What triggers neck pain and headaches simultaneously. How are these symptoms connected. What treatment options are available for alleviating neck pain and headaches. How can lifestyle changes help prevent these issues.

The Intricate Connection Between Neck Pain and Headaches

Neck pain and headaches often go hand in hand, creating a complex web of discomfort that can significantly impact daily life. The relationship between these two symptoms is not coincidental; in fact, many neck issues can directly lead to headaches by irritating, straining, or compressing the nerves in the cervical region. Understanding this connection is crucial for effective diagnosis and treatment.

What exactly causes this painful duo? The root causes can be diverse, ranging from simple lifestyle factors to more serious medical conditions. Let’s explore some of the most common culprits:

• Poor posture
• Neck strain
• Injuries
• Pinched nerves
• Herniated cervical disks
• Stress and tension
• Underlying medical conditions

Everyday Habits Contributing to Neck Pain and Headaches

In our modern, tech-driven world, certain daily habits can significantly contribute to neck pain and subsequent headaches. Are you guilty of any of these common practices?

• Prolonged smartphone use (“text neck”)
• Extended periods at the computer
• Poor ergonomics at work or home
• Improper sleeping positions
• Carrying heavy bags on one shoulder

These seemingly harmless activities can lead to muscle strain, poor posture, and increased tension in the neck and shoulders. Over time, this can result in chronic pain and frequent headaches.

The Impact of Technology on Neck Health

How does our increasing reliance on technology affect our neck health? The phenomenon known as “text neck” is becoming increasingly prevalent. This condition occurs when people spend long periods looking down at their phones or tablets, putting excessive strain on the neck muscles and spine. Similarly, poor computer ergonomics can lead to a forward head posture, which can cause both neck pain and tension headaches.

Medical Conditions Linking Neck Pain and Headaches

While lifestyle factors play a significant role, several medical conditions can also cause the combination of neck pain and headaches. Understanding these conditions is crucial for proper diagnosis and treatment.

Herniated Cervical Disc: A Common Culprit

A herniated cervical disc occurs when one of the soft discs between the vertebrae in your neck becomes damaged and bulges out of the spinal column. How does this lead to both neck pain and headaches? If the herniated disc presses on a nerve, it can cause pain that radiates from the neck to the head, resulting in a headache.

Pinched Nerves: The Domino Effect

A pinched nerve in the neck can trigger a cascade of symptoms. When a nerve in the cervical region is irritated or compressed, it can lead to:

• Stiff neck
• Throbbing headache in the back of the head
• Pain exacerbated by neck movement
• Shoulder pain
• Muscle weakness
• Numbness or tingling sensations

The Role of Headaches in Causing Neck Pain

While neck issues can lead to headaches, the reverse is also true. Certain types of headaches can contribute to or exacerbate neck pain. Understanding these connections can help in developing a comprehensive treatment approach.

Tension Headaches: The Vicious Cycle

Tension headaches are often described as a feeling of a tight band around the head. What causes these headaches, and how do they relate to neck pain? The root causes of tension headaches often include:

• Stress
• Anxiety
• Lack of sleep
• Poor posture

These factors can lead to tightened muscles at the back of the neck and the base of the skull, creating a cycle of pain that affects both the head and neck.

Migraines: More Than Just a Headache

Migraines are often associated with moderate to severe, throbbing pain in the head or neck. How do migraines differ from other types of headaches? In addition to head pain, migraines can cause:

• Neck pain
• Nausea
• Increased sensitivity to sound or light
• Visual disturbances

Common triggers for migraines include stress, hormonal fluctuations, skipping meals, and changes in weather. Understanding and avoiding these triggers can help reduce the frequency and severity of migraines and associated neck pain.

Temporomandibular Joint (TMJ) Disorders: The Unexpected Link

TMJ disorders affect the jaw and surrounding muscles and ligaments. How can a jaw problem lead to neck pain and headaches? The connection lies in the complex network of muscles and nerves in the face, jaw, and neck. TMJ disorders can cause pain that radiates from the jaw to the neck, and the tension in these muscles can trigger headaches.

What factors contribute to TMJ disorders?

• Genetics
• Jaw injuries
• Arthritis of the jaw
• Teeth grinding
• Jaw clenching

Symptoms of TMJ disorders can extend beyond the jaw, affecting the neck and causing headaches. These may include jaw popping, ear pain, and tooth sensitivity.

Cervicogenic Headaches: When Neck Problems Trigger Head Pain

Cervicogenic headaches (CGH) are a prime example of how neck issues can directly cause headaches. These are considered secondary headaches, meaning they’re a result of another underlying condition. What causes cervicogenic headaches?

