Fibromyalgia

See your doctor, this information is educational. This is intended to complement conventional medicine, not to replace it.

What is fibromyalgia? There has been much confusion about this condition in part

because it has been given many names. It used to be called fibrositis, or myofascial

pain, myofascial pain syndrome, psychogenic rheumatism, fibromyositis,

myofasciitis, tensionmyalgia, or psychological muscle disorder.

Chronic muscular pain is just one facet of this syndrome; it runs much deeper than

just sore and aching muscles or joints. Just living with gravity and our modern day

stress can cause much of the soreness and muscle tension that most people

experience. However, when we have the condition of fibromyalgia, or myofascial

pain syndrome, all of the stress and tension is intensified ten-fold.

The chronic pain can be regional, myofascial pain syndrome (in the connective

tissue or muscles) or widespread fibromyalgia with overall aches and pains

accompanied by neurological and other problems. The condition can be very severe

and has many faces.

Since mostly women suffer from fibromyalgia, most experts think it is connected to

the hormone estrogen. It could be an estrogen insufficiency or certain hormonal

changes that affect the muscle pain. It's usually found in women over thirty.

I have never heard of males with this condition in my thirty years of experience. I

have known only a few women that actually were diagnosed with this condition.

The pain of fibromyalgia is different in every individual and has no limits;

sometimes it's a dull pain and other times sharp. It can be numbness on the

surface of the skin or deep, muscular aching that is dull, shooting, burning,

throbbing or stabbing, sharp pain. Most often, the pain and stiffness are worse in

the morning, and it's not unusual to hurt in the muscle groups that are used more

often: upper neck, shoulders, low back, hips, and legs. In fact, often every joint may

hurt. Here again it varies with the person. Their activities or jobs, as well as their

mechanical postures, can dictate where they will suffer most.

The Chronic fatigue has been described as "feeling unmotivated" or "having mental

fatigue." Some patients told me if they could get the strength to get out of bed then

they could deal with the rest of the day.

Chronic Headaches Recurrent migraine or tension type headaches are seen in about

50-60% of fibromyalgia patients and can pose a major problem. Just dealing with

the daily activities of life can be a struggle for these patients.

Most have a sleep disorder called the alpha-EEG anomaly. This means that they

don't get to the deeper levels of sleep and they are constantly interrupted by

awakening brain activity. Thus, when they wake up they feel that they didn't get any

rest and the body did not get a chance to recover. This condition creates added

stress, which keeps them in the vicious cycle. One of my patients said she felt like

she'd been run over by a truck when she got up every morning. Another one is

Myoclonus or PLMS (nighttime jerking of the arms and legs), restless leg syndrome,

and bruxism (teeth grinding).

Temperomandibular Joint Dysfunction Syndrome (TMJ) is connected with the

headaches or face pain in 25-30% of FMS patients. Research indicates that

as many as 90% of fibromyalgia patients may have jaw and facial tenderness that

could produce the same symptoms of TMJ.

Irritable Bowel Syndrome (IBS) It's common for many of these women to have bowel

problems, constipation or diarrhea. Frequent abdominal or chest pain is also not

uncommon. These symptoms are found in 60% to 70% of fibromyalgia patients,

according to the research, in addition to PMS and painful menstrual periods

(dysmenorrhea).

Other common symptoms include muscle numbness and or tingling sensations;

muscle twitching; swollen extremities, dry skin or skin sensitivity, dry eyes and

mouth; dizziness and impaired coordination. Often patients experience sensitivity to

weather or wind, rain, and changes in temperature. Hormonal fluctuations

(premenstrual and menopausal states), depression, anxiety and overexertion can all

contribute to symptom flare-ups.

The holistic approach seeks to approach the problem on all levels-- mental,

nutritional, and physical. Each aspect of these problems needs a specific modality or

therapy. We recommend the use of conventional medicine with nutritional, herbal,

biochemical nutrients, bio-mechanical body therapy, and mind-body methods

designed to enhance the body's own natural healing systems.

