Headache – Drowning it down!

Headache is defined as any pain arising from the head, face or the upper neck and may be due to a variety of causes. Frequent headaches may affect the quality of life. It is advisable to consult a doctor though people often tend to self-treat with over-the-counter medicines. It may be a primary disease, or it may be secondary to some other underlying medical condition. They can vary in severity from an irritating dull ache to very excruciating and debilitating pain. It is imperative to find out and treat the underlying cause if any.

Headaches may be secondary to a variety of causes. Visual defects and the resulting eye strain can be relieved with a pair of prescription glasses. Those due to raised blood pressure or to glaucoma, a condition associated with increased pressure within the eyes, will necessitate appropriate medications. Dental causes of headache include caries teeth, impacted molars or inflammation of the jaw joint due to habitual grinding of teeth. These will need the attention of a dentist. Sinusitis is usually diagnosed with x-rays and relieved with medications or surgery. Irritation of cranial nerves can cause excruciating headaches, and the cure lies in detecting and removing the cause in the brain. Other curable neurological causes include brain tumours, brain abscesses, aneurysms, meningitis etc. This list is by no means exhaustive. The diagnosis of these dangerous and treatable causes is urgent and hence the necessity for obtaining early medical attention.

Migraine is essentially a diagnosis of exclusion based on symptoms, after ruling out the secondary headaches. There are no investigations to clinch the diagnosis of migraine. The usual symptoms include unilateral or rarely bilateral headaches associated with nausea, vomiting, dizziness etc. Migraine may have triggers, and these include bright sunlight, menstrual periods, fatigue, hunger, sleeplessness, alcohol, chocolate, coffee etc.Tension headaches, cluster headaches, vertiginous migraine, menstrual migraine etc. are a few of the examples in this grey spectrum. Typically, migraine sufferers find it difficult to tolerate bright sunlight or loud sounds. Treatment options include pain killers of various potencies to tide over, and as can be expected, there is no definite cure. Many of these medications have side effects and may be addictive, especially if overdosed.

I must confess that I was a patient of migraine myself a few years ago and suffered from severe, debilitating headaches. I underwent several investigations, including scanning and angiography of the blood vessels in my brain. As all the tests were negative, I was finally diagnosed as having a variant of migraine. I can well empathise with headache patients as I cannot forget the excruciating pain comparable to the crazy and rhythmic tapping of a sledgehammer within the skull. Though mostly kept in abeyance with medications, it troubled me at the most importunate of times. I dared not budge outside my home without medications.

I recall an incident, which though hilarious retrospectively, caused me some embarrassment. I had been to attend a conference on sleep disorders after taking a tablet for a splitting headache. I was soon snoring and nodding my head in sleep while in the very first row. The sedative side effect of the pill had taken over much to the chagrin of the organisers. Fortunately for me, these headaches are now in the past. I have not had a relapse for the last few years, and the medications in my purse have been safely disposed of.

I came across a deceptively simple treatment modality called ‘Water Therapy for Migraine’. One of the many theories for the cause of migraine is that of chronic dehydration, and drinking water has resulted in relief within thirty minutes to three hours. Though sceptical at first, I decided to try it, especially as it was safe, cheap and relatively effortless.  Two glasses of water at the aura stage- when the headache is kick-starting, and then a glass of water every hour, until the heaviness in the head settled, irrespective of whether one was thirsty or not.

There is a hypothesis that dehydration causes the brain to shrink and pull away from the skull, triggering a migraine. Probably the cause of several variants of migraine could be attributed to this theory. Many of my patients with intractable headaches have reported relief with this simple and cost-effective therapy. Not all of them were easily convinced initially, but most were willing to try it because of its simplicity. Of course, all relevant investigations to rule out the dangerous and treatable causes is a prerequisite.

I wish to share the experience of a telemedicine patient of mine, based in the United States. She was in the habit of taking one or more tablets of a drug belonging to the triptan class daily, for her debilitating headaches. Triptans are prescription medications with several side effects, and a dosage greater than twice a week is usually not recommended. These drugs are also habit-forming, and an excess of the drug can cause drug overuse headaches, kicking in a vicious cycle. The lady was at her wit’s end as she was unable to procure any further prescriptions for her ever-increasing need for the drug. Though she was initially sceptical, I managed to convince her to give water therapy a try. I reassured her that she could continue with triptans during the water therapy according to her need, and requested feedback.

Within a week, she had managed to reduce her dependence on the medications, and after about two months, she was jubilant. Now, she has dull aches on the rare occasions that she forgets to hydrate herself, and these are relieved with some water. Her progress has made her happy and free to travel without the burden of medications in her purse. Hope more and more chronic headache patients become aware of and benefit from this.

There is hardly any research on the usefulness of water therapy due to the lack of funds. Probably, not much profit is envisaged in the project by pharmaceutical companies. Until they manage to sell us the plain and humble water with the beguiling tagline – ‘containing all the goodness of bottled water’, let us drown our headaches with a few gulps from a tumbler.