• Inflammation in the neck
• Neck injury or trauma
• Malformations of the cervical vertebrae
• Chronic neck strain

The pain from cervicogenic headaches typically begins in the neck and moves upwards, potentially causing symptoms such as:

• Stiffness
• Nausea
• Blurred vision
• Increased sensitivity to light or sound

Occipital Neuralgia: A Unique Type of Headache

Occipital neuralgia is characterized by throbbing pain that usually begins in the neck and moves upwards. What sets this type of headache apart? The pain is typically caused by irritation or inflammation of the occipital nerves, which are located in the scalp. This can result in pain in various areas:

• Back of the head
• Scalp
• Forehead
• Behind the ears or eyes

Occipital neuralgia can be triggered by several factors, including chronic neck tension, cervical disc disease, osteoarthritis of the upper cervical spine, and nerve compression.

Treatment Approaches for Neck Pain and Headaches

Given the complex relationship between neck pain and headaches, treatment often requires a multifaceted approach. The specific treatment plan will depend on the underlying cause, severity, and type of symptoms experienced.

Medication Options

What medications are commonly used to treat neck pain and headaches? Depending on the specific diagnosis, a healthcare provider might recommend:

• Over-the-counter (OTC) pain relievers (e.g., ibuprofen, acetaminophen)
• Prescription pain relievers (e.g., naproxen, ketorolac tromethamine)
• Triptans for migraines
• Muscle relaxants
• Steroid injections

It’s important to note that overuse of certain medications, particularly acetaminophen, can lead to rebound headaches, potentially worsening the condition.

Physical Therapy and Exercise

How can physical therapy help with neck pain and headaches? A skilled physical therapist can provide:

• Targeted exercises to strengthen neck muscles
• Stretching techniques to improve flexibility
• Posture correction strategies
• Manual therapy to alleviate muscle tension
• Education on ergonomics and lifestyle modifications

Regular exercise, particularly exercises that focus on neck and shoulder strength and flexibility, can help prevent and manage both neck pain and headaches.

Alternative Therapies

What alternative treatments show promise for neck pain and headaches? Some patients find relief through:

• Acupuncture
• Massage therapy
• Chiropractic care
• Yoga and mindfulness practices
• Biofeedback

While the effectiveness of these treatments can vary from person to person, many individuals report significant improvement in their symptoms with these complementary approaches.

Lifestyle Changes for Prevention and Management

Prevention is often the best medicine when it comes to neck pain and headaches. What lifestyle changes can help reduce the risk and severity of these issues?

• Improving posture, especially when using electronic devices
• Setting up an ergonomic workspace
• Taking regular breaks from sedentary activities
• Practicing stress-reduction techniques like meditation or deep breathing
• Ensuring adequate sleep with proper neck support
• Staying hydrated and maintaining a balanced diet
• Engaging in regular physical activity

By incorporating these changes into daily life, many individuals find significant relief from chronic neck pain and headaches.

The Importance of Ergonomics

How can proper ergonomics make a difference in preventing neck pain and headaches? Ergonomic improvements in your work and home environment can significantly reduce strain on your neck and shoulders. Consider the following adjustments:

• Positioning your computer screen at eye level
• Using a headset for phone calls instead of cradling the phone between your ear and shoulder
• Adjusting your chair to support your lower back and promote good posture
• Using a standing desk for part of the day to vary your position
• Ensuring proper lighting to reduce eye strain

These simple changes can have a profound impact on reducing the frequency and severity of neck pain and associated headaches.

When to Seek Medical Attention

While many cases of neck pain and headaches can be managed with self-care and lifestyle changes, there are instances where professional medical attention is necessary. When should you consult a healthcare provider?

• If pain persists for more than a week despite self-care measures
• If you experience severe pain or sudden onset of symptoms
• If pain is accompanied by numbness, tingling, or weakness in the arms or legs
• If you develop a fever along with neck pain
• If headaches are severe, frequent, or interfere significantly with daily activities
• If you’ve recently been involved in an accident or suffered a head injury

Early intervention can prevent the development of chronic issues and lead to more effective treatment outcomes.

Diagnostic Procedures

What diagnostic tools might a healthcare provider use to investigate neck pain and headaches? Depending on the suspected cause, your doctor may recommend:

• Physical examination
• X-rays to check for bone abnormalities or arthritis
• MRI or CT scans to evaluate soft tissues, nerves, and blood vessels
• Blood tests to rule out infections or other systemic conditions
• Nerve conduction studies to assess nerve function

These diagnostic procedures help pinpoint the exact cause of your symptoms, allowing for a more targeted and effective treatment approach.

What Is Causing My Neck Pain and Headache?

Neck pain and headaches are often mentioned at the same time, as a stiff neck can cause a headache.

In fact, many neck problems can irritate, strain, or compress the nerves in the neck, which could trigger a headache.

