to take another dose. After a while, you get a headache whenever you stop taking the medicine.

Prescription medicines to prevent headaches

Your doctor may recommend that you take a prescription medicine every day to prevent headaches. You may want to try a prescription medicine to prevent a headache if:

  • You are using over-the-counter medicines to stop headaches more than 3 times a week.
  • Over-the-counter medicines to stop headaches aren’t working well for you.

Your doctor may have you try one or more medicines, such as an antidepressant or a medicine that prevents seizures. These medicines can help prevent headaches even if you don’t have depression or seizures.

Avoiding triggers

You may be able to prevent or reduce tension headaches by learning what causes your headaches and trying to avoid those triggers. For more information, see Living With Tension Headaches.

Reducing stress

How you think can affect how you feel. So finding ways to relax and stop negative thoughts may help prevent headaches.

You may want to try:

  • Techniques to stop negative thoughts.
  • Progressive muscle relaxation.
  • Ways to manage your time.
  • Breathing exercises.
  • Guided imagery.
  • Meditation.
  • Yoga.

For more information, see Living With Tension Headaches.

Treatment if headaches get worse

If you continue to have tension headaches while you are getting treatment, you and your doctor may want to try another treatment.

You may have to try different drugs or doses. If you have already tried several medicines, your doctor may order tests (such as an MRI or CT scan) to find out if a health problem is causing your headaches.

Other things to think about

  • Even with treatment, you will most likely still get some tension headaches. But you probably will get them less often. And they may hurt less when you do get them.
  • If you also have depression or anxiety, talk to your doctor. Treatment for these health problems also may help you have fewer headaches.


Finding and avoiding the things—or triggers—that lead to tension headaches can reduce how often you get headaches and how bad they are when you do get them.

Headache triggers can include:

  • Stress.
  • Anxiety.
  • Fatigue.
  • Hunger.

Using a headache diary can help you find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you were doing before the headache started. This information can help you avoid things that bring on your headaches. And the diary also can help your doctor plan your treatment.

If you have headaches caused by muscle tension in your neck, shoulders, and upper back, pay attention to your posture during your daily activities. You also can try muscle relaxation and other ways to reduce muscle tension.

Your doctor also may prescribe medicine to help prevent tension headaches.

Living With Tension Headaches

You may have fewer headaches—and less pain when you do get them—if you:

  • Find and avoid triggers for your headaches.
  • Keep a headache diary to find out what triggers your headaches.
  • Take over-the-counter drugs to stop a headache.
  • Take medicine as your doctor advises to stop or prevent a headache.
  • Reduce stress with relaxation and positive-thinking methods.

Find and avoid triggers

You can reduce how many headaches you have by finding out what triggers them and avoiding those things. Triggers may include stress, hunger, and lack of sleep.

Use a headache diary

Use a headache diary to find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you were doing when the headache started. This information can help you avoid things that bring on your headaches. A diary also may help your doctor plan your treatment.

Take medicines as your doctor advises

If you have mild to moderate headaches, your doctor probably will want you to take over-the-counter medicines to stop your headaches. These include medicines like acetaminophen (such as Tylenol) and ibuprofen (such as Advil). Be safe with medicines. Read and follow all instructions on the label.

If over-the-counter medicines don’t stop your headaches well enough—or you get a lot of headaches—your doctor may prescribe medicine to prevent headaches.

Don’t take medicine too often. Talk to your doctor if you’re taking medicine more than 3 days a week to stop a headache, or if you have a headache on more than 15 days a month. Taking too much over-the-counter pain medicine can lead to more headaches. These are called rebound headaches.

Reduce stress

One Man’s Story:

Jerry, 32

“I hold my stress in my shoulders and neck. My shoulders are always up around my ears. A lot of times, I leave at the end of the day with a big headache.”—Jerry

Read more about how Jerry reduced his stress.

Stress can cause tension headaches.

You can lower your stress with positive thinking and relaxation methods. Research shows that you can change how you think. And how you think affects how you feel. Try these techniques on your own or with help from a therapist or counselor trained in muscle relaxation, meditation, biofeedback, or cognitive-behavioral therapy.

Learn how to lower your stress with these topics:

You also can learn to stop thinking all the time about things that bother you.

Seek help if you think that your tension headaches may be linked to depression or anxiety. Treating these health problems can reduce how often you get headaches.


Your doctor may recommend medicine to treat or prevent tension headaches.

You might only need to take an over-the-counter medicine for pain. These medicines usually have fewer side effects than prescription drugs. Always be safe with medicines. Read and follow all instructions on the label.

Over-the-counter drugs to stop headaches

Over-the-counter medicines that you can use to stop a headache include:

  • Acetaminophen (such as Tylenol).
  • Aspirin (such as Bayer).
  • Ibuprofen (such as Advil).
  • Naproxen (such as Aleve).
  • Medicine that combines aspirin, acetaminophen, and caffeine (such as Excedrin).

Try to avoid taking over-the-counter drugs more than 3 times a week, because you may get rebound headaches. These are different from tension headaches. They usually occur after headache medicine has worn off. This leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine.

Prescription drugs to prevent headaches

Your doctor may recommend that you take a prescription medicine every day to prevent headaches. You may want to take this medicine if:

  • Over-the-counter medicines don’t work to stop your headaches.
  • You’re taking over-the-counter medicines to stop headaches more than 3 times a week.
  • You get a headache more than 15 days a month.

Medicines used to prevent tension headaches include:

  • Antidepressants, such as amitriptyline.
  • Seizure medicines, such as topiramate.
  • Medicines that relax muscles, such as tizanidine.
  • Antianxiety medicines, such as buspirone.

Botulinum toxin type A (BTX-A) is sometimes injected into the muscles in the face and head to treat headaches. In the past, doctors thought that spasms caused tension headaches. But BTX-A injections do not seem to help with symptoms of tension headaches.footnote 1 And BTX-A may cause weakness of the facial muscles and may make it hard for you to swallow.

What to think about

  • The type of tension headache you have may help your doctor decide which drug to prescribe.
  • There are other things you can try besides daily medicine. For example, you could use cognitive-behavioral therapy or biofeedback.
  • The medicine that you take may cause side effects. Some side effects may last for a few weeks or for as long as you take the medicine.
  • You may have to try several different drugs or types of drugs before you find the one that is right for you. Make sure to tell your doctor how well a drug stops your headaches.
  • Certain pain medicines can cause a bad reaction if you take them with other medicines. Before you begin taking pain medicines, be sure to let your doctor know about all of the drugs you take. This includes over-the-counter medicines and complementary treatments (such as herbs).

Other Treatment

Using other treatments along with medicines may help you stop a tension headache or prevent one.

If you decide to try one or more of these treatments, make sure your doctor knows. He or she may have advice on how to use other treatments safely. Other treatments for headaches include:



  1. Jackson JL, et al. (2012). Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: A meta-analysis. JAMA, 307(6): 1736–1745. DOI: 10.1001/jama.2012.505. Accessed February 1, 2016.

Other Works Consulted

  • Digre KB (2016). Headaches and other head pain. In L Goldman, A Shafer, eds., Goldman-Cecil Medicine, 24th ed., vol. 2, pp. 2356–2364. Philadelphia: Saunders.
  • Haghighi AB, et al. (2010). Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura: A randomised, double-blind, placebo-controlled, crossed-over study. International Journal of Clinical Practice, 64(4): 451–456.
  • Headache Classification Committee of the International Headache Society (2013). The international classification of headache disorders, 3rd ed. (beta version). Cephalalgia, 33(9): 629–808. DOI: 10.1177/0333102413485658. Accessed February 1, 2016.
  • Holland S, et al. (2012). Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78(17): 1346–1353.
  • Kedia S, et al. (2014). Neurologic and muscular disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 776–861. New York: McGraw-Hill.
  • Ropper AH, et al. (2014). Headache and other craniofacial pains. In Adams and Victor’s Principles of Neurology, 10th ed., pp. 1310–1390. York: McGraw-Hill Education.


Current as of:
August 4, 2020

Author: Healthwise Staff
Medical Review:
Kathleen Romito MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Martin J. Gabica MD – Family Medicine

Chronic daily headaches Disease Reference Guide

Medically reviewed by Drugs.com. Last updated on March 30, 2021.


Most people have headaches from time to time. But if you have a headache more days than not, you might have chronic daily headaches.

Rather than a specific headache type, chronic daily headaches include a variety of headache subtypes. Chronic refers to how often the headaches occur and how long the condition lasts.

The constant nature of chronic daily headaches makes them one of the most disabling headache conditions. Aggressive initial treatment and steady, long-term management might reduce pain and lead to fewer headaches.


By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition.

There are short-lasting and long-lasting chronic daily headaches. Long-lasting headaches last more than four hours. They include:

  • Chronic migraine
  • Chronic tension-type headache
  • New daily persistent headache
  • Hemicrania continua

Chronic migraine

This type typically occurs in people with a history of episodic migraines. Chronic migraines tend to:

  • Affect one side or both sides of your head
  • Have a pulsating, throbbing sensation
  • Cause moderate to severe pain

And they cause at least one of the following:

  • Nausea, vomiting or both
  • Sensitivity to light and sound

Chronic tension-type headache

These headaches tend to:

  • Affect both sides of your head
  • Cause mild to moderate pain
  • Cause pain that feels pressing or tightening, but not pulsating

New daily persistent headache

These headaches come on suddenly, usually in people without a headache history. They become constant within three days of your first headache. They:

  • Often affect both sides of your head
  • Cause pain that feels like pressing or tightening, but not pulsating
  • Cause mild to moderate pain
  • Might have features of chronic migraine or chronic tension-type headache

Hemicrania continua

These headaches:

  • Affect only one side of your head
  • Are daily and continuous with no pain-free periods
  • Cause moderate pain with spikes of severe pain
  • Respond to the prescription pain reliever indomethacin (Indocin)
  • Can become severe with development of migraine-like symptoms

In addition, hemicrania continua headaches are associated with at least one of the following:

  • Tearing or redness of the eye on the affected side
  • Nasal congestion or runny nose
  • Drooping eyelid or pupil narrowing
  • Sensation of restlessness

When to see a doctor

Occasional headaches are common, and usually require no medical attention. However, consult your doctor if:

  • You usually have two or more headaches a week
  • You take a pain reliever for your headaches most days
  • You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches
  • Your headache pattern changes or your headaches worsen
  • Your headaches are disabling

Seek prompt medical care if your headache:

  • Is sudden and severe
  • Accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness or difficulty speaking
  • Follows a head injury
  • Gets worse despite rest and pain medication


The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause.

Conditions that might cause nonprimary chronic daily headaches include:

  • Inflammation or other problems with the blood vessels in and around the brain, including stroke
  • Infections, such as meningitis
  • Intracranial pressure that’s either too high or too low
  • Brain tumor
  • Traumatic brain injury

Medication overuse headache

This type of headache usually develops in people who have an episodic headache disorder, usually migraine or tension type, and take too much pain medication. If you’re taking pain medications — even over-the-counter — more than two days a week (or nine days a month), you’re at risk of developing rebound headaches.

Risk factors

Factors associated with developing frequent headaches include:

  • Female sex
  • Anxiety
  • Depression
  • Sleep disturbances
  • Obesity
  • Snoring
  • Overuse of caffeine
  • Overuse of headache medication
  • Other chronic pain conditions


If you have chronic daily headaches, you’re also more likely to have depression, anxiety, sleep disturbances, and other psychological and physical problems.


Taking care of yourself might help ease chronic daily headaches.

  • Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted.
  • Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly.
  • Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.
  • Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese.
  • Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy — such as walking, swimming or cycling. To avoid injury, start slowly.
  • Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation.
  • Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.


Your doctor will likely examine you for signs of illness, infection or neurological problems and ask about your headache history.

If the cause of your headaches remains uncertain, your doctor might order imaging tests, such as a CT scan or MRI, to look for an underlying medical condition.


Treatment for an underlying condition often stops frequent headaches. If no such condition is found, treatment focuses on preventing pain.

Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to your headaches. If you’re taking pain relievers more than three days a week, the first step might be to wean yourself off these drugs with your doctor’s guidance.

When you’re ready to begin preventive therapy, your doctor may recommend:

  • Antidepressants. Tricyclic antidepressants — such as nortriptyline (Pamelor) — can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches.

    Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem, others), might help in treating depression and anxiety, but have not been shown to be more effective than placebo for headaches.

  • Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. These include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL) and propranolol (Inderal, Innopran XL).
  • Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. Options include topiramate (Topamax, Qudexy XR, others), divalproex sodium (Depakote) and gabapentin (Neurontin, Gralise).
  • NSAIDs. Prescription nonsteroidal anti-inflammatory drugs — such as naproxen sodium (Anaprox, Naprelan) — might be helpful, especially if you’re withdrawing from other pain relievers. They can also be used periodically when the headache is more severe.
  • Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. Botox would most likely be considered if the headaches have features of chronic migraines.

The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

Alternative medicine

For many people, complementary or alternative therapies offer relief from headache pain. It’s important to be cautious, however. Not all complementary or alternative therapies have been studied as headache treatments, and others need further research.

  • Acupuncture. This ancient technique uses hair-thin needles inserted into several areas of your skin at defined points. While the results are mixed, some studies have shown that acupuncture helps reduce the frequency and intensity of chronic headaches.
  • Biofeedback. You might be able to control headaches by becoming more aware of and then changing certain bodily responses, such as muscle tension, heart rate and skin temperature.
  • Massage. Massage can reduce stress, relieve pain and promote relaxation. Although its value as a headache treatment hasn’t been determined, massage might be particularly helpful if you have tight muscles in the back of your head, neck and shoulders.
  • Herbs, vitamins and minerals. Some evidence exists that the herbs feverfew and butterbur help prevent migraines or reduce their severity. A high dose of vitamin B-2 (riboflavin) also might reduce migraines.

    Coenzyme Q10 supplements might be helpful in some individuals. And oral magnesium sulfate supplements might reduce the frequency of headaches in some people, although studies don’t all agree.

    Ask your doctor if these treatments are right for you. Don’t use riboflavin, feverfew or butterbur if you’re pregnant.

  • Electrical stimulation of the occipital nerve. A small battery-powered electrode is surgically implanted near the occipital nerve at the base of your neck. The electrode sends continuous energy pulses to the nerve to ease pain. This approach is considered investigational.

Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

Coping and support

Chronic daily headaches can interfere with your job, your relationships and your quality of life. Here are suggestions to help you cope with the challenges.

  • Take control. Commit yourself to living a full, satisfying life. Work with your doctor to develop a treatment plan that works for you. Take good care of yourself. Do things that lift your spirits.
  • Seek understanding. Don’t expect friends and loved ones to instinctively know what’s best for you. Ask for what you need, whether it’s time alone or less attention paid to your headaches.
  • Check out support groups. You might find it useful to talk to other people who have painful headaches.
  • Consider counseling. A counselor or therapist offers support and can help you manage stress. Your therapist can also help you understand the psychological effects of your headache pain. In addition, there’s evidence that cognitive behavioral therapy can reduce headache frequency and severity.

Preparing for an appointment

You’re likely to start by seeing your family doctor or a general practitioner. However, you may be referred to a headache specialist.

Here’s some information to help you get ready for your appointment.

What you can do

Be aware of pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance, such as restrict your diet.

  • Keep a headache journal, including when each headache occurred, how long it lasted, how intense it was, what you were doing immediately before the headache started, and anything else notable about the headache.
  • Write down your symptoms and when they began.
  • Write down key personal information, including major stresses or recent life changes and family history of headaches.
  • List all medications, vitamins or supplements you’re taking, including doses and frequency of use. Include medications used previously.
  • Write down a list of questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember information.

For chronic headaches, some questions to ask your doctor include:

  • What’s the likely cause of my headaches?
  • What are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What’s the best course of action?
  • I have other health conditions. How can I best manage them together?
  • Should I see a specialist?
  • Are there printed materials I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • Have your headaches been continuous or occasional?
  • How severe are your headaches?
  • What, if anything, seems to improve your headaches?
  • What, if anything, appears to worsen your headaches?

What you can do in the meantime

To ease your headache pain until you see your doctor, you might:

  • Avoid activities that worsen your headaches.
  • Try over-the-counter pain relief medications — such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others). To avoid rebound headaches, don’t take these more than three times a week.

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Headaches: When to Call the Pediatrician

By: Namrata Patel, MD & Steven Leber, MD, PhD, FAAP

“My head hurts.” Across the U.S., parents hear this complaint from their children and teenagers at a rate so frequent that it can be hard to know whether it is, in fact, a painful headache (or just an excuse to stay home from school). Head pain in babies and children too young to tell you their head hurts are often fussier, crankier, and unable sleep.

While most headaches are harmless and go away within a few hours, recurrent headaches of any type can cause school problems, behavioral problems, and/or depression. In this article, learn when to involve your pediatrician.
It’s important to know when headaches may be a symptom of something more serious.

Home Care for Children’s Headaches

Anyone who has ever had a mild, occasional headache knows rest and relaxation is often the best treatment. Other things like ice packs, warm shower or baths, naps in a dark room, and head and neck
massage may also help.

Use Caution with Over-the-Counter Pain Medicine

Don’t be tempted to turn to over-the-counter pain medication every time your child complains of head pain.
If you do, be sure to always read the label for any medication to determine the right dose based on your child’s weight.

  • Acetaminophen (Tylenol): You can give your child one dose to help reduce headache. Do not exceed the maximum dosage and frequency for children, 22-33 milligrams per pound within a 4-hour period.

  • Ibuprofen (Motrin/Advil): If acetaminophen does not initially work, you can also give one dose of ibuprofen. Do not exceed the maximum dosage and frequency for children, 13-22 milligrams per pound within a 12-hour period.

  • Keep track of how often you are giving these medications. If you are using more than 3 doses total per week, consult your pediatrician to determine if other medication is required.

  • Using more than three doses per week can also lead to
    medication overuse headaches (also known as analgesic rebound headaches). Children and teenagers can get these types of headaches from taking pain medicine too often, and therefore, being dependent on the medication. The over-the-counter medications no longer work to reduce pain, and the headaches become more frequent and more painful! Not good.

Keep a Headache Diary

There are a number of types of headaches, as well as potential causes. So, it can be helpful to see if a pattern develops. There are many different apps and online tools available to help you and/or your child. Your pediatrician will use this information to determine the best course of treatment.

What to include in a headache diary?

  • Date and time of headache

  • How long did the headache last?

  • What symptoms did your child experience?

  • What helped relieve the pain?

  • What made the pain worse?

  • Did anything specific happen that day (a test coming up in school, infectious symptoms, eating a certain food, trouble sleeping, etc.)?

Common Types of Headaches:

Each type of headache may be treated differently. A detailed history and physical exam help your pediatrician figure out what kind of headache your child has. Based on your child’s diagnosis, your pediatrician will create a plan with you on how to best relieve your child’s pain.

Tension headaches

  • Mild or moderate headache

  • Typically develops during the middle of the day

  • Constant, dull or achy pain

  • Sensation of tightness that feels like a band or circle around the head

  • Pain located in the forehead or on both sides of the head

  • Neck pain

  • Fatigue


  • Daily headaches

  • Headaches caused by straining from coughing, sneezing, running or having a bowel movement.

  • Headaches that occur along with pain in the eye or ear, confusion, nausea or vomiting, sensitivity to light and sound, or numbness.

  • Headaches that keep coming back and get worse.

  • Headaches following a head injury that don’t go away after a week.

  • Headaches severe enough to wake from sleep.


​ ​

  • Sudden, severe head pain happening for the first time–especially if your child has double vision, seems confused, sleepy, hard to wake up, has numbness or projectile vomiting.

  • Headache with a stiff neck, or complaints of neck pain, especially with a fever.

Migraine headaches

  • Throbbing pain that is often on one side of head, but can be on both sides–particularly in children

  • Light and/or noise sensitivity

  • Fatigue

  • Nausea and vomiting

  • Mood changes

  • An aura: flashes of light, zig-zag lines or other odd vision changes that may appear before or during a migraine

Note: Some symptoms of a migraine may be slightly different in children than adults.

Congestion headaches

  • Pain and pressure above a sinus, often above the eyebrow, behind the eye, and under the cheekbone

  • Pain may be on just one side of the face/head

  • Blocked or runny nose

Medication overuse (analgesic rebound headaches)

  • Pain starting behind the eyes and moving up the front of the head, or dull ache around the forehead

  • Grogginess

  • Irritability

  • Flu-like aches and pains

  • May start after pain reliever use ends

  • Caffeine in sodas and energy drinks can also be a culprit

Headaches after a head injury


Does my child need a CT-scan?

Imaging of the brain, blood tests and invasive procedures are NOT required to diagnose headaches. In some cases, brain imaging or a lumbar puncture is needed if a more serious condition is suspected. If necessary, the pediatrician will discuss what further tests are needed and why. The pediatrician may also recommend that your child see a pediatric neurologist who can help provide further recommendations for your child’s headache.


Many times, when children get headaches, they’ll be gone as quickly as they come. Rest, rehydration, and healthy routines will usually keep them go away. But, be sure to call your pediatrician any time you have concerns about your child’s headache pain.

Additional Information:

About Dr. Patel:

Namrata Patel, MD, is a Pediatric Neurology Resident at Michigan Medicine’s C.S. Mott Children’s Hospital. Within the American Academy of Pediatrics, she is a member of the Section on Pediatric Trainees.

About Dr. Leber:

Steven Leber, MD, PhD, FAAP, is a Pediatric Neurology Attending at Michigan Medicine’s C.S. Mott Children’s Hospital. Within the American Academy of Pediatrics, he is a member of the Section on Neurology.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Types, Home Treatments and Prevention

A headache is one of the most common complaints of children and teenagers. Fussiness, crankiness and not being able to sleep may be the only signs of head pain in children who are too young to tell you where they hurt.

There are many different types of headaches. Each type may be treated differently. A detailed history and physical exam help figure out what kind of headache your child has. All members of the family (mother, father and child, if possible) should help give the medical history.

Types of Headaches

Tension Headache – This is a less common and least serious type of headache. It happens when the muscles in the head and neck tighten and ache. Your child may say the pain feels like a tight band around the head. Emotional stress and getting too tired are the two most common causes. Family conflicts, school problems and peer pressures may add to everyday stress. Tension headaches can be a result of these pressures.

Congestion Headache – These headaches occur with viral infections (such as colds and flu) and usually stop when the illness is over. Sinus congestion and infections can cause head pain around the eyes and nose.

Medication Overuse or Analgesic Rebound Headache – This type of headache is becoming more common. When a child or teen-ager with headaches takes pain medicine too often, the headaches may become more frequent and more painful. Taking pain medicine for headaches more than twice a week for several weeks may cause this type of headache.

Headaches After a Head Injury – Headaches are common after a head injury. They are usually mild and go away within a week. Sometimes, though, the pain may occur for several weeks or months after an injury. Refer to the Helping Hand: Head Injury (HH-I-41 or HH-I-42) if the injury occurred in the last 24 to 48 hours.

Headaches with Dental Problems (such as jawbone joint problems) – This is an unusual cause of headache in children. The child may have jaw pain or discomfort, pain in the temples and a clicking sound when opening the jaw. Grinding of the teeth may cause this type of headache. A dental exam should be done.

Migraine Headache – This is a severe type of headache and is not discussed in this Helping Hand. If your child has Headache Migraine, your doctor will give you more information after a thorough physical exam and medical history are done.

Home Treatments

The best treatment for a mild, occasional headache is rest and relaxation. Giving ibuprofen (such as Motrin® or Advil®) may give your child relief. Ask your pharmacist, doctor or nurse for the right dosage. Do not give aspirin or other medicines unless directed by your child’s doctor. Use heat or cold, whichever helps your child the most.

  • Do not give medicine too often. Giving medicine for headache pain too often may cause the headache to occur more often and be more severe. Don’t give pain medicine for headache more than 2 times per week. If it is given more often for several weeks, the headache may get worse.

