Integrative Treatments of Headaches

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Integrative Treatments of
Headaches

• Marge Roberts, RN, BSN, MSHP, DAHom
• President/CEO, Newton Labs
• President/CEO, CAMA

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Objectives

• Discuss the differential diagnoses of headaches
• Describe a minimum of four categories of
  complementary treatments for headaches
  
• Discuss evidence based complementary therapies
• Discuss stress reduction approaches and strategies

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Why CAM?

• Decrease side effects of chemical drugs
• Other medical conditions limit drug use
• Inadequate response to drugs
• Have preference for non-drug therapy
• Client pregnant, nursing, planning pregnancy

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Diagnosis

• Headaches Requiring Immediate Medical Care
• Very severe headache , especially if it is
  unusual for the client
  
• Headache accompanied by stiff neck or high fever
• Headache that occurs after a head injury
• Headache accompanied by neurological signs such
  as seizure, weakness of a part of the body,
  visual disturbances, speech disorders, dizziness,
  etc.

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Diagnosis

• Vascular Irregularities
• Migraine
• Throbbing, pulsating
• Usually on one side with pressure behind one eye,
  may spread to other side
  
• During sleep/may awaken
• Worsens with normal activity
• Nausea, vomiting, light noise sensitivity,
  runny/stuffy nose, diarrhea, fatigue
  

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Diagnosis

• Vascular Irregularities
• Cluster
• Increases in intensity over 10-15 minutes
• On one side and doesnt switch sides
• Occurs daily/qod for weeks
• During sleep/may awaken
• Watery eyes, constricted pupils, droopy eyelids,
  forehead/face/eyes swollen, runny/stuffy nose
  

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Diagnosis

• Muscle Contractions
• Tension
• Dull, deep, steady pain
• On both sides, all over head, across forehead,
  temples, pain in back of neck
  
• Lasts for minutes or days
• Not worsened by activity
• No nausea/vomiting, sensitivity to light or noise
  (not both), tight muscles of neck, scalp, upper
  back, scalp back tender to touch

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Diagnosis

• Other
• Sinus
• Deep, steady pain
• Pain around eyes, cheekbones, forehead, bridge of
  nose
  
• Worsened by leaning over, sudden movement,
  exercising
  
• Fever, runny/stuffy nose, facial swelling,
  plugged ears, evidence of sinus infection

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Diagnosis

• Other
• Chronic Daily Headache (CDH)
• Transformed migraine
• Drug-induced
• Non drug-induced
• Chronic tension-type headache
• New daily persistent headache
• Post traumatic headache
• Caffeine Withdrawal Headache
• Monosodium glutamate-induced Headache

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Complementary Treatments for Headaches
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Homeopathy

• Discovered 200 years ago by Samuel Hahnemann
• Complete healing system with its own method of
  diagnosis own remedies
  
• Evaluate symptoms to establish appropriate
  remedies
  
• 1900s - accepted into U.S. medicine
• Decline with the advent of the AMA and
  introduction of fast-acting synthetic drugs

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Homeopathy

• Made from plant, animal, minerals
• Remedies natural prepared a specific way
  (dilution succussion)
  
• Regulated by FDA
• Theory of enzymatic or hormonal-like mode of
  action
  
• Second largest medical system in the world

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Headache

• All headaches are not created equal
• Covers 89 pages in J.T. Kents Repertory
• Subtle symptoms are observed
• Pulsating
• From stooping
• After sleep
• While walking

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Bryonia

• Bursting, splitting headache
• As if hit with a hammer from within
• Worse from stooping, motion, opening eyes, moving
  eyeballs
  
• Frontal headache frontal sinuses involved
• Pressing ,crushing, aching pain in eyes

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Nux vomica

• In occiput or over eyes
• Vertigo in morning and after dinner
• Congestive headache
• Scalp sensitive
• Photophobia
• Oversensitive

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Cimicifuga racemosa

• Shooting and throbbing after mental worry or
  over-study
  
• Wild feeling in brain
• Intense aching of eyeball
• Photophobia from artificial light
• Pain from eyes to top of head
• Opening and shutting sensation in brain

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Coffea cruda

• As if nail were driven into head
• Sensitive hearing
• Worse in open air
• Seems as if brain is torn to pieces
• Worse from noise, smells, narcotics

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Homeopathic Complexes

• Made from a selection of remedies
• Thought to be more effective in todays world due
  to changes in human condition
  
• Easier for the consumer to self-treat and the
  practitioner to advise
  
• Eliminates the need for having a variety of
  single remedies for one condition

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Hypnotherapy

• An artificially induced state characterized by a
  heightened receptivity to suggestion
  
• All hypnosis is self-hypnosis the client always
  enters hypnosis in a natural way, of his or her
  own accord A. M. Krasner, PH.D.
  
• Hypnotherapy induces a deep, multilevel
  relaxation, increases tolerance to adverse
  stimuli, eases anxiety, and enhances affirmative
  imagery. Gerard V. Sunnen, M.D.

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Brigham Womens Hospital

• 42 patients
• Chronic headaches
• Hx of poor response to conventional treatment
• Split in two groups hypnotherapy comparison
  group

• Hypnotherapy Group experienced reduced frequency
  and duration of headaches, cutting the intensity
  by 30
  
• Gutfeld, G. Rao, L. 1992

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Self-hypnosis in Children

• 28 children aged 6-12
• Migraine
• Compared propranolol, placebo, hypnotherapy
• Split into two groups
• Drug, placebo, self-hypnosis
• Placebo, drug, self-hypnosis

• Mean number of headaches
• 13.3 placebo
• 14.9 propranolol
• 5.8 self-hypnosis
• No significant change in severity

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Traditional Chinese Medicine

• Herbalism
• Exercise
• Acupuncture
• Acupressure
• Non-cauterizing laser
• Piazo-electrical current
• Moxibustion

• NIH Consensus Statement 1997
• Endorsed acupuncture as a complement to
  allopathic treatment for headache

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Traditional Chinese Medicine

• Acupuncture Points
• LI 4
• GV 16
• GB 20
• B 2

• Herbs
• Feverfew
• Exercise
• Tai Chi
• Qigong

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Aromatherapy

• Branch of herbal medicine
• Therapeutic effect
• Through smell
• Effect limbic system
• Through pharmacological properties
• Antibacterial, antiviral, antispasmodic,
  vasodilator, vasoconstrictor, diuretic

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Aromatherapy

• Lavender
• Analgesic, sedative, antispasmodic, vulnerary,
  antidepressant
  
• Roman Chamomile
• Analgesic, sedative, antispasmodic, vulnerary,
  stomachic
  
• Sweet Marjoram
• Analgesic, sedative, antispasmodic, vulnerary,
  vasodilator
  

• Eucalyptus
• Anti-inflammatory, antiviral, expectorant,
  decongestant, antispasmodic
  
• Spike Lavender
• Analgesic, decongestant, vulnerary
• Peppermint
• Analgesic, vasoconstrictor, anesthetic,
  antispasmodic, stimulant, decongestant
  
• Blue Chamomile
• Analgesic

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Stress Reduction Approaches

• Hydrotherapy
• Biofeedback
• Progressive muscle relaxation
• Yoga
• Massage

• Guided imagery
• Physical exercise
• Food choices
• Deep-breathing exercises
• Reflexology

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Implications for the Provider

• Not judging therapies/clients
• Drug interactions
• Honoring culture
• Need for that which is familiar
• History and data collection
• Encourage dialogue/self-reporting