We know that the best way to approach a vague disease is to use conventional

holistic practices such as good nutrition, lower fat intake (especially the saturated

fats), less sugar and fewer junk foods. Increase water intake for flushing the system

and increase intake of anti-oxidants Vitamins C, E, beta carotene, and a good multi-

vitamin, with increased doses of cell salts and selenium. Some medical experts say

phosphatigylserine, which is a lipid (fat processor) and gingko biloba can also help

ease the condition. Also, adding fish oil capsules.

From a natural perspective, GABA itself is available from the health food stores over

the counter. Again, I just want to caution anyone self-medicating, even with natural

substances.

Magnesium-calcium and selenium supplements also may help by acting on some of

the same neural and muscle receptor sites that GABA influences.

About 80% of our chronic pain patients are deficient in magnesium. That's because

physical pain (and also mental anguish) cause the muscles to overwork and the

muscles use up much more magnesium than normal. This is a reason why many

athletes need extra magnesium as well.

Ironically, the muscles really need that magnesium to function and not having

enough of it increases muscle spasm and pain, as well as the general vulnerability to

stressful stimuli such as loud noises, chemicals, and emotional distress. So this

hyper-sensitivity puts people in that kind of vicious cycle.

Many of these patients have hypoglycemia or blood sugar control problems as well.

This is normally due to the stress of their illness on the glucose/insulin system.

Excess stress causes the body to be on high alert. Consequently, the dietary

guidelines described above could be very helpful in conjunction with a few quick

and helpful nutritional tricks. A small supplementation of olive oil, chromium, or

glutamine can usually reverse this common complication.

Natural remedies to help sleep are valerian root, 5-hydroxy tryptophan, passion

flower, GABA, and melatonin. Relaxation or meditation training and other natural

approaches can do much to restore good sleep. This is a bit more complicated than

it sounds; we advise that you consult with a professional. Of course, some

medicines can also help with sleep as long as care is taken to not create a habit or

dependence on these drugs. Reducing alcohol as well as reducing caffeine and

sugar will help the body sleep better.

The most interesting recent research is that the kinds of medicine that work best for

fibromyalgia and myofascial pain are not the traditional narcotic pain suppressors

such as vicodine, codeine, or the highly potent, non-steroidal, anti-inflammatory

medicines such as Celebrex or muscle relaxers such as Flexeril.

The best medicines acrording to Dr. Podell to use instead are those that act on our

nervous system and neurochemistry to reduce and reverse allodynia, the body's

abnormal increased sensitivity to that pain.

The most surprising news is that many of the best new medicines are actually old

standbys that have been used for many years for other conditions. Because of the

complexity of fibromyalgia, we are just re-discovering the beneficial effects for

helping the neuro-chemistry. Some of the common medicines used are Baclofen,

Elavil, Flexeril, Gabatril, Klonopin, Neurontin, Paxil, Sinequan, Serzone, Xanax, and

Zofran.

The above medications, of course, can cause some side effects in some people, so

see your doctor for any questions you may have.

Biochemistry and Metabolism

Since every body is very individual there are laboratories specializing in diagnosis

that can help us detect metabolic imbalances and dysfunctions.

1. Essential fatty acid analysis which often shows a deficiency of omega-3 essential

fatty acids. Certain amino acids analysis often shows a deficiency of the chain

relationship of amino acids, with glutamine, taurine, tryptophan or tyrosine being

the most common.

2. Other theories pertaining to alterations in neurotransmitters like serotonin and

nor epinephrine. As mentioned before, substance P has an immune system function.

Substance P is a pain neurotransmitter that has been found by repeat studies to be

elevated three-fold in the spinal fluid of fibromyalgia patients. Two hormones that

have been shown to be abnormal are cortisol and growth hormone (HGH).

3. A comprehensive digestive and stool analysis can point to digestive enzyme

deficiencies, yeast, candida or Epstein-Barr, bacterial overgrowth, or even parasites,

which most people will have. The key is your immune system can usually handle it

and when it can't then you succumb to worse problems.

I feel that enhancing or strengthening the immune