  • Apply a cold compress. Place a cold, wet washcloth or ice wrapped in a washcloth on the head or neck (Picture 1). Don’t place ice directly on the skin because it can damage the skin.

  • Apply heat. Place a warm – not hot – wet washcloth on the head or neck, or have your child take a warm shower.

Keep a Record

Keep a record of the headaches over a period of time. This will help the doctor decide on a plan of treatment for your child. (Use the Headache Records on pages 4 and 5.)

When to Get Emergency Care

Take your child to an emergency room immediately if your child has:

  • Sudden, severe head pain happening for the first time – especially if the child has double vision (sees 2 of things), seems confused, sleepy (hard to wake up), has numbness or projectile vomiting (vomit shoots out of the mouth).

  • Headache with a stiff neck, or complaints of neck pain, especially with a fever.

When to Call the Doctor

Call your child’s doctor if any of these things occur:

  • Daily headaches, especially if they interfere with school or play.

  • Headaches caused by straining from coughing, sneezing, running or having a bowel movement.

  • Headaches that occur along with pain in the eye or ear, confusion, nausea or vomiting, sensitivity to light and sound, or numbness.

  • Headaches that keep coming back and get worse.

  • Headaches similar to those suffered by other family members.

  • Headaches following a head injury that don’t go away after a week.

  • Headaches severe enough to wake the child from sleep.


  • Make sure your child gets plenty of rest.

  • Serve meals at regular times (don’t let your child skip meals).

  • Your child should drink plenty of liquids, especially water. Sports drinks may also be given.

  • Make sure your child gets regular exercise.

  • Try to keep your child from feeling too much stress. Encourage your child to talk openly with you so you’re aware of what’s troubling him or her.

  • Some children are sensitive to certain foods. It may help to avoid these foods for a while to see if the headaches go away: Chocolate, cured meats such as hot dogs and bacon, aged cheeses, fried foods, caffeine (found in coffee, tea, and colas).

Follow-Up Appointment

Headaches in Children (PDF)

HH-I-158 6/92, Revised 3/12 Copyright 1992-2012, Nationwide Children’s Hospital

Chronic daily headaches

By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition.

There are short-lasting and long-lasting chronic daily headaches. Long-lasting headaches last more than four hours. They include:

  • Chronic migraine
  • Chronic tension-type headache
  • New daily persistent headache
  • Hemicrania continua

Chronic migraine

This type typically occurs in people with a history of episodic migraines. Chronic migraines tend to:

  • Affect one side or both sides of your head
  • Have a pulsating, throbbing sensation
  • Cause moderate to severe pain

And they cause at least one of the following:

  • Nausea, vomiting or both
  • Sensitivity to light and sound

Chronic tension-type headache

These headaches tend to:

  • Affect both sides of your head
  • Cause mild to moderate pain
  • Cause pain that feels pressing or tightening, but not pulsating

New daily persistent headache

These headaches come on suddenly, usually in people without a headache history. They become constant within three days of your first headache. They:

  • Often affect both sides of your head
  • Cause pain that feels like pressing or tightening, but not pulsating
  • Cause mild to moderate pain
  • Might have features of chronic migraine or chronic tension-type headache

Hemicrania continua

These headaches:

  • Affect only one side of your head
  • Are daily and continuous with no pain-free periods
  • Cause moderate pain with spikes of severe pain
  • Respond to the prescription pain reliever indomethacin (Indocin)
  • Can become severe with development of migraine-like symptoms

In addition, hemicrania continua headaches are associated with at least one of the following:

  • Tearing or redness of the eye on the affected side
  • Nasal congestion or runny nose
  • Drooping eyelid or pupil narrowing
  • Sensation of restlessness

When to see a doctor

Occasional headaches are common, and usually require no medical attention. However, consult your doctor if:

  • You usually have two or more headaches a week
  • You take a pain reliever for your headaches most days
  • You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches
  • Your headache pattern changes or your headaches worsen
  • Your headaches are disabling

Seek prompt medical care if your headache:

  • Is sudden and severe
  • Accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness or difficulty speaking
  • Follows a head injury
  • Gets worse despite rest and pain medication

Persistent headache or back pain ‘twice as likely’ in the presence of the other — ScienceDaily

People with persistent back pain or persistent headaches are twice as likely to suffer from both disorders, a new study from the University of Warwick has revealed.

The results, published in the Journal of Headache and Pain, suggest an association between the two types of pain that could point to a shared treatment for both.

The researchers from Warwick Medical School who are funded by the National Institute for Health Research (NIHR) led a systematic review of fourteen studies with a total of 460,195 participants that attempt to quantify the association between persistent headaches and persistent low back pain. They found an association between having persistent low back pain and having persistent (chronic) headaches, with patients experiencing one typically being twice as likely to experience the other compared to people without either headaches or back pain. The association is also stronger for people affected by migraine.

The researchers focused on people with chronic headache disorders, those who will have had headaches on most days for at least three months, and people with persistent low back pain that experience that pain day after day. These are two very common disorders that are leading causes of disability worldwide.

Around one in five people have persistent low back pain and one in 30 have chronic headaches. The researchers estimate that just over one in 100 people (or well over half a million people) in the UK have both.

Professor Martin Underwood, from Warwick Medical School, said: “In most of the studies we found that the odds were about double — either way, you’re about twice as likely to have headaches or chronic low back pain in the presence of the other. Which is very interesting because typically these have been looked as separate disorders and then managed by different people. But this makes you think that there might be, at least for some people, some commonality in what is causing the problem.

“There may be something in the relationship between how people react to the pain, making some people more sensitive to both the physical causes of the headache, particularly migraine, and the physical causes in the back, and how the body reacts to that and how you become disabled by it. There may also be more fundamental ways in how the brain interprets pain signals, so the same amount of input into the brain may be felt differently by different people.

“It suggests the possibility of an underpinning biological relationship, at least in some people with headache and back pain, that could also be a target for treatment.”

Currently, there are specific drug treatments for patients with persistent migraine. For back pain, treatment focuses on exercise and manual therapy, but can also include cognitive behavioural approaches and psychological support approaches for people who are very disabled with back pain. The researchers suggest that those types of behavioural support systems may also help people living with chronic headaches.

Professor Underwood added: “A joint approach would be appropriate because there are specific treatments for headaches and people with migraine. Many of the ways we approach chronic musculoskeletal pain, particularly back pain, are with supportive management by helping people to live better with their pain.

“We could look at developing support and advice programmes that are appropriate for this population. And being aware of this relationship has the potential to change how we think about managing these people in the NHS on an everyday basis. There is a need for doctors and other healthcare professionals to think that when treating one issue to ask about the other and tailor the treatment accordingly. For future research, there’s probably work that needs to be done to understand what the underlying mechanisms behind this relationship are.”

Story Source:

Materials provided by University of Warwick. Note: Content may be edited for style and length.

Treatment and prevention of migraine and headache with the “Cefaly” apparatus

If you have regular headaches.

Migraine unsettles you, interferes with full-fledged work, brazenly interferes with your plans, disrupting your usual way of life.

Pills no longer help, and as you know, “one cure, another cripple.”

Turn your attention to headache treatment and prevention with the Cefaly .

What is Cefaly? How does it work?

The medical device Cefaly was developed in Belgium.

The trigeminal nerve plays a role in most headaches and migraines. Its upper branches run under the skin of the forehead above the eyes.

Cefaly is a trigeminal neurostimulator. The device works by means of an electrode located in the forehead

Stimulation of the trigeminal nerve with Cefaly has a sedative effect on the nervous system.Regular repetition of this sedative effect changes the threshold of the migraine and reduces the frequency of attacks.

Indication for Cefaly:

  • Migraine without aura (common migraine)
  • Migraine with aura
  • Retinal migraine (Migraine with visual aura)
  • Episodic migraine
  • Chronic migraine
  • Tension headache

How is the Cefaly procedure?

If the neurologist after the appointment prescribed you a course of procedures Cefaly , having come for the procedure:

  1. you will cleanse the skin of the forehead, for better contact of the electrode with the skin;
  2. will place the device Cefaly on the head
  3. will include the required program.There are three of them: the first is intended for the treatment of an acute attack, the second is for the prevention of tension headaches, and the third is for the prevention of migraine pains.
  4. session lasts 20 or 40 minutes, depending on the indication;
  5. The doctor can control the intensity of the exposure during the procedure
  6. the device will turn off itself

How quickly can Cefaly help me?

Effective course – 15-20 sessions.

The device Cefaly uses 3 programs :

  1. Treatment of severe headache attacks (migraines).As a rule, a session of 40 minutes is prescribed 2-3 times a day.
  2. Treatment and prevention of tension headache following stress. Duration of 1 session 20 min, course – 15-20 sessions in a row
  3. prevention of migraine pain, helps to reduce the frequency of migraine attacks. Duration of 1 session 20 min, course – 15 sessions in a row

Can Cefaly be used during pregnancy?

Cefaly can be used during pregnancy.The device is often recommended for women during pregnancy in order to reduce or eliminate the use of medications.

Safety and Security Cefaly

The neurostimulation method has been used for over 20 years.

The magnetic field around Cephalic is less than 0.2µT (i.e. 2mG). This power is much less than the field generated by, for example, an electric shaver (usually between 15 and 1500µT when measured at a distance of 3cm) or a hair dryer (average between 6 and 2000µT).

Cefali has the CE mark of the European Community Medical Standard and is ISO certified.

Contraindications :

  • Recent trauma to the brain or face (less than 3 months ago).
  • Damage to the skin in the area of ​​the electrode on the forehead.
  • Allergy to acrylate.
  • Skin hypersensitivity: +/- 5% of people have a hypersensitivity to the forehead skin and cannot tolerate the sensations of the Cefaly apparatus.
  • Other electrodes implanted in the head area.
  • Neuralgia of the trigeminal nerve.

In some cases, the following side effects of appear:

  • drowsiness
  • redness of the skin at the site of exposure (due to stimulation of local blood supply disappears a few minutes after the session)
  • Allergy to the gel applied to the electrode, in the form of a skin rash on the forehead. RARELY! In such cases, special electrodes can be used.
  • headache during or after the session. This complication is VERY RARE!

Where to get the Cefaly headache treatment procedure?

At the MEDA Family Clinic in Pushkin (St. Petersburg), the procedure is performed by a neurologist with 20 years of experience Kotova Elena Nikolaevna.

You can make an appointment by calling (812) 459-03-20 or in the form of an online appointment at the bottom of the page

Cost of headache treatment with Cefaly apparatus in St.Pushkin

There are contraindications, prior consultation with a neurologist is required

Treatment and prevention of migraine and tension headache with the Cefaly apparatus, 20 min. 500
Treatment and prevention of migraine and tension headache with the “Cefaly” apparatus, 40 min 600

Headache – useful information from NMC

Dear parents! Have you ever experienced a headache? For sure
most of you will answer this question in the affirmative, since it is one of the
the most frequent complaints with which a person comes to the doctor.Research
show that 70-80% of adults in Europe and America complain of headaches
pains of varying duration. The same is the case in Russia. Actually,
this figure may be higher, because many people with headaches,
do not go to the doctor, self-medicate, not realizing the seriousness
their condition, or do not want to be examined for fear of finding a severe
pathology. Headache, or cephalalgia, can be major, and often
the only manifestation of more than 50 different diseases of the nervous system or
internal organs.

It was long believed that headaches in children are rare, but
it turned out that children are as susceptible to headaches as adults, and
suffering can occur at any age. Scientists have found that almost 50%
such children are not consulted by a doctor and are treated by their parents on their own, with
referring to a neurologist 75% of children with cephalgia need treatment and only 12%
families fully comply with the doctor’s recommendations. This suggests that parents do not
consider this complaint as a serious reason to see a doctor.Wherein
prolonged headache can significantly affect the overall well-being of the child,
disrupt his behavior and performance at school and reduce the quality of life. Head
pain always speaks of trouble in the child’s body. It is kind
alarm for parents and doctors. No wonder even in ancient Greece they said that
pain is the watchdog of health.