Often, neck pain is caused by poor posture, neck strain, or injury.

In other cases, it could be caused by medical conditions, including a pinched nerve or herniated cervical disk.

There are several factors that can contribute to neck pain, including injuries, strains, and certain medical conditions.

Some common causes of neck pain include:

• stiff neck muscles
• phone use
• computer use
• poor posture
• sleeping positions
• injury
• herniated disc

A herniated cervical disc occurs when one of the soft discs between one of the seven vertebrae in your neck becomes damaged and bulges out of your spinal column. If this presses on a nerve, you can feel pain in your neck and head.

A pinched nerve occurs when a nerve in your neck is irritated or compressed. With so many sensory nerve fibers in the spinal cord in your neck, a pinched nerve here can result in a number of symptoms, including:

• stiff neck
• throbbing headache in the back of your head
• headache caused by moving your neck

Other symptoms can include shoulder pain along with muscle weakness and numbness or tingling sensations.

Some types of headaches can contribute to neck pain, which may be caused by issues with certain muscles or nerves.

The source of a tension headache is often traced back to a buildup of:

• stress
• anxiety
• lack of sleep

These conditions can result in tightened muscles at the back of your neck and the base of your skull.

A tension headache is often described as mild to moderate pain that feels like a band tightening around your head. It’s the most common type of headache.

Migraine

Migraine is often associated with moderate to severe, throbbing pain in the head or neck.

This can cause neck pain and other migraine symptoms, like nausea and increased sensitivity to sound or light.

Some of the most common triggers for migraine headaches include:

• stress
• hormone fluctuations
• skipping meals
• changes in weather

Temporomandibular joint (TMJ) disorders

TMJ disorders affect the jaw and the muscles and ligaments that surround it.

Although it can be difficult to determine the specific cause of TMJ disorders, they may be due to a combination of factors, including:

• genetics
• jaw injury
• arthritis of the jaw
• grinding teeth
• jaw clenching

TMJ can affect the jaw bone and muscles around the jaw joint. This can be worsened by chewing gum, eating ice, and eating crunchy or chewy foods. This may lead to pain and swelling in the surrounding tissues, including the neck.

It may also cause other symptoms, like jaw popping, ear pain, and tooth sensitivity.

Some types of headaches could be caused by certain neck problems, including injury, inflammation, and chronic neck tension.

Cervicogenic headache (CGH)

Cervicogenic headaches are considered secondary headaches, meaning that they’re caused by other issues, like neck problems.

Some of the potential causes of cervicogenic headaches include:

• inflammation
• neck injury or trauma
• malformations of the cervical vertebrae
• neck strain

Because the cervical nerves are responsible for relaying pain signals, neck problems can trigger cervicogenic headaches, which could cause pain, stiffness, nausea, blurred vision, and increased sensitivity to light or sound.

Occipital neuralgia is a type of headache characterized by throbbing pain, which usually begins in the neck and moves upwards.

This type of headache may also cause pain in the back of the head, scalp, forehead, and behind the ears or eyes.

It’s usually caused by injury, irritation, or inflammation of the occipital nerves, which are a type of nerve found in the scalp.

This could be due to issues like:

• chronic neck tension
• cervical disc disease
• osteoarthritis of the upper cervical spine
• nerve compression

Treatment for neck pain and headache can vary based on many factors, including the cause, severity, and type of issue that you’re experiencing.

Treating headaches

Your doctor might recommend any of a variety of treatments, depending on the specific type and cause of your headaches.

Several medications are commonly used to treat headaches, including:

• Over-the-counter (OTC) pain relievers. These include ibuprofen (Motrin, Advil) or acetaminophen (Tylenol). But overuse of Tylenol could cause more headaches.
• Prescription pain relievers. Examples include naproxen (Naprosyn), ketorolac tromethamine (Toradol), or indomethacin (Indocin).
• Triptans. These drugs treat migraines and would be prescribed for someone experiencing tension headaches along with migraines. An example is sumatriptan (Imitrex).
• Steroid injections. This treatment is often recommended for headaches to help calm the nerves and decrease swelling. It may be especially useful for occipital neuralgia, migraines, and TMJ disorders.
• Muscle relaxers. Some types of muscle relaxers, like tizanidine (Zanaflex), can help reduce tension and stiffness in the muscles to treat headaches, occipital neuralgia, and TMJ disorders.
• Ditans. These medications may be used to relieve nausea or increased sensitivity to light or sound associated with certain types of headaches, like migraines. One of the most common types is lasmiditan (Reyvow).
• Tricyclic antidepressants. This class of medications is sometimes prescribed to prevent migraine and occipital neuralgia.
• Anticonvulsants. These drugs may help reduce symptoms caused by migraine or occipital neuralgia.
• Blood pressure medications. One 2015 review found that beta-blockers like propranolol, atenolol, and metoprolol may help decrease migraine symptoms.
• Botox injections. Botox is an FDA-approved treatment for chronic migraines. One 2017 review found that it’s been shown to reduce migraine severity and frequency.

