Headaches are a widespread chronic Pain condition and are the most common reason for people to buy over-the-counter pain medications. Despite this, Headache science is slow-moving, with many scientists still learning about the reasons behind Headaches and why we have them in the first place. However, as the understanding of what causes headaches increases, so do the number of innovative therapies and treatments. That makes the study of the science of headaches incredibly important.
The basic science of headaches
Although headaches feel like pain inside the brain, they’re actually not. The brain doesn’t have any pain receptors, so the brain isn’t able to experience pain. As Dawn A. Marcus, with Scientific American explains:
“Interestingly, brain tissue does not feel pain in the same way skin or other organs do. Because the brain is encased in a hard, protective covering, it has not developed to respond to touch or pressure sensations like other, more exposed parts of our bodies have. Indeed, a brain surgeon can actually cut brain tissue in an awake patient without the patient feeling the knife.”
Headache pain that feels like it’s occurring in the brain then is actually the result of damage to the surrounding structures, like the nerves, blood vessels, muscles, or sensory organs. The damage to these structures can result from injury, inflammation, or disease.
For example, if the sinus cavities are inflamed and painful, the nerves there may relay that information to the brain. The brain will interpret this information as pain within the brain itself, so even though the source of the pain is outside the brain, it can feel like the pain is originating inside the brain.
Some headaches, particularly tension-type headaches, might also be caused by eyestrain, anxiety, stress, sleep deprivation, or jaw problems. Therefore, tension-type headaches aren’t associated with a specific nerve or nerve cluster. Rather, the associated nerve or nerve cluster for a tension-type headache is dependent on which muscle group is undergoing extreme strain, which leads to the headache.
The following video discusses headache science in more detail. It also gives a brief overview of the causes and types of headaches.
New research into headache science
New headache research is constantly uncovering some pretty amazing things when it comes to headaches. It’s now known for example that the human biological clock – and, by extension, headaches – are tied to the earth’s rotation. Many people experience more headaches, particularly cluster headaches, during the summer months. The seasonality of cluster headaches can sometimes lead to a misdiagnosis of sinus headaches that accompany summer allergies.
Other people may experience severe headaches on the longest and shortest days of the year. Because these days are so far apart, it can make it very difficult to reach a correct diagnosis or to obtain the correct treatments.
Likewise, many headaches are caused by hormonal changes, especially in women. As ScienceDaily reports:
“A large percentage of headaches among females are caused by ever-fluctuating estrogen during menstrual years. This can occur prior to, during or even midcycle menstruation.”
You can keep up with the latest headache science on Science Daily, with new reports coming out from scientists all over the world daily. Recent articles have considered causes of headaches related to the number of microbes in a person’s mouth or vitamin deficiencies. You can even set up email alerts so you get the latest news sent directly to your inbox.
The science of headaches and neuroplasticity
Other headache science research is focusing on the relationship between neuroplasticity and chronic headaches. Neuroplasticity is the brain’s ability to change with experience and use. For instance, the first time a person sits down at a keyboard, he or she will type very slowly, because he or she will have to look for each key. Over time, thanks to neuroplasticity, this person will learn where the keys are and be able to type quickly without looking at the keyboard.
Researchers at the University of Adelaide conducted a study on neuroplasticity. People without any sort of chronic pain began to carry out a simple task (moving the thumb in a certain direction) more quickly over time, signaling a neuroplastic change in the brain. However, people with chronic pain (including chronic headache pain) didn’t get faster over time. This indicates that chronic pain can impair neuroplasticity. The results of this study, according to its lead author, could give researchers a novel insight into pain that could lead to novel, targeted treatments.
New surgical techniques to treat chronic headaches
Several plastic surgeons are also developing surgical techniques that help treat chronic headaches. Dr. Bahman Guyuron, American Society of Plastic Surgeons (ASPS) member and surgeon at Case Western Reserve University in Cleveland, developed a headache treatment that grew out of a fairly simple observation. Dr. Guyuron noticed that several migraine headache patients had improved headaches after a cosmetic forehead-lift.