We hope that our story about headaches will help parents carefully
treat the child’s complaints and choose the right tactics of behavior.We
consider the following questions:

  1. What is headache
  2. What causes and processes cause headache
  3. How headache manifests itself in children at different ages
  4. What are the types of headaches
  5. How to prevent the development of headache attacks
  6. How to give first aid to a child with a headache

So, headache, or cephalgia (from the Greek word “cephalon” – brain and
“Algos” – pain) refers to any discomfort in the head area.Undoubtedly
that pain assessment is related to accumulated experience, therefore, the smaller the child, the
it is less likely that he can give a correct assessment of his feelings and assess
them like pain. Newborn children and children under 2-3 years old cannot localize pain and
talk about it, so the headache assumption can be based on
indirect symptoms and features of the child’s behavior.

So, in a child of the first year of life, it can be: a sharp anxiety,
throwing back the head, screaming, grimacing pain with closing eyes and wrinkling
face, refusal to eat, regurgitation, vomiting.At the age of 2-3 years, children with headaches
can already point to a sore spot, pressing their hands to the head, pulling out and
pluck your hair. In older children, headaches may be indicated by
lethargy, decreased interest in the environment, drowsiness, frequent mood swings,
tearfulness, unmotivated aggressiveness, negativism, sleep disturbance. And only in
at school age, the child can clearly feel and describe the pain, define it
localization and character.

It is very important for parents to assess the severity of the headache.Can be distinguished
the following types of headaches by severity:

  1. Mild headache – unstable pain, aggravated by physical
    load, passes on its own without disturbing the child’s behavior. Reception
    painkillers relieve an attack for a long time.
  2. Headache of moderate intensity – persistent headache, disturbing
    child behavior and diminishing with medication.
  3. Severe headache – persistent headache that does not respond to
    pain medications.At the same time, children scream, rush, hold their hands for
    head, looking for a comfortable position to relieve headache, expression
    face – suffering.

Schoolchildren can be asked to assess the severity of a pain attack with
using a scale called the visual analogue scale (VAS). On it
it is required to note the intensity of the headache in points, if taken as 1 most
slight and insignificant pain, and after 10 – the strongest and unbearable pain (more
see details.below).

Thus, it is possible to more clearly determine the severity of headache in
older children. In small children and especially in infants, you can
presumably assess the severity of the headache as follows. If during
a child’s headache can be distracted, calmed, played with toys, or
put to bed, then the headache is probably mild. If, despite the efforts,
the child continues to scream, rush, is not interested in his favorite activities, then
the headache is severe.

It is also necessary to understand that headache can be a manifestation
various pathological processes in the nervous system and in the body as a whole. She
can be an independent disease. Doctors call this headache
primary . An example of a primary headache
are migraine, tension headache, cluster cephalalgia, etc. Less often
headache is a manifestation (symptom) of any disease.
Such headaches are considered secondary or
.Most common headache
occurs in the following cases:

  1. Traumatic brain injury.
  2. Diseases of the cardiovascular system – stroke, cerebral hemorrhage,
    transient cerebrovascular accident, congenital vascular anomaly
    brain, increase or decrease in blood pressure.
  3. Intracranial processes of a non-vascular nature – increased intracranial
    pressure as a result of a tumor, inflammation, hydrocephalus.
  4. Infection. Any infection almost always causes a headache. This is
    may be meningitis, encephalitis, childhood infections (chickenpox, scarlet fever,
    rubella, measles, etc.), SARS.
  5. Diseases of the endocrine system.
  6. Diseases of the eyes, ears, paranasal sinuses (sinusitis), changes
    temporomandibular joint.
  7. Disease of the cranial nerves.
  8. Poisoning with various chemicals.Uncontrolled
    the use of analgesics (paracetamol, analgin, citramone, nurofen, etc.)
    can provoke a drug (abusal) headache.
  9. Diseases of any internal organs (for example, gastritis, gastroduodenitis,
    pyelonephritis, pneumonia, hepatitis and many others)

How does a headache form?

In the process of evolution in the human body, specialized nerve
endings that capture and process information obtained from
the environment or internal organs, which are called receptors.With their
irritation, a person may experience various sensations, including pain.
Many pain receptors are located in the structures and tissues of the head:
blood vessels, venous sinuses of the dura mater, cranial
nerves, aponeurosis, muscles, scalp, periosteum. Do not contain pain
receptors only the bones of the skull and the pia mater. Precisely on which
the receptors are irritated, and the nature of the headache depends.

For example, with irritation of receptors located in the walls of blood vessels
there is vascular headache .She
characterized by a gradual onset, usually of moderate intensity,
is pulsating in nature, i.e. a person experiences a “knocking” sensation in the head,
synchronous with the pulse. The usual localization of vascular headache is in the area
temples, forehead, eye sockets or occiput, occurs regardless of the time of day,
aggravated by moving the head, provoked by a change in weather, emotional
tension. This type of headache is present with migraine, vegetative dystonia,
decrease or increase in blood pressure, vascular malformations

In case of damage to the receptors of the soft tissues of the head,
muscle tension headache
Patients note
feeling of external contraction around the head (“helmet”, “hat”, “helmet”, “hoop” on
head), tension and soreness of the muscles of the head, neck, less often – the shoulder girdle.
Headache can be short-term (episodic) or long-term,
repetitive (chronic). In most cases, it starts with
in the morning, by the middle of the day it slightly decreases, and in the evening it increases again.Its localization is different. More often the headache occupies the entire head, i.e. is an
diffuse. Less commonly, it occurs in the parieto-occipital, frontotemporal regions.
This mechanism of the onset of headache underlies the headache.

Pathological processes in the dura mater, for example, meningitis,
cerebral hemorrhage, provoke meningeal headache .
It occurs suddenly, abruptly, as a rule, the patient can indicate the time up to
up to minutes from the onset of the headache.The pain is very sharp, unbearable, diffuse,
often accompanied by vomiting and changes in consciousness, neurological abnormalities
in the form of numbness, weakness in the limbs, or speech impairment, convulsions. This
a headache indicates a serious brain accident and requires
emergency hospitalization and consultation with a neurologist.

CSF headache occurs when
changes in pressure on the venous vessels and sinuses of the brain and it happens
with a decrease or increase in intracranial pressure.To increase it may
lead tumors of the nervous system, abscesses, abnormalities in the structure of the brain,
hydrocephalus. This headache often occurs at night or in the morning, has
diffuse, bursting character, sometimes episodic, but gradually increasing,
accompanied by vomiting, which can occur suddenly at the height of the headache
without prior nausea. Sometimes in children with this type of headache
the forced position of the head is detected, i.e. the child chooses such a pose,
in which the headache decreases somewhat.

In young children, an increase in intracranial pressure can be
a symptom of perinatal encephalopathy and manifest itself in a rapid increase in size
head, pulsation and bulging fontanelle, divergence of cranial sutures,
throwing back the head, increased frequency and increased regurgitation.

With a decrease in intracranial pressure, the nature of the headache also has its own
peculiarities. It intensifies in a standing position, walking, has a diffuse
permanent character, relieved by lying down, head down and
raised foot end of the bed, often accompanied by dizziness and
tinnitus.Such a headache can be with craniocerebral trauma,
accompanied by a violation of the integrity of the meninges.

With irritation of the cranial nerves, neuralgic head
. More often it is localized at the place of passage of certain
cranial nerves that feed the muscles and scalp. This headache wears
paroxysmal character, lasts from a few seconds to 2-3 minutes,
characterized by significant intensity and resembles an electric shock or
lumbago.Pain attacks can be triggered by talking, chewing,
touching the skin of the face.

Psychogenic headache not based on
vascular, muscular, CSF dynamic or neuralgic mechanism, and
is the result of impaired regulation of various parts of the nervous
systems and changes in the metabolism of biologically active substances in the brain,
responsible for the transmission of the pain impulse. Provokes psychogenic headache
stress.Contribute to the formation of this type of headache features
the child’s temperament: anxiety, emotional imbalance,
suspiciousness, hypersensitivity. Often such a headache
accompanied by anxiety, fear. She is constant, monotonous, small
intensity, without clear localization, mainly occurs in the morning, decreases
in the afternoon and grows again in the evening. Its intensity changes little when taken
pain medications.

Type of headache Movement Examples
  • arterial spasm
  • dilatation of arteries
  • Decreased venous tone
  • slowing down of blood flow through the vessels of the head
  1. migraine
  2. cluster cephalalgia
  3. chronic paroxysmal hemicrania
  4. headache with vegetative dystonia
  5. headache with an increase or decrease in blood pressure
Muscle tension headache
  • Head muscle tension
  • enhancement of the transmission of a nerve impulse
  1. tension headache
  2. headache with vegetative dystonia
  • irritation of the dura mater receptors
  1. meningitis headache
  2. headache with cerebral hemorrhage
  • increased intracranial pressure
  • decrease in intracranial pressure
  1. Headache with brain tumors, brain abscesses
  2. Headache due to impaired circulation of intracranial fluid
  • Nerve irritation by a pathological process
  1. trigeminal neuralgia
  • absent vascular, muscular, CSF dynamic, neuralgic
  • the coordinated work of all parts of the nervous system is disrupted
  1. headache with neurosis
  2. headache with vegetative dystonia
  • combination of all mechanisms

Let’s get acquainted with the manifestations of primary headaches.

Tension headache

Tension headache, according to statistics, occurs in 70% of all headaches
pain. This is the most common type of headache. In childhood, the head
tension pain occurs in 1 in 100 children, with both boys and girls affected
to her equally often. Scientists have noticed that tension headache occurs in
people of mental work, whose professions are associated with prolonged concentration
attention or prolonged, uncomfortable position of the head and neck.In children, it can be
prolonged stay in an antiphysiological (wrong) position during preparation
lessons, playing or working on the computer, sleeping in an uncomfortable position. At the heart of this view
headache is a prolonged tension of the muscles of the head, the trigger of which
is acute or chronic stress.

From distant ancestors, the ancient mechanism of the body’s response to a situation was transmitted to man,
life-threatening (“fight or flight”). When a person is in danger, he has
all reserves are mobilized for a lightning-fast and most effective response to
saving lives: the digestion process is suspended, the work of the heart is activated,
the adrenal hormone adrenaline is released into the bloodstream, muscles tighten, in
their blood supply increases, the body is ready “to escape or defend.”In modern
society, a person is rarely threatened by real physical danger, but these reactions
always arise in response to an acute or chronic traumatic situation, and
not only negative (death of loved ones, illness, conflict situation at school and
at home, fatigue, hunger), but also positive (holiday, disco, successful exams).
Stresses occur to us many times during the day, forcing the muscles of the body to
strain. The muscles of the shoulders, neck, and head are most susceptible to this.”Dangerous” for the body
the situation has already ended, and muscle spasm in these areas can persist for a long time.
At the same time, the vessels supplying the muscles are squeezed, the delivery of oxygen to the cells is disrupted.
Muscle cells, signaling a lack of oxygen, produce special hormone-like
substances – prostaglandins, which act on pain receptors and a person feels

Tension headache has the following features:

  • duration of an attack from 30 minutes to 7 days
  • has a monotonous, squeezing, constricting character (“helmet”, “helmet”, “hoop”
    on the head)
  • Usually painful sensations are localized in the cervico-occipital region or occupy
    the whole head, almost always bilateral headache
  • Headache of mild to moderate intensity, not aggravated by physical
    load, i.e.e. Children can play, do homework, watch TV, etc.
  • is rarely accompanied by nausea, loss of appetite, headache does not increase
    sound, bright light

The described sensations can be increased by wearing a tight headgear, causing
feeling of squeezing, discomfort in the head. Children with tension headaches often
increased excitability, nervousness, anxiety, a tendency to depression are noted.
If tension headache is less than 15 days a month (or less than 180 days in
year), then it is called an episodic tension headache, if more than 15
days a month (or more than 180 days a year), then a chronic tension headache.


This is the second most common type of primary headache. Almost all people though
have had a migraine attack once in their life, and 30-40% of the world’s population suffer
migraines regularly. Among children from 5 to 15 years old, about 10% have migraines, children with migraines
miss school 2 times more often than healthy peers.