Your doctor might also recommend a massage to help relieve the tension in your neck and shoulders.

If your headache is caused by other factors like jaw or neck problems, treatment may focus on addressing underlying issues. It may involve a combination of exercise, physical therapy, medications, cold/heat therapy, or rest.

In severe cases, surgery may also be recommended for issues like TMJ disorders or occipital neuralgia if other treatment methods don’t help. But in the case of TMJ, a doctor may recommend using a mouthguard at night to prevent teeth grinding (which can contribute to headaches).

Treating a pinched nerve in your neck

Your doctor may recommend one or a combination of the following treatments for a pinched nerve in your neck:

• Cervical collar. This is a soft, padded ring that limits motion. It allows the neck muscles to relax.
• Physical therapy. Following a specific set of guided, physical therapy exercises can strengthen neck muscles, improve range of motion, and relieve pain.
• Oral medication. Prescription and OTC medications your doctor might recommend to ease pain and reduce inflammation include aspirin, naproxen, ibuprofen, and corticosteroids.
• Injections. Steroid injections are used to lessen swelling and relieve pain for a long enough period for the nerve to recover.

Surgery is an option if these less invasive treatments don’t work.

Treating a herniated cervical disc

Surgery for a herniated disc is necessary for only a small number of people. In some cases, a doctor may recommend more conservative treatments instead, including:

• OTC pain medications, like naproxen or ibuprofen
• prescription pain medications, like narcotics including oxycodone-acetaminophen
• muscle relaxers
• cortisone injections
• certain anticonvulsants, like gabapentin
• physical therapy

To prevent headaches related to neck pain, there are things you can do to avoid a stiff neck at home. Consider the following:

• Practice good posture. When standing or sitting, your shoulders should be in a straight line over your hips with your ears directly over your shoulders. Forward head posture, which is common when using electronics, could be a culprit. Here are 12 exercises to improve your posture.
• Adjust your sleep position. Try to sleep with your head and neck aligned with your body. Some chiropractors recommend sleeping on your back with a pillow under your thighs to flatten your spinal muscles.
• Customize your workspace. Adjust your chair so your knees are a bit lower than your hips. Place your computer monitor at eye level.
• Take breaks. Whether you’re working at your computer for long periods of time or driving long distances, frequently stand up and move. Stretch your shoulders and neck.
• If you smoke, consider quitting. Among other problems it can cause, smoking can increase your risk of developing neck pain.
• Watch how you carry your stuff. Don’t use an over-the-shoulder strap to carry heavy bags. This goes for purses, briefcases, and computer bags, too.

A stiff neck and headache are typically not something to worry about. But there are some situations when a doctor visit is needed. They include the following:

• The neck stiffness and headaches are persistent for a week or two.
• You have a stiff neck and numbness down your arms.
• A serious injury is the reason for your stiff neck.
• You experience a fever, confusion, or both alongside neck stiffness and headache.
• Eye pain accompanies your stiff neck and headache.
• You experience other neurological symptoms, such blurry vision or slurred speech.
• You experience headaches that wake you up from sleep.
• You experience “thunderclap” headaches.
• You have headaches that are limiting your daily activities.
• You have headaches that are not responding to conservative treatment.

It’s not unusual for a stiff neck and headache to occur at the same time. Often, neck pain is the driving force behind a headache.

Stiff necks and headaches are commonly connected to lifestyle habits. Self-care and lifestyle changes can usually treat a stiff neck and headache.

If you have persistent, intense neck pain and headaches, consider talking with your doctor. This is especially the case if you’re also experiencing other symptoms, like:

• fever
• arm numbness
• blurry vision
• eye pain

Your doctor can diagnose the underlying cause and provide the treatment you need to get relief.

What Is Causing My Neck Pain and Headache?

Having neck pain alone is challenging enough, especially if it involves neck stiffness and reduced head mobility. When headache is also present, additional problems may include increased pain, visual disturbances, concentration issues, dizziness, or others.

Headaches stemming from a neck problem are usually chronic and vary in type depending on the cause. View Slideshow: 7 Types of Headaches

See Understanding Neck Pain and Dizziness

Several conditions can cause neck pain and headache. Some conditions may start as a neck problem and then send symptoms up to the head, whereas other conditions begin in the head and send pain down to the neck. Getting an accurate diagnosis is important in order to create a treatment program to successfully manage the condition and reduce pain.

See All About Neck Pain

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Headaches Caused by a Neck Problem

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Occipital Neuralgia Symptoms Causes and Treatments Infographic

in our Infographic Center.