As a result of this, Dr. Guyuron developed migraine surgeries that “deactivate” bundles of nerves that trigger migraines. A Botox injection, which paralyzes nerves and provides temporary relief from migraines, is first applied to make sure the correct triggering nerves have been identified. Overall, these surgeries have been largely successful, with approximately 88% of patients experiencing an improved quality of life after surgery.
Recently, Dr. Guyuron conducted another study comparing samples of triggering nerves with nerves from people without migraines. The nerves belonging to people with chronic migraines were indeed different. The myelin sheath, which surrounds and protects nerves in much the same way that plastic insulation material surrounds and protects electric wires, was damaged on the nerves of people with migraines. This both explains why the surgeries are successful and opens the door to future, less-invasive treatments that focus on rebuilding the myelin sheath around nerves.
Another team of headache science surgeons at the Louisiana State University Health Sciences Center has developed a surgery on the eyelids that can reduce headaches. The triggering nerves are identified with Botox injections, and the surgeon accesses and decompresses the nerves through the upper eyelid. This technique is more accessible, requiring less specialized equipment and training, and also provides patients with a bonus cosmetic eyelid surgery. Patients were selected carefully to make sure they were good candidates for the surgery. Over 90% of patients in the study experienced positive results.
Research into migraine science
Finally, migraines are a form of headache that require even more research given their severe and chronic nature. And, the science of headaches is exact when it comes to migraines. As Gizmodo explains:
“For your doctor to diagnose you with having migraines, and as such be treated with medications for them,your headache must meet the following criteria: you must have at least 5 attacks per year that all have the same presentation; the headache last 4-72 hours; be associated with nausea and/or vomiting; and come with photophobia (intolerance to light) or phonophobia (intolerance to sound). The pain associated with your headache must also meet some criteria: it should only be on one side of your head; have a pulsating quality that is moderate or severe; and is aggravated, or causes the avoidance of, physical activity.”
Our video on the topic covers these four phases in more detail. To read more about the science of migraines, check out Science’s coverage of the topic.
So, what does headache science say about treatment?
First, the science of headaches is ever-evolving which means that treating chronic headaches of any type or category can be difficult. But it will become more focused and refined with the more headache science is published.
What we do know is that the first step in headache treatment is at-home remedies to reduce stress and tension. This is particularly appropriate with tension headaches. Lifestyle changes that have been shown to be particularly effective in treating this pain include:
- Dietary modifications
- Drinking enough water
Secondary to that is tracking your symptoms. As new headache science shows, there are seasonal variations that can influence headache severity. To see if that’s causing your head pain, or if dietary or environmental causes are behind your pain, the best thing you can start doing today is tracking your symptoms. Click here to read the research behind tracking, and to get some recommendations for the best tracking apps you can use.
If lifestyle modifications haven’t worked, your next course of treatment will be over-the-counter pain medications, such as ibuprofen or acetaminophen.
If those don’t work, talk to your doctor about the next stage of treatment. This might include prescription pain medications, some of the more cutting-edge therapies we’ve listed above, or injections.
An injection to treat headache pain can act both as a diagnostic tool and as a treatment. If an injection to a specific nerve provides pain relief, it’s certain that that particular nerve was behind the painful headaches. Steroids, analgesics, or Botox might be considered as injectable medications to relieve nerve-related headache pain.
Alternative treatments can be useful sometimes, too. Acupuncture and chiropractic adjustment might be able to provide relief. Biofeedback is a method of therapy that involves visualizing the effects of stress and tension and learning to relax and control headache triggers.
Have you ever considered a new, innovative treatment for your chronic headaches? What fascinating studies have you learned about from the science of headaches? If you want to talk to a doctor today about your options for reducing your headache pain, click the button below.
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