Migraine is a disease of young people. The first attack occurs more often
up to 40 years, but the peak incidence falls on 12 – 38 years.Under 12 years of age, migraines are more common
occurs in boys, and after puberty in girls. Among women
migraine attacks are observed 2-3 times more often than in men.

Migraine has existed for thousands of years before it was identified and received
its name. The first clinical features of migraine were mentioned in the writings of Hippocrates,
Celsus (1st century BC), and the most complete description of this type of headache was made by
Greek physician Areteus of Cappadocia (1st century BC)n. BC), who called migraine “heterocrania”,
which meant – “another head”, which accurately determines the patient’s condition during
migraine attack. Galen (2nd century BC) introduced the term “hemicrania”, which means
“Half”, one-sided headache, because a characteristic feature of this disease
there is a headache in one half of the head.

Later this term was transformed in French literature into the term “migraine”
and is firmly entrenched in all languages ​​to denote this type of headache.

Many famous people have suffered from migraines. Among them were Charles Darwin, Frederick
Chopin, Alfred Nobel, Karl Marx, Edgar Alan Poe, Pyotr Ilyich Tchaikovsky, Lev Tolstoy.
The fact that so many famous and highly educated people suffered from one
and the same disease, apparently, is associated with special “migraine” character traits,
such as mental alertness, determination, emotionality, commitment, activity.
It has been noticed that people suffering from migraine are “doers” by nature, they are firmly on their way to the intended
goals, and no obstacles, not even a painful headache, can stop

Migraine is hereditary. It is known that if both suffer from migraines
parent, then the risk of migraine in their children is 60-90%, if there is a migraine
in the mother, then this type of headache can be transmitted to the child in 75% of cases if
the father is 30%.

The development of an attack is based on a metabolic disorder of special substances in the nervous
system – mediators (serotonin and tyramine), which contribute to signal transmission
from one nerve cell to another, and the individual characteristics of the reaction of the vessels of the head
the patient’s brain for these mediators.

Various factors provoke migraine. These can be stressful situations, excessive
exercise, excessive or insufficient sleep, exposure to strong odors,
loud sounds, prolonged viewing of bright glare (flickering of the TV screen
or computer, foliage), abuse of foods containing tyramine (chocolate,
coffee, cocoa, citrus fruits, wine, spicy cheeses), endocrine changes (period of sexual
maturation, pregnancy, menstruation).

A migraine attack has characteristic features:

  • This is a paroxysmal headache lasting from 4 to 72 hours
  • one-sided headache – half of the head hurts, and from attack to attack
    one or the other half of the head may hurt. The whole head rarely hurts
  • character of headache – throbbing
  • headache is amplified by sound, light, noise, physical activity, therefore, patients
    prefer to lie in the dark during an attack, covering their head and eyes
  • at the height of the headache there is often nausea, vomiting
  • intensity of headache moderate or significant
  • there may be redness of the eye, swelling of the eyelids on the side of the headache

Migraine can be divided downstream into two types: migraine with aura (classical
migraine) and migraine without aura (simple migraine).Aura (from Latin “breeze”) is called
specific symptoms that precede a headache attack. Most often
these are darkening of vision, the appearance of flashes of light in front of the eyes, a change in shape
and the size of objects in the field of vision, numbness or tingling in the face, limbs,
less often – violation of movements in the arms and legs. The aura usually lasts from 5 to 60 minutes,
followed by a “bright” gap in the form of the absence of complaints, which can last
up to 1 hour. Then an attack of headache develops, the characteristics of which were
given above.

In migraine without aura, an attack of headache may be preceded by irritability,
tearfulness, isolation, moodiness, severe yawning, drowsiness, hypersensitivity
to smells.

In children, migraine without aura is more common, and the duration of the attack is shorter than
in adults – 2-48 hours. Symptoms of the aura should be recorded by the doctor or the child’s parents
it can be very difficult, because often children cannot correctly describe their feelings.
The course of migraine in children also has its own differences.Doctors describe special types
“Child migraine”:

  1. Abdominal migraine. Headache attacks can alternate with severe,
    throbbing pain in the abdomen, sometimes with vomiting or loose stools. Often such
    children are admitted to surgical hospitals with suspected acute appendicitis.
  2. Benign paroxysmal vertigo. This type of “child migraine”
    more often between the ages of 1 and 5 years and manifests itself in the form of sudden attacks
    dizziness, which children report themselves.Dizziness is accompanied by
    unsteadiness of gait, pallor, sweating, loss of consciousness does not occur. IN
    in older age, an attack may end with an episode of headache. Last
    seizures for several minutes and very often disappear without treatment until the age of five.
  3. Hemiparetic form of migraine. Occurs at an early age, 1-2 years
    life in the form of the development of short-term impaired movement and weakness in the hands
    and legs.
  4. Dysphrenic migraine.It proceeds in the form of episodes of violation of the child’s behavior:
    aggressiveness, negativism, anger, inappropriate behavior appear,
    the child’s orientation in space is disturbed for a duration of several hours
    up to 1-3 days. After an attack, children calm down, fall asleep, and upon awakening
    may complain of a headache.
  5. “Alice’s Syndrome” is another variant of the course of migraine in childhood. Front
    with a headache attack, children experience visual illusions: all objects around
    seem to be either reduced or enlarged, less often vision occurs
    objects in a different color, violation of the perception of time.Following these illusions
    an attack of headache may follow. The syndrome is so named due to the similarity of the data.
    symptoms with descriptions of bizarre pictures that Alice saw while traveling
    Through the Looking Glass, captured in the book by L. Carroll “Alice Through the Looking Glass”. Suggest
    that the visions displayed in the book are nothing more than hallucinations that
    experienced by the author himself during a migraine attack.

Cluster (beam) headache, chronic paroxysmal hemicrania

Cluster headache occurs in childhood
less common than migraines or tension headaches, predominantly in boys
after 10 years of age.It is assumed that there is a genetic predisposition
to the formation of this type of headache. A seizure occurs as a result of a change
blood flow through the vessels of the brain and regulation processes in the nervous system. Characterized
cluster headache as follows:

  • This is an extremely sharp, severe, unbearable headache that makes the child
    rush, scream, worry
  • has a searing, boring character
  • localized in the region of the temple, orbit sometimes with a sensation of “squeezing” the eye
    followed by spreading to the entire half of the head, the area of ​​the ear, teeth, neck,
  • always one-sided (one half of the head hurts)
  • duration of an attack from 30 to 90 minutes
  • occurs more often at night
  • never accompanied by nausea or vomiting
  • frequency of attacks from 1 to 8 per day (usually 2-3), attacks last from 2 to 6 weeks,
    then there is a break for several months or years, i.e.e. headaches occur
    as if “bundles”. Hence the name “beam” or “cluster” head
    pain (from the English claster – “bundle”)
  • an attack may be accompanied by redness of the eye, nasal congestion, lacrimation,
    facial sweating on the pain side

Chronic paroxysmal hemicrania – another type
headache in childhood, very similar to the flow of a cluster headache
pain, but more common in adolescent girls.The duration of the attack is shorter, from
2 to 45 minutes, but the frequency of headache episodes is much higher – from 10 to 30
per day.

Secondary headaches

Parents must remember that headaches in children can be
a manifestation of trouble in the child’s body and be a symptom of any
diseases. Such headaches, as already mentioned, are called secondary.
We invite you to get acquainted with the most frequent situations in which you may encounter

Post-traumatic headache may occur in
a child at any age. Post-traumatic, i.e. resulting from an injury
only the headache that appeared immediately after the craniocerebral
injury or no later than 14 days after the injury, it can last from several weeks
up to several months. Scientists have found that even with seemingly insignificant
harmless head injuries in the nerve cells, changes occur, they are disturbed
metabolism, which leads to the appearance of a headache, and the nervous system after
injuries can fully recover only after 2-3 years.

Interestingly, this type of headache occurs more often after mild craniocerebral
trauma, such as after a concussion rather than a severe injury
head (leading to disability). By nature, in some cases, it is similar to
migraine, in others – tension headache. More often the headache is dull
squeezing character, aggravated by physical or mental stress, emotional
stress. This headache is always accompanied by increased fatigue, a decrease
attention, memory, school performance.

Therefore, any child with a head injury should be monitored by a neurologist,
who, on the basis of examination and examination, can recommend courses of restorative
treatment with drugs that feed the nervous system. This will help prevent
adverse consequences of injury.

Headache can be caused by changes in blood pressure .
It is dangerous to both decrease and increase blood pressure relative to age

With a decrease in blood pressure, headache is accompanied by dizziness,
nausea, weakness, darkening of the eyes, a tendency to faint, with an increase
– the headache has a pulsating or pressing character, is localized more often in the occipital
areas may also be associated with vomiting or nausea.

In order for the doctor in this situation to be able to correctly assess the condition of your child,
it is necessary in a calm home environment to independently measure him
blood pressure regardless of how you feel in the morning and evening and with headache
pain for 2-4 weeks, writing all the data in a diary.

Headache often accompanies diseases of the nasopharynx, ears, eyes
or teeth
, such as tonsillitis, sinusitis, otitis media, caries, pulpitis. Sinusitis
are called inflammatory diseases of special air cavities located
in the frontal bone and near the nasal cavity. You can think of sinusitis if the background
colds, the state of health worsened, nasal congestion increased and a headache appeared
pain in the forehead, eyebrows, or on the sides of the nasal bridge in the infraorbital region.Otitis media (ear inflammation) can also present with severe headache. In young years
it is especially difficult to figure out what hurts the child, the ear or the head, since small
children cannot clearly localize their feelings.

Therefore, if a headache has joined a prolonged cold in your child
pain, consult an ENT doctor.

Headache may be associated with foci of chronic infection in the body,
located in the tonsils (chronic tonsillitis), or in the teeth (caries, pulpitis,
periodontitis).A child with chronic tonsillitis must be monitored by an ENT doctor
and a pediatrician, to carry out medical procedures that cleanse and revitalize the tonsils,
prescribe treatment chickens that strengthen the body’s defenses, since inflamed
The tonsils can be a constant source of infection for other organs. With diseases
teeth headache appears in the temporal or parotid region, it can be very painful,
constant. This situation requires urgent treatment by a dentist.Long-lasting
a tooth infection can spread through the bloodstream or lymph into the cranial cavity, causing
meningitis or brain abscess.

Headache can be provoked by changes in the temporomandibular
. Children of schoolchildren most often suffer from this type of headache.
age and adolescents. The cause of the development of abnormalities in the joint is considered to be malocclusion,
jaw injury or joint inflammation (arthritis). The headaches are one-sided,
aggravated by chewing food or opening the mouth, localized in the lower part
face, temporal region or lower jaw.

Headaches can be caused by hypoxia (deficiency
oxygen in the blood or tissues) arising from diseases of the internal organs or
blood, for example, with anemia (a decrease in the level of hemoglobin in the blood). Consequently,
to identify the causes of headache, a complete study of the state of all
internal organs.

If a child’s headache persists for a long time, then very often parents resort to
to the help of painkillers to relieve an attack at their own discretion.Improper and erratic medication can lead to
medicinal or “abusal”

“Abuse” headache occurs at any age, accounting for about 10% of
all types of headaches. It has medium intensity, monotonous character and
usually does not increase with exercise. To medications, after
which may develop a headache include pain relievers (for example,
analgin, ketonal), anti-inflammatory (indomethacin, ibuprofen, voltaren and their
analogues), antiallergic agents (tavegil, suprastin, diphenhydramine), some
antibiotics (tetracycline) and many others.This does not mean that children cannot at all
use any medications, on the contrary, with the correct selection of the dose and frequency
taking medication will certainly improve the condition of the child. Parents need to understand
that any treatment should be carried out only under the supervision of a physician after careful
examination and clarification of the diagnosis.