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Occipital Neuralgia Symptoms Causes and Treatments Infographic

in our Infographic Center.

Headaches stemming from a neck problem are usually chronic and vary in type depending on the cause. Common examples include:

Headaches such as CGH that result due to another underlying condition are called secondary headaches. Headaches that are not associated with another underlying condition are called primary headaches.

In This Article:

• What Is Causing My Neck Pain and Headache?

• How Neck Pain and Headache Can Occur Together

• Neck Pain and Cervicogenic Headache

• Neck Pain and Tension Headache

• Neck Pain and Migraine Headache

• Slideshow: 7 Types of Headaches

Headaches That May Cause Neck Pain

View this

Neck Pain and Headaches Go Together Infographic

in our Infographic Center.

View this

Neck Pain and Headaches Go Together Infographic

in our Infographic Center.

Certain headaches may cause pain to be radiated to the neck. Examples of headaches causing neck pain are:

• Tension headache. Tension headache is a common headache characterized by moderate to severe non-throbbing pain in the forehead, scalp, and neck. Tension headache occurs when muscles of the scalp and neck become tense, such as from tension, stress, fear, and/or emotions.
• Migraine headache. A migraine is a recurring headache that causes moderate to severe throbbing and pulsating pain on one side of the head. Other symptoms may include nausea and sensitivity to light and/or sound. Neck pain associated with migraines are common and may start before the migraine attack or occur during a migraine attack.
• Temporomandibular joint (TMJ) headache. TMJ headache is a dull ache starting at the temples and around the TMJ and may resemble an earache. Disorders of the TMJ that can cause headaches include degeneration of muscles, ligaments, and/or bone of the TMJ; injury to the TMJ, or dislocation of the TMJ. Neck pain can occur due to muscle fatigue or weakness in the TMJ. The involuntary grinding and/or clenching of teeth, known as bruxism, leads to tired and tight TMJ muscles causing face and neck soreness. Individuals are usually unaware of this condition because bruxism can be involuntary and may also occur in sleep.
• Hemicrania continua is a primary headache of unknown origin characterized by one-sided continuous headache of moderate intensity. The condition also exhibits exacerbations of severe intensity during which pain spreads to other areas including neck, shoulder, and area around the ear.

Other types of headaches or problems in the head may also lead to neck pain.

View Slideshow: 7 Types of Headaches

Diagnosing and Treating Neck Pain and Headache

Clinicians use information from the features of headache, physical examination, and diagnostic tests to make an accurate diagnosis of the type of headache. It is also possible for two headaches to occur together. Treatment of primary headaches include medications for both immediate relief and sustained relief (by preventing future attacks). Treatment of secondary headaches focuses on the underlying condition to control symptoms.

See Diagnosing Neck Pain

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When Is Headache and Neck Pain Serious?

Immediate medical attention is advised in neck pain and headache associated with one or more of the following symptoms:

• Pain and numbness radiating down one or both arms
• Stiff neck with high fever and/or headache
• Headache triggered by coughing, sneezing, running, bending, straining with a bowel movement, or Valsalva maneuver (attempt to expel air with the mouth shut and nostrils pinched tight)
• Seizures, slurred speech, loss of balance and blurry vision
• Unintended weight loss or nausea

See When Is a Stiff Neck Serious?

These symptoms may indicate serious underlying conditions such as aneurysms, meningitis, stroke, or tumor. Neck pain as a result of trauma to the base of the skull (such as from motor vehicle accidents or sports) must be considered as an emergency and treated without delay.

Dr. Zinovy Meyler is a physiatrist with over a decade of experience specializing in the non-surgical care of spine, muscle, and chronic pain conditions. He is the Co-Director of the Interventional Spine Program at the Princeton Spine and Joint Center.

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• Slideshow: 7 Types of Headaches

• Cervicogenic Headache Causes and Risk Factors

• Cervicogenic Headache Symptoms

• Surgical Options and Injections for Cervicogenic Headache

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Does drinking chocolate cause migraines?

Can chocolate cause migraines? What foods really have an impact on the occurrence of an attack?

Throbbing, often unilateral headaches that are aggravated by physical activity and are usually accompanied by nausea, increased sensitivity to light and noise, indicate migraine attacks. Millions of people suffer from excruciating headache attacks, hundreds of thousands of them cannot even leave the bed – the pain is so intense. There are many known triggers (triggers) that provoke the disease. And the fact that food can be a migraine trigger is evidenced by numerous studies. Doctors are especially distrustful of chocolate, red wine, cheese and citrus fruits, considering them to be the culprits of migraines. But is it possible to say with 100% certainty that these products are seizure provocateurs?