The most life-threatening diseases that are manifested by headache,
there may be brain tumors, cerebral hemorrhages, inflammatory diseases
nervous system (meningitis, encephalitis, abscess, etc.)). These diseases require urgent
diagnosis and treatment. Remember “dangerous” symptoms , the appearance
which speaks of life-threatening conditions . When the appearance
at least one of these symptoms requires urgent medical advice:

  • the nature and frequency of headache attacks suddenly changed, they became significantly
    more intense and much more often
  • according to the patient’s assessment, this headache attack is the strongest in his life
  • headache accompanied by fever
  • Headache accompanied by seizures, impaired sensitivity or movement
    limbs, impaired speech, coordination or changes in memory and thinking
  • headache accompanied by impaired consciousness
  • headache disrupts sleep
  • headache preceded by vomiting
  • The headache is not treatable and is constantly getting worse

So, to summarize the above:

  • childhood headache is common and has its own characteristics
  • headache can be either an independent disease or a manifestation
    (symptom of) diseases in any organ and system
  • Therefore, a child suffering from a headache should be examined and comprehensively
    examined by the attending physician to identify abnormalities in the body
  • the volume and number of examinations is determined by the attending physician based on complaints
    and inspection results
  • a child with a headache should also be consulted by a neurologist and ophthalmologist

In order to help the doctor figure out what is the cause of the headache in your
child, parents need to carefully monitor the child’s condition, analyze
his condition and answer the following questions:

  • When did the child have a headache?
  • What is the nature of the headache (throbbing, compressing, pressing, bursting
  • Where does it hurt (forehead, back of the head, temples, crown, whole head)?
  • What sensations precede the headache?
  • What is accompanied by a headache (nausea, vomiting, change in consciousness, lethargy,
    weakness, etc.)?
  • How long does a headache attack last (seconds, minutes, hours)?
  • What is the typical headache intensity? If the child is small, then the approximate
    its intensity is determined by the child’s behavior, and schoolchildren can assess the strength
    attacks themselves, indicating the severity of pain in points
  • Does the general state of health change with a headache and how?
  • Does exercise affect headaches?
  • What triggers an attack?
  • How does a headache relieve?
  • Is there a deterioration in the condition at the moment?

Headache prevention

Only understanding can give the most powerful weapon to fight headaches
the reasons for its occurrence.If the parents and the child himself can understand what causes
an attack of pain, it can be prevented.

In order to find out, it is necessary to keep a diary of headaches. It fixes
date and time of the onset of the headache, its intensity, duration, nature.
And, most importantly, the diary notes all the factors that could affect
the occurrence of a headache attack. They are called triggers. These include
stress, fatigue, changes in weather, dietary habits, phases of the menstrual cycle.And finally, in the diary it is necessary to note which drugs were used to stop
headache, in what doses, and what was the effect of their use.

This simple method is indispensable for identifying headache triggers, choosing tactics
treatment. Thanks to the diary, the patient himself will be able to regulate his lifestyle for
in order to avoid headaches.

Parents or a child can come up with a variant of entries in the diary themselves, but in it
the following data should be reflected: the time of the beginning and end of the pain attack, which
preceded the onset of the headache and what provoked and accompanied it,
also indicates the intensity, localization and nature of pain, drugs that
were given to the child to relieve an attack.For example, it might look like this:

When did the headache start? Time 15:00
There were violations before the onset of headache view no
other senses
Was there a headache right-hand +
double-sided (diffuse)
Was there a headache compression
pulsating +
What was the intensity of the headache? light
medium strength +
Does the headache have nausea? no
moderate +
Is there vomiting with a headache? no +
Does light irritate for headaches? no
moderate +
Is the sound annoying for headaches? no
strong +
What made this attack easier? sleep
When did the headache go away? 17:30
Have any medications been used to relieve pain? yes
What? paracetamol
Indicate their dose 0.25 tab
What triggered this attack? food
fatigue +
stress +

It is recommended, if possible, to indicate in the diary the intensity of the pain attack
on a headache intensity scale (visual analogue scale):

    90 037 0 – no headache,
  • 10 – intolerable headache

Similarly, the degree of headache relief with medication is indicated. This is
will help to assess the effectiveness of the drugs used:

It is possible to reduce the risk of a pain attack by observing the regime of the day, sleep,
adhering to a diet with the exclusion of foods that provoke headaches.

Mode of day

  1. The duration of sleep in a child must comply with age standards.
    So, for example, age standards for the duration of night sleep in schoolchildren
    5-7 grades are at least 10 hours, 8-9 grades – 9 hours, 10-11 grades
    – not less than 8.5 hours. A 1-hour day’s rest is also desirable. In case of violation
    sleep duration headaches often occur on weekends or holidays,
    when the child is allowed to sleep longer.Provokes a headache with excess
    in sleep, serotonin, which is produced during sleep. Insufficient sleep also
    harmful, since the nervous system cannot fully recover.
    This situation occurs among high school students, when loaded with lessons,
    classes in preparatory courses, they systematically do not get enough sleep, which leads
    to the appearance of frequent headaches. The appearance of a headache can be influenced by an uncomfortable
    posture during sleep, i.e.because it causes a spasm of the muscles of the head and a painful attack. But
    sleep and healthy. Migraine attacks, for example, go away during sleep, and even if the child
    cannot fall asleep, it is useful for him to lie down in the darkness and silence, and the pain will certainly
    will subside.
  2. Rational mode provides for an alternation of intellectual and physical
    loads. The daily stay of the child in the fresh air is mandatory. It can
    be walking, outdoor games, their duration for preschoolers
    must be at least 3.5 hours, for younger students at least 3 hours, for adolescents
    at the middle level of education – at least 2.5 hours, and for high school students – 1.5-2
    hours a day.
  3. It is necessary to draw up a schedule of additional classes in the sections, circles,
    preparatory courses so that the child can definitely rest and not be loaded
    until late in the evening. In accordance with the hygiene guidelines for
    a 5th grade student should not spend more than 2 hours doing homework,
    6-7 grades – 2.5 hours, 8-9 grades – no more than 3 hours, 10-11 grades no more
    4 hours.
  4. When preparing lessons or playing, the child needs to do an easy
    gymnastics, loading all muscle groups and gymnastics for the eyes.These techniques help
    reduce muscle tension, including from the muscles of the head, which prevents
  5. It is required to restrict TV viewing and work on the computer
    up to 2 hours a day in total. In this case, the continuous duration of work
    at the computer should not exceed 20 minutes for students of grades 5-7, 25 minutes
    for 8-9 graders and 30 minutes for older children. This will reduce the load on
    eye muscles and reduce the risk of an attack.It is recommended to exclude
    watching action-packed films on a crime theme and “horror films”, especially
    before bedtime.

Power supply

Although people of all ages often eat just about anything, for children with headaches
pain relief, proper nutrition is paramount. Unfortunately, children, and in
especially adolescents, have their own views on their lifestyle and nutrition.
They often prefer to eat a hamburger, chips or snickers.Such food is unlikely
is it acceptable for healthy children, but for those suffering from headaches it is categorically

The child’s nutrition should be balanced in all ingredients, should not be
monotonous, the number of meals per day should be at least 4-5, is contraindicated
dry food. With poor nutrition, a headache can be triggered
long breaks between meals. In this case, the headache causes
lowering blood sugar levels – hypoglycemia.As a result of hypoglycemia,
constriction of the vessels responsible for the supply of glucose to the brain, which causes pain. IN
food should have a sufficient amount of iron. Its deficiency increases the risk of
headache due to a decrease in the ability of the blood to carry oxygen. At the same time, it suffers
every cell of the body, including the nervous system. A good source of iron
is lean meat, fish, green leafy vegetables, legumes, raisins, eggs. Baby food
should be rich in vitamins, especially group B.They are also needed for normal
the functioning of the nervous system. Rich in these vitamins, broccoli, spinach, green
peas, potatoes, nuts, brewer’s yeast.

Many food products contain special biologically active substances capable of
provoke a headache attack in people sensitive to them. To identify
These triggers will benefit from keeping the diary discussed earlier. Let’s get to know
with some of them.

  1. Tyramine – has the ability to increase blood pressure, decrease,
    and then the blood vessels in the brain dilate, resulting in pain
    attack.A large amount of tyramine is found in cheese (roquefort, cheddar), yoghurts,
    sour cream, in all canned foods, any salted fish, salami, smoked meats,
    sausages. When frozen, the amount of tyramine in food increases, therefore
    it is advisable to eat only fresh food. Following a diet low
    content of tyramine, you need to focus on the characteristics of your own
    sensitivity to this substance. So, one person has a headache
    after eating cheese, and the other when using sausages for food.
  2. Monosodium glutamate. It is a flavoring agent found in many processed
    foods, especially in Chinese food. Glutamate-provoked headache
    the pain is even called the “headache of a Chinese restaurant.” It is usually used
    for preparing snacks. It is advised to beware of potentially
    containing glutamate, and check the ingredient list on food labels.
  3. Nitrite (“sausage” headache).Nitrite has long been used for canning
    meat and giving it a special taste and color. They have a vasoactive effect,
    causing the expansion of blood vessels on the surface of the brain, face, and the integument of the skull.
    Fast foods such as hot dogs are very high in nitrite.
  4. Caffeine. Caffeine increases the risk of headaches due to the effect
    vasodilation after the effect of caffeine is weakened. On termination
    caffeine intake can cause withdrawal symptoms, which are manifested by headaches
    pain, weakness, irritability, decreased attention.These symptoms develop
    in people who are accustomed to drinking a lot of coffee, strong tea, cola.
  5. Cold foods (“frozen” headaches). After eating ice cream
    reflex headaches may occur due to irritation of cold receptors
    soft palate, pharynx.

Stress Management

One of the most frequent triggers of headache is stress. Most
children are sensitive to it. Anxious family, school, or bad relationships
with peers exacerbate stress and aggravate headaches.In childhood it is laid
foundation for future life. But when she’s clouded by recurring headaches
the child may develop a violation of educational, social, emotional
behavior. The character of such children is very often imprinted by their illness.
They feel like they are being given a headache as punishment for bad behavior, and that says
that they are not as good as others. Such thoughts can make a child withdrawn,
depressed and apathetic, he may develop depression, anxiety.It’s in your
the queue intensifies the seizures. A vicious circle forms: headache causes fear,
anxiety of the child, and fear causes a headache.

If, as a result of the examination, the attending physician does not find serious diseases
(tumors, anomalies in the development of the nervous system, severe pathology of internal organs),
It is likely that functional (reversible) conditions underlie the headache. Necessary
explain to the child that not only he has headaches, his disease requires
treatment, but not life threatening.

A psychologist, psychotherapist, who
will be able to teach the child and his parents methods of auto-training (self-regulation).

First aid for a headache attack

  1. If the child has at least one of the “dangerous” symptoms that indicate
    severe disorders in the body (see earlier), it is necessary to urgently call an ambulance
    help ”or contact your doctor.
  2. If headache is mild to moderate in intensity, does not worsen
    the child’s well-being, you need to put the child to bed in a calm environment,
    after sleep, the headache will surely subside or become less intense.

If headache persists after rest, use pain relievers
(analgesics). When treating headaches in childhood, doctors try not to use
medications used in adults because they can have a negative effect
on the growing organs and systems of the child’s body. Currently, children are allowed
for use, two drugs from the group of analgesics. This is paracetamol (acetaminophen)
and ibuprofen. They have fewer side effects and are easily tolerated.A single dose of the drug and the frequency of administration is determined only by a doctor. It should be especially
emphasize that analgesic drugs are recommended to be used no more often than
5-8 times a month. With more frequent use, “abusal” (medicinal)
headache. If pain attacks are rare (less than 2 per month), then compliance is sufficient
regime moments, elimination of triggers to reduce headache attacks and,
if necessary, use of analgesics.With more frequent pains,
courses of preventive treatment using drugs that feed the nervous system.
The duration and nature of this drug treatment are determined by the doctor based on
from the individual characteristics of the course of the disease after a comprehensive examination.

Spinal anesthesia | orto.lv

An anesthetic medication is injected into the spinal canal (where the spinal cord ends anatomically).Typically, for the procedure to administer spinal anesthesia, the patient should be in a seated position with the back arched and chin pressed against the chest.

“ORTO” clinic performs spinal anesthesia during operations on the cross ligaments, ankle and foot area, as well as hip prosthetics. For knee replacement, spinal anesthesia is combined with an epidural.

After administration, spinal anesthesia begins to act almost immediately.The maximum effect is achieved after 20 minutes and lasts from 4 to 6 hours.

How will I feel after anesthesia is administered?

Immediately after administration of the drug, you may feel warmth, slight numbness and a feeling of heaviness in the legs. After about 10-15 minutes, you will not be able to lift your legs, they will become numb, become heavy, and lose sensitivity.

How will I feel during the operation?

If a long operation and a monotonous posture are planned, then over time you may experience discomfort, despite the fact that you will not feel pain.Discomfort can be created, for example, by stretching the leg, strong touching, and ambient noise. If you do not want to be awake, the anesthesiologist will provide you with a light sleep during the operation. In addition, the anesthesiologist monitors your pulse, pressure, breathing and consciousness.

How will I feel after the operation?

Within six hours after the operation, you will feel slight numbness in your legs, mild pain may occur in the wound area, and limb mobility will be restored.After the operation, bed rest must be observed until the morning of the next day.

Spinal anesthesia is considered safe, but in rare cases, side effects may occur:

  • in 20% of cases there may be nausea or vomiting;
  • In 20-30% of cases, urinary retention occurs, since spinal anesthesia also affects the work of the muscles of the bladder. As a rule, with the introduction of a medication that relaxes smooth muscles, the normal functioning of the bladder is restored.If necessary, a catheter is inserted into the bladder;
  • the skin may itch and itch. For this purpose, special drugs are provided to reduce the manifestation of this side effect;
  • 90,037 Less than 5% of people experience headaches. Most often, this phenomenon affects young and slender people within three to seven days after spinal anesthesia. Sometimes nausea and vomiting can be added to the headache. The pain is more pronounced in an upright position and when the head is tilted down.Lying on your back pain will decrease. The reason for the headache is that after the injection, a hole the size of a needle remains in the lining of the spinal cord, through which the cerebrospinal fluid can leak, as a result of which the blood supply to the brain increases, which causes the headache. Usually, in the next six weeks, the hole in the membrane closes and the headaches disappear. This process is facilitated by:

    • daily fluid intake at least 2 liters;
    • drinking two cups of coffee;
    • caffeine tablets 200 mg 2 times a day;
    • Coca Cola;
    • three days of bed rest;
    • Pain medications.

In some cases, in order to relieve headaches, a second injection is made with the introduction from the patient’s own blood, thereby the hole in the lining of the spinal cord is closed by a blood clot – a blood patch. The action begins within 24 hours and is effective up to 95%. We would like to inform you that this side effect does not affect your quality of life, does not increase the frequency and severity of headaches in the future.

90,000 (PDF) Headache. Free yourself and forget.Forever and ever.

I.G. Malkina-Pykh. “Headache. Free yourself and forget. Forever ”


do we consume with the body or do not notice it, but do not treat it like a devoted friend or

an equal partner? Why do we impose our power on the body in the same way as the environment dictates our

way of life? The origins of the formation of our way of living in our body are numerous and

are diverse. They lie in the real experiences we have received and the underlying beliefs and beliefs that have prevailed in the family, culture and educational system.

According to the Swiss child psychologist Jean Piaget, in the first two years of life

we think with the body, since we do not yet speak speech. Before we can begin to speak and understand

speech, we go through the sensory-motor stage of learning. We get to know the world, taste it

when we grab, crawl, fall, twist. And all this with the help of the body.

What we learn at this moment forms the basis of the subsequent emotional

life. How were we looked after as infants? If our needs were not met, then in

eventually we ourselves closed for them.If we have been mistreated, we have learned

to mistreat ourselves. If we were protected and lovingly cared for, we learned that

deserves kind treatment and attention. From what we see and hear, we teach effective or destructive ways of being in our body. Parents, or

those who cared for us, are the first example of attitude to the body.

But often the family intervenes in every aspect of development and leaves little room for

for a natural reaction.If we are prompted or forced to sit, stand or walk until

when we are ready for it, then muscle clamps may develop, affecting movement

and distorting posture. If the child has to finish the game according to the schedule

or wake up before he gets enough sleep, then he is thereby shown that the internal

rhythm that can be followed does not exist or does not exist. We lose a sense of harmony with ourselves and with our environment, we begin to make mistakes and doubt the ability to think

with our body and stop believing it.

When we stop listening to the body, we gradually forget how to listen. And how many

many of us live with such physical problems as constantly clenched jaws, heads –

pains, ulcers, back pains or asthma – all because we have learned to restrain our feelings!

Maybe we turned off the sensations because we didn’t want to know what was really wrong

? Are we really convinced that if we do not feel something, then this something does not exist?

Remember, our body is our first classroom.From the first

days of life, physical sensations create patterns of emotional life,

set patterns of relationships and provide us with resources and opportunities.

Working with the body now, we get the opportunity to notice that we have learned something

well, but we have not learned something, and it is necessary to learn again.

At the beginning of life, we do not recognize ourselves as separate from the world or the world as separate from ourselves. But

our “I” is gradually formed. Since the boundaries of the body separate us from our environment,

our first identification is identification with the body.This “I” is the somatic, corporeal

ny, fleshly, material “I” – the “I” of the body.

Thus, the image of “I” is, first of all, the image of the body, because through the body we learn

who we are when we physically feel it and see it. The image of “I” is associated with how the body is oriented in time and space, with the contours of the body, bodily sensations and visual perception.

However, the image of the body or the image of “I” is not only what we see when we look

at ourselves, but also how we feel and control parts of the body.It includes mental, emo-

rationality and historical aspects – what we feel, what we think about our appearance and

how all previous experiences have shaped us: both painful and pleasant, filled

90,000 Headaches in mental illness

Headaches associated with mental illness.

A headache is considered secondary (associated with a mental illness) when a new headache first appears in close association with a mental illness.This rule also applies to pain that has the clinical characteristics of migraine, tension headache, or cluster headache. In many cases, the diagnosis of a headache associated with a mental illness becomes apparent only after the pain is relieved or significantly reduced following successful treatment or spontaneous remission of the mental illness.

Examples of headaches associated with mental illness include a patient with delusional ideas about a metal plate allegedly secretly embedded in his head and complaining of persistent headaches, as well as a patient whose headache is a symptom of somatisation disorder .In most cases, a headache that occurs against the background of a mental illness has no causal relationship with this disease, but is a comorbid disorder (i.e., it may have a single biological basis with this disease). It is known from the literature that headache is a comorbid disorder in a number of mental disorders, such as depression, dysthymia, panic, somatoform and generalized anxiety disorders , and adaptation disorders .In these cases, it is necessary to establish both the diagnosis of primary headache and comorbid mental disorder. Facts have been obtained that comorbid mental disorders, primarily depression, aggravate the course of migraine and tension headaches (in the form of increased frequency and intensity of attacks, as well as a decrease in the effectiveness of traditional therapy). Therefore, in many cases, the timely detection and treatment of comorbid mental disorders is an important condition for the successful treatment of headache.

How to deal with a headache

Almost every one of us is faced with a headache. But for some, this is a short-term state of mild severity, while for others it is a real nightmare with a complete breakdown. Headache appears for many reasons and is localized in different areas of the head.

The main reasons include stressful situations, physical or mental fatigue, arterial hypertension, vascular abnormalities, spasms due to osteochondrosis of the cervical spine.But, whatever the reason, it is necessary to take immediate measures to eliminate pain.

When you need a doctor’s help

Irritants leading to headaches and migraines can be internal or external:

  • oxygen starvation of the brain due to changes in the composition of the blood, its increased viscosity;

  • damage to the tissues of the spine;

  • vascular spasms;

  • violation of cerebral circulation due to vascular damage at the base of the skull;

  • low and high frequency noise;

  • lack of sleep and stress;

  • infectious processes;

  • malignant tumors;

  • meningitis.

The nature of headaches varies, but pain relievers are taken in all cases. However, if they are used too often, addiction and lack of the desired effect may occur. In what cases is the doctor’s help needed? They turn to a therapist for persistent headaches that cannot be anesthetized by conventional means, as well as:

  • primary pain in a patient over 45 years old;

  • for frequent attacks that last for a long time;

  • if the pain is constantly accompanied by nausea or vomiting;

  • if soreness increases with bending or sharp turns of the head.

After a survey, the doctor will prescribe additional examinations, for example, MRI, ultrasound, X-ray, if necessary, refer to a neurologist, dentist, otolaryngologist or other specialist. With constant pain and the absence of medical assistance, the patient may develop depression, a complete breakdown.

Medical attention is needed because headache can be a symptom of cytomegalovirus activity. There is no cure for CMV, but it can be suppressed, otherwise there is a danger of lung disease, central nervous system disorders and even loss of vision.To exclude a health hazardous condition, you need to consult with a specialist, donate blood for possible infections.

What medicines can you take

Pain in the head may be throbbing, pressing, cutting, or dull. With severe pain and intolerance, antispasmodics and analgesics are needed, but you need to know that over time they may have the opposite effect – they will provoke pain.

Medicines can be in the form of tablets, injections, rectal suppositories.Before use, it is worth considering contraindications, side effects. A doctor may prescribe neurotropic antispasmodics or prescription drugs that are effective for excruciating pain but are addictive.

Other pain relief drugs

As a first aid for headaches – taking a comfortable position with a cool compress on the forehead; in case of hypertension, cold treatment should be avoided. Massaging the neck and head may help. It is important to give up bad habits – alcohol and smoking, otherwise there will be no effect of treatment.The fact is that from smoking the vessels of the brain narrow, and from alcohol they expand, and this process is uncontrollable.

In case of pain, you can also take a walk in the fresh air, perform aromatherapy or take inhalation. It will be good to take a bath with the addition of any of the essential oils: sandalwood, eucalyptus, mint, lavender. Herbal teas with honey, marjoram, ginger, mint, lemon can help improve the condition. At night it is good to drink tea with chamomile, take motherwort or valerian. If a person is tormented by pain due to blood pressure, coffee and strong tea should be avoided.What other measures can be taken:

  • refuse to use salt;

  • monitor nutrition, eat vegetables, fruits rich in vitamins and minerals;

  • improve blood circulation with contrasting foot baths;

  • to do acupressure of the temples;

  • to monitor the use of sufficient amount of water to remove toxins from the body;

  • avoid stress;

  • Ventilate the room.

You can resort to such methods if the exact cause of the pain is established and you can relieve the condition yourself. They can also help with mild and intermittent pain. Otherwise, you first need to see a doctor for a diagnosis. Knowing the cause, you can quickly take the necessary measures to eliminate and control the appearance of pain.

90,000 Motor neuron disease (MND) | Stavropol Regional Clinical Hospital

Motor neuron disease (MND) is a progressive neurodegenerative disease that affects motor neurons in the brain and spinal cord.The gradual death of cells in the nervous system leads to a steadily increasing muscle weakness that affects all muscle groups.

The neurons of the brain that are responsible for movement (upper motor neurons) are located in the cerebral cortex. Their processes (axons) descend into the spinal cord, where contact with a neuron in the spinal cord occurs. This contact is called a synapse. In the area of ​​the synapse, a neuron in the brain secretes a chemical substance (transmitter) from its process, which transmits a signal to a neuron in the spinal cord.

Neurons of the spinal cord (lower motor neurons) are located in the lower regions of the brain (bulbar region), as well as in the cervical, thoracic, or lumbar regions of the spinal cord, depending on which muscles they send their signals to. These signals, along the processes of the neurons of the spinal cord (axons), reach the muscles and control their contractions. Bulbar neurons are responsible for muscle contraction associated with speech, chewing and swallowing; cervical spine – for contraction of the diaphragm, hand movements; thoracic region – for body movements; lumbar spine – for the movement of the legs.

Manifestations of damage to motor neurons

When neurons of the spinal cord are damaged, muscle weakness increases, muscles lose weight (atrophy), involuntary twitching (fasciculations) appear in them. Fasciculations don’t just feel like twitching, they can also be seen. This is similar to subcutaneous muscle flutter.