Hot dog headache and Chinese restaurant syndrome

People can actually be very sensitive to ingredients in food. Intolerance to histamine or tyramine proteins found in mature cheese or citrus fruits can affect pain. However, these are not migraine attacks, but secondary headaches caused by a certain substance. In addition to the headache, there are usually other complaints, such as gastrointestinal problems. The use of different nitrites, which are used to preserve sausages and meat, is also a possible cause. Doctors have even begun to use the term “hot dog headache” lately. After eating canned meat, some people may experience severe headaches.

Main migraine provocateurs

1. Glutamate. The flavor enhancer glutamate, which is often used in Asian dishes, causes in sensitive people, in addition to headaches, facial numbness or neck stiffness, abdominal pain, chest tightness, high blood pressure, and palpitations. This phenomenon is known as China Restaurant Syndrome. Symptoms begin 10-30 minutes after eating. Glutamate headaches can last for several hours. Glutamate possibly causes headaches due to over-activation of nerve cells in the brain. However, in controlled studies, the described symptoms could not be clearly attributed to glutamate consumption. Therefore, experts suspect that psychosomatic factors also sometimes play a role in severe physical reactions to certain ingredients. Most of all glutamate is found in semi-finished products, chips, soy sauces. In the list of ingredients, it will be listed as monosodium glutamate or E621.
2. Aspartame: An artificial sweetener found mainly in light and diet foods, many soft drinks and chewing gum. As early as 1989, American researchers found that headaches could be caused by a diet rich in aspartame. Currently, a study from Tel Aviv shows that chewing gum can trigger migraine attacks. If a migraine sufferer (and others) suddenly feels a headache after drinking sparkling water, they should avoid foods containing sweeteners such as aspartame. For him, they will be at risk.
3. Histamine. If your head starts to hurt after eating hard cheese or drinking a glass of wine, then histamine may be to blame. In addition to a headache, redness, rash, fatigue, dizziness, and digestive problems may appear. Other foods that contain a lot of histamine: jerky, nuts, tuna.

Expected pain. Is chocolate really that bad?

If a person expects to get a migraine attack from food, this may indeed happen. Just as positive expectations can make us feel better (the “placebo effect”), so too can fear make us feel worse. This is called the “nocebo effect” (in Latin, “I will be hurt”, “I will hurt myself”). Many migraine patients are convinced that after eating chocolate, they pay with a bout of pain. But some scholars believe that this impression is misleading. Cravings for sweet and high-calorie foods may precede an attack of pain and are already part of the attack. And snacking on chocolate itself doesn’t cause pain, it’s just the last, mostly fruitless, defensive response to a sugar deficiency in nerve cells. The desire to eat chocolate indicates the onset of a migraine attack, which would have happened anyway – even if the chocolate would not have been eaten.

Conclusion: no special diet needed for migraines

Experts believe that the effect of diet on migraines is, according to recent data, rather low. In general, sufficient fluid intake supports cerebral circulation and thus reduces the risk of pain. Whether certain dietary supplements can prevent a migraine attack remains unclear. In the past, many researchers believed that migraine was an allergic reaction to certain substances in food, but studies have not yet proven this. Eating regularly, based on complex carbohydrates and sufficient fluids, is the best defense against migraines.

Leaflet for the population on the prevention of enterovirus infections

Monday,
29
July
2019

memo

Enteroviral infections (EVI) are a group of acute diseases caused by enteroviruses, characterized by a variety of clinical manifestations from mild febrile conditions to severe meningitis. Enteroviruses are stable in the environment and can persist for a long time in wastewater, swimming pools, open water, household items, food (milk, fruits, vegetables). The virus quickly dies when heated, boiled. EVI is characterized by the rapid spread of the disease.

Seasonality – summer-autumn, often May-August.

Possible ways of transmission of infection: airborne, contact-household, food and water. Serous viral meningitis is the most typical and severe form of enterovirus infection.

The source of infection are patients and virus carriers, including patients with an asymptomatic form.

The disease begins acutely, with a rise in body temperature to 39-40 degrees. There is a severe headache, dizziness, vomiting, sometimes pain in the abdomen, back, convulsive syndrome, often pronounced catarrhal manifestations from the oropharynx, upper respiratory tract. If similar complaints appear, it is urgent to isolate the patient, because. it is a source of infection, for others, and consult a doctor.

Given the possible routes of transmission, personal prevention measures should include personal hygiene, drinking regimen (boiled water, bottled water), careful processing of consumed fruits and vegetables and subsequent rinsing with boiling water. You should avoid visiting mass events, places with a large number of people (public transport, cinemas, etc.). Wet cleaning of residential premises is recommended at least 2 times a day, ventilation of premises.