If the neurons of the brain are affected, the muscles become weak, but stiffness (spasticity) appears, that is, the tone of the muscles increases, it becomes difficult to relax them.

When the neurons of the brain and spinal cord are simultaneously affected, these signs can occur in different combinations. That is, muscle weakness can be accompanied by fasciculations and muscle loss, as well as stiffness.

Depending on which parts of the brain and spinal cord are affected, these signs can appear in the muscles responsible for the movements of the arms, legs, breathing or swallowing.

Different types of motor neuron disease ALS

This is the most common form of the disease, when motor neurons of both the brain and spinal cord are involved in the pathological process.
ALS is characterized by weakness and extreme tiredness in the limbs. Some people report weakness in their legs when walking and such weakness in their hands that they cannot hold things and drop them.

Muscle twitching (fasciculations)

What’s going on? Twitching and muscle twitching sensations under the skin (fasciculations) are often the first and most annoying symptoms of ALS. In some people, they are localized in individual muscles, but they can spread over time.

What can be done? For medication relief of these symptoms, you should contact your doctor. In many cases, the twitching will go away on its own over time.

Muscle weakness and joint stiffness

What’s going on? As the number of signals from motor neurons to muscles decreases, the latter are used less and lose mass over time. This leads to a feeling of weakness and can cause imbalance and gait, which increases the risk of falling.

What can be done? The decrease in muscle mass cannot be stopped by exercise, since the disease progresses irreversibly. However, exercise can help maintain flexibility and mobility in the joints, which helps maintain muscle function, balance, and body position. You need to see your doctor in order to create a suitable exercise program. A nutritionist can also help with advice on how to eat properly to maintain body weight and further slow down the rate of muscle loss.

Muscle cramps and spasms

What’s going on? Muscle tension or spasms develops due to impairment of signal transmission from motor neurons. This leads to impaired motor activity and coordination of movements, as well as an increased risk of falls. Sudden muscle spasms can be extremely painful.

What can be done? To eliminate this symptom, as a rule, it is sufficient to change the position of the body while resting in a bed or chair.Exercise is part of the problem. In addition, your doctor may prescribe medications to help you relax.


What’s going on? Decreased physical functionality of muscles requires high energy expenditures to maintain daily activity. Other causes of fatigue include breathing problems, shortness of breath, decreased food intake, and dehydration.

What can be done? Make a plan for doing things for the day.This will help maintain a balance between being active and getting adequate rest. It is also important to consult with a dietitian about increasing food calories and fluid intake.


What’s going on? ALS does not directly cause pain or discomfort. But they can be the result of a number of other reasons. For example, pain occurs as a result of muscle spasms, general spasticity, muscle tension, skin pressure, or constipation. Therefore, it is important to find out the cause of the symptom.

What can be done? Recommendations exist for optimal body positions, support, prevention of local compression, and drug therapy. In case of prolonged pain, you must contact a medical institution. Your doctor can find the right pain reliever.

Problems with swallowing

What’s going on? When the muscles of the face, mouth and larynx are affected, swallowing is difficult. Disruption of the normal process of eating and swallowing is called dysphagia.As a result, a person receives less nutrients and fluids, which can lead to a decrease in body weight.

What can be done? It is necessary to contact a speech therapist and nutritionist who will assess the degree of swallowing impairment and change in body weight, as well as talk about possible solutions to the problem. Including, in order to increase the intake of proteins and carbohydrates with food, you need to adjust the diet. There are also alternative methods that can support or completely replace the diet.

Saliva and phlegm

What’s going on? If swallowing is impaired, excess saliva accumulates in the oral cavity, which leads to drooling and associated discomfort. The consistency of the secretion can be either watery or thick. Increased viscosity is associated with a decrease in the amount of fluid entering the body. In this case, saliva is removed with great difficulty. Dry mouth can also develop from medication, dehydration, breathing through the mouth, or mucosal candidiasis.

What can be done? Among the options for solving this problem are nutritional adjustments, drug therapy and the use of aspiration devices for cleaning the oral cavity (suction).

Cough and choking

What’s going on? These phenomena can occur as a result of ingestion of food or saliva into the respiratory tract.

What can be done? At the moment, there are effective techniques that help to deal with these problems.Your doctor will tell you about this.

Breathing problems

What’s going on? In ALS, the respiratory muscles are affected sooner or later. As the disease progresses – especially in the later stages – breathing problems develop. When this happens, the patient will need breathing equipment and specialist advice.

What can be done? If a person experiences shortness of breath, weakness, sleep disturbances, morning headaches, or drowsiness during the day, their doctor may refer them to a pulmonologist.Methods for correcting the problem may include breathing and exercise, advice on creating a comfortable posture, effective coughing techniques, drug therapy, and special ventilation equipment.

Speech and communication problems

What’s going on? As the muscles of the face and larynx weaken, and the ventilation of the lungs further decreases, it becomes more difficult for a person to speak. This difficulty in speaking is called dysarthria.

What can be done? The attending physician will help to assess the problem and select the techniques for its solution.We also recommend consulting a physiotherapist who will advise on equipment or aids, depending on what kind of manipulation the person with ALS is capable of. Means for speech and communication (they are also called “means of alternative and auxiliary communication”) include both simple techniques (gestures, writing, alphabet tables, etc.) and more technically complex (using a computer).

Emotional lability (pseudobulbar effect)

What’s going on? Some people with ALS have bouts of uncontrollable laughing and / or crying that are difficult to control.These reactions do not occur in all patients, and they are involuntary.

What can be done? Drug therapy may be considered to relieve symptoms. Such reactions can cause some concern in others, but if they know that these manifestations are part of the symptoms of ALS, it will be easier for them to cope with it.

Emotional reactions

What’s going on? Some people with ALS experience a range of emotional states, including anxiety, fear, anger, sadness, depression and denial.These reactions are normal.

What can be done? Being aware of your emotional states is the first step to solving problems associated with experiences. If these conditions are too pronounced and persist for a long time, we strongly recommend that you seek help from a doctor. In some cases, drug therapy and / or psychotherapy is effective.

Violation of higher mental functions

What to do? Problems with memory, learning, word selection, or decreased concentration are known as higher mental functions.According to some reports, these conditions occur in 35% of patients with ALS, but they proceed rather unnoticed. Only in a few are they extremely pronounced. In this case, they speak of frontotemporal dementia, which is accompanied by severe impairment of cognitive functions.

What can be done? Requires the participation of a multidisciplinary team of specialists, including psychologists and psychiatrists.

What is not affected by ALS?

Taste, sight, touch, tactile sensations and hearing.

As a rule, with ALS, there are no noticeable changes in the listed systems and sense organs. However, the course of the disease is individual for each person. If you suspect, be sure to consult your doctor.

In most cases, these senses are not affected by ALS, however, some sufferers experience changes in taste, skin hypersensitivity or problems with thermoregulation.

Bowel dysfunctions and incontinence

Disorders of bowel and urinary bladder functions do not usually occur in ALS, however, impairment of physical activity contributes to the creation of additional difficulties in using the toilet.Constipation may occur with dietary changes, dehydration, anxiety, drug therapy, or decreased mobility. Persistent constipation can be followed by diarrhea. Any changes in bladder and bowel function should be monitored as they may be symptoms of other conditions.

Sexual function

ALS, as a rule, does not affect sexual function, however, the patient’s perception of his own sexuality may change. Physical changes can leave an imprint on all stages of the intimate process.Discussing emerging issues with your partner and doctors openly will help maintain an intimate relationship.

Eye muscles

The movements of the eyeballs are preserved in most people with ALS. If the muscles in the neck are affected, the use of appropriate support will help.

Heart muscle

ALS does not directly affect the heart.

ALS Treatment

To date, no ways have been developed to defeat the disease itself. Therefore, the existing treatment solves two problems: prolonging life and improving its quality.The first area includes the use of the drug riluzole, respiratory support and nutritional support. The second is focused on minimizing excessive salivation, muscle cramps and spasticity, emotional instability, and pain.


Riluzole is the only drug registered in the USA and Europe for slowing down the course of ALS. The drug is not registered in the Russian Federation and therefore is not officially available for ALS patients.

Riluzole helps to reduce the amount of glutamate (a chemical transmitter in the central nervous system), which is released during transmission of a nerve impulse.Excess glutamate has been shown to damage neurons in the brain and spinal cord. The results of clinical trials show that those who took riluzole had an increase in life expectancy of two to three months compared with those who took a placebo.

Data on the effectiveness of the drug were obtained during studies that lasted 18 months. Unfortunately, there is no reliable information about the effectiveness of the drug in the more distant stages of the disease. In addition, it must be remembered that the drug has contraindications for use and a number of side effects.

Riluzole is available in tablet form and is taken twice a day.

Masitinib (masivet) for ALS

Information about masitinib available on the Internet offers hope for a cure for many people with ALS. Since the drug is available in Russia, some are already taking it on their own and under their own personal responsibility. However, masitinib is currently not approved for use in ALS patients. It is used to treat cancer in animals and it is for these purposes that it is commercially available.

Therapy for breathing disorders

There are a number of therapies and medications available for those with breathing problems. For recommendations on this matter, you should contact a pulmonologist.
Generally, there are two options:

  1. non-invasive ventilation of the lungs (NIV), in which a special device pumps air into a face mask, which helps the patient to breathe on their own;
  2. invasive ventilation of the lungs (tracheostomy, mechanical ventilation), in which an airway is installed through a tracheostomy cannula.

Gastrostomy feeding is the preferred method for ALS patients. This is the only way to feed people as long as they want, in the right amount and without discomfort for the person himself.

During gastrostomy, a feeding tube is inserted into the stomach through the anterior abdominal wall. The tube is compact, as thick as a ballpoint pen, and is very flexible. It is not visible under the clothes.

There are two ways to place a gastrostomy tube: percutaneous endoscopic gastrostomy (PEG) and X-ray gastrostomy (RG).In our country, experience has been accumulated in the installation of gastrostomy by the PEG method.

Complementary therapy

Complementary therapies relieve symptoms and reduce stress in some people with ALS. But it should be remembered that these methods are not a treatment for the disease.
Complementary therapy is outside the scope of conventional medicine, but it does enhance the effectiveness of standard treatment.

The methods of complementary therapy for ALS include massage, acupuncture, aromatherapy and reflexology.

Nutritional support (ensuring adequate nutrition)

As the disease progresses, the muscles of a person responsible for chewing and swallowing become slow, sluggish and weak. As a result, the process of eating can be very stretched, a person begins to choke. If swallowing is difficult, then to reduce their own discomfort, the patient often begins to reduce the diet. In turn, lack of water and food leads to dehydration, weight loss, and decreased immunity.

Special therapeutic food can compensate for the lack of calories. In Russia, you can buy food from three main manufacturers – Nutricia, Nestle and Fresenius. When the amount of food consumed decreases as a result of decreased appetite or swallowing disorders, it is highly desirable to add such foods to the diet every day. With certain types of ALS, there may be restrictions on a particular form of nutrition, so you should consult a neurologist.

Timely provision of food access to the body by installing a nasogastric tube or gastrostomy tube allows you to feed and water a person who loses the ability to swallow on their own as the disease progresses.


Antioxidants are a class of nutrients that help the body prevent free radicals from damaging cells.

It is believed that people with ALS may be more susceptible to the harmful effects of free radicals, and research is underway to determine the beneficial effects of antioxidant-rich supplements on the body.

Some products containing antioxidants that have already undergone clinical trials to determine the effect on ALS have not been proven to be effective.

Alternative treatment

Currently, the only drugs that slow the progression of ALS are riluzole and edaravone. The effectiveness of expensive drugs is low, so it is understandable why people with ALS want to try other therapies.

What are stem cells?

Stem cells are cells that have not yet formed in order to perform specific functions. They can self-renew and give rise to various types of cells, such as, for example, blood cells, muscle and nerve cells.

The media attention and general interest in stem cells are related to the fact that in the future they can be used to restore or replace normal cells that have died due to some kind of disease.