In no case should the child be allowed to visit an organized children’s group (school, preschool institutions) with any manifestations of the disease. At the first signs of the disease, you should immediately seek medical help, do not self-medicate!

Enteroviral meningitis

Enteroviral meningitis is a viral infectious disease characterized by fever, severe headaches, and vomiting.

The incubation period for enteroviral serous meningitis is on average about 1 week. City residents are more likely to get sick, mainly children under 7 years old who attend preschool institutions. Meningeal syndrome is usually benign, with improvement within a few days. Fatal outcomes are rare.

Serous meningitis is accompanied by fever, headaches, photophobia, and meningeal symptoms. The clinical picture of enteroviral meningitis largely depends on the age of the patients. Newborns and young children (up to 2 – 3 months) are in a special risk group. Enteroviral CNS damage at this age is usually part of a severe systemic disease. At the same time, serous meningitis and/or meningoencephalitis can be diagnosed in 27-62% of children with enterovirus infection. In the case of progressive development of systemic manifestations of infection, such as liver necrosis, myocarditis, necrotizing enterocolitis, intravascular coagulation, the disease resembles bacterial sepsis. The lethal outcome observed in some children is not associated with CNS damage, but is the result of acute liver failure (ECHO viruses) or myocarditis (Coxsackie viruses). In older children and adults, the disease of enteroviral meningitis begins acutely, with a sudden rise in temperature to 38 – 40 ° C. This is followed by the development of stiff neck, headaches, photophobia. Some patients have vomiting, loss of appetite, diarrhea, rash, pharyngitis, myalgia. The illness usually lasts less than one week. Many patients feel much better shortly after a lumbar puncture. Neurological symptoms associated with inflammation of the meninges in young children include neck stiffness and fontanel bulging. Symptoms may be blurred. The development of serous meningitis is often accompanied by such signs of the disease as fever, anxiety, poor sleep, skin rashes, rhinitis, diarrhea. In the case of a mild enterovirus infection, meningeal syndrome in children proceeds benignly and, as a rule, quickly, within 7–10 days, ends in complete recovery without residual effects. A spinal puncture has a beneficial effect on the course of serous meningitis, leading to a decrease in intracerebral pressure and contributing to a rapid improvement in the child’s condition.

The prognosis for children and adults who have had enteroviral meningitis is usually favorable. There are, however, indications that some children who have had enteroviral meningitis suffer from speech disorders and have difficulties in schooling. In adults, headaches may persist for several weeks after the infection.

Enteroviral meningitis can be caused by Coxsackie A and Coxsackie B, ECHO viruses, enteroviruses 68 and 71 serotypes, contain RNA. Epidemic outbreaks of serous meningitis with high contagiousness are possible. Predominantly affected children aged 5-9years. The incidence increases significantly in spring and summer.

Enteroviral infection in children. Symptoms and treatment

Enteroviral infections are a group of diseases caused by several types of viruses. The disease is caused by Coxsackieviruses, polioviruses and ECHO (ECHO). These viruses have in their structure a capsule and a nucleus containing RNA. The structure of the capsule can be very different, so the so-called serotypes (varieties) are isolated. There are 3 serological types of polioviruses. Viruses of the Coxsackie group are divided into Coxsackie A and Coxsackie B. Coxsackie A viruses have 24 serological varieties, Coxsackie B has 6. ECHO viruses have 34 serological types. After an enterovirus infection, persistent lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with an enterovirus infection several times in his life. Also, this feature does not allow the development of a vaccine to protect our children from this disease. The disease has a seasonality: outbreaks of the disease are most often observed in the summer-autumn period.

Causes of infection with enterovirus infection

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a carrier of the virus. Virus carriers do not have any manifestations of the disease, but the viruses are in the intestines and are excreted into the environment with feces. This condition can be observed in children who have been ill after a clinical recovery, or in children in whom the virus has entered the body, but could not cause the disease due to the strong immunity of the child. The virus carrier can persist for 5 months.

Once in the environment, viruses can persist for quite a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil; when frozen, they can survive for several years; heated to 45º C die in 45-60 seconds). Viruses tolerate changes in the pH of the environment well and feel great in an environment with a pH of 2.3 to 9.,4, therefore, the acidic environment of the stomach does not have any effect on them and the acid does not fulfill its protective function.

How enterovirus infection is transmitted

The transmission mechanism can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene is not followed. Most often, infection occurs through water, when drinking raw (not boiled) water. It is also possible to infect children through toys if children take them in their mouths. Most often, children aged 3 to 10 years are ill. In children who are breastfed, there is immunity in the body received from the mother through breast milk, however, this immunity is not stable and quickly disappears after the cessation of breastfeeding.

Symptoms of enterovirus infection

Viruses enter the body through the mouth or upper respiratory tract. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist the protective properties of the body), tropism (the tendency to infect individual tissues and organs) of the virus, and the state of the child’s immunity.

Enteroviral infections have both similar manifestations and different ones, depending on the species and serotype. The incubation period (the period from the virus entering the child’s body until the first clinical signs appear) is the same for all enterovirus infections – from 2 to 10 days (usually 2-5 days).

The disease begins acutely – with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature stays for 2-3 days, after which it decreases and stays at normal levels for 2-3 days, then rises again for 1-2 days and finally returns to normal. When the temperature rises, the child feels weakness, drowsiness, headache, nausea, and vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they may return. The cervical and submandibular lymph nodes also increase, as viruses multiply in them. Depending on which organs are most affected, there are several forms of enterovirus infection. Enteroviruses can affect: the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

With the defeat of the mucous membrane of the oropharynx, the development of enteroviral tonsillitis occurs. It is manifested by an increase in body temperature, general intoxication (weakness, headache, drowsiness) and the presence of a vesicular rash in the form of fluid-filled vesicles on the mucous membrane of the oropharynx and tonsils. These bubbles burst, and in their place ulcers are formed, filled with white bloom. After recovery, no traces remain at the site of the sores.

When the eyes are affected, conjunctivitis develops. It can be one- and two-sided. It manifests itself in the form of photophobia, lacrimation, redness and swelling of the eyes. There may be hemorrhages in the conjunctiva of the eye.

With muscle damage, myositis develops – muscle pain. Pain appears on the background of an increase in temperature. Soreness is observed in the chest, arms and legs. The appearance of pain in the muscles, as well as temperature, can be undulating. When the body temperature decreases, the pain decreases or disappears completely.

With damage to the intestinal mucosa, the presence of loose stools is observed. Stools of normal color (yellow or brown), liquid, without pathological (mucus, blood) impurities. The appearance of loose stools can be both against the background of an increase in temperature, and isolated (without an increase in body temperature).

Enteroviral infections can affect various parts of the heart. So, if the muscle layer is damaged, myocarditis develops, if the inner layer is damaged with capture of the heart valves, endocarditis develops, if the outer shell of the heart is damaged, pericarditis develops. The child may experience: increased fatigue, weakness, palpitations, drop in blood pressure, rhythm disturbances (blockade, extrasystoles), pain behind the sternum.

With damage to the nervous system, encephalitis, meningitis can develop. The child has: severe headache, nausea, vomiting, fever, convulsions, paresis and paralysis, loss of consciousness.

With liver damage, acute hepatitis develops. It is characterized by an increase in the liver, a feeling of heaviness in the right hypochondrium, pain in this place. Perhaps the appearance of nausea, heartburn, weakness, fever.

With skin lesions, exanthema may appear – hyperemia (red coloration) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the level of the skin, appears simultaneously.

An enterovirus infection is also observed with a skin manifestation in the form of a vesicular rash on the palms and feet. After 5-6 days, the bubbles are blown away without opening, and in their place a pigmentation area (brown dot) is formed, which disappears after 4-5 days.

Boys may have inflammation in the testicles with the development of orchitis. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (tonsillitis, loose stools, and others). The disease passes quite quickly and does not bear any consequences, however, in rare cases, the development of aspermia (lack of sperm) in adulthood is possible.

There are also congenital forms of enterovirus infection, when viruses enter the child’s body through the placenta from the mother. Usually, this condition has a benign course and is cured on its own, however, in some cases, an enterovirus infection can cause an abortion (miscarriage) and the development of a sudden death syndrome in a child (the death of a child occurs against the background of complete health).

Very rarely, damage to the kidneys, pancreas, lungs is possible. The defeat of various organs and systems can be observed both isolated and combined.

Diagnosis of enterovirus infection

The diagnosis of enterovirus infection is confirmed only by laboratory – the detection of enteroviruses or their ribonucleic acid (RNA) in sterile types of clinical material, as well as the detection of enteroviruses or their RNA in two samples of non-sterile clinical materials of different types.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics. The child is shown bed rest for the entire period of fever. Meals should be light, rich in proteins. A sufficient amount of liquid is needed: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Treatment is carried out symptomatically, depending on the manifestations of infection – tonsillitis, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis. In some cases (tonsillitis, diarrhea, conjunctivitis, etc.), bacterial complications are prevented.

Children are isolated from an organized team for the entire period of the disease. In the children’s team may be after the disappearance of all symptoms of the disease.

Prevention of enterovirus infection

For prevention, it is necessary to observe the rules of personal hygiene: wash hands after going to the toilet, walking on the street, drinking only boiled water or water from a factory bottle, it is unacceptable to use water from an open source (river, lake) to drink a child.

There is no specific vaccine against enterovirus infection, since a large number of serotypes of these viruses are present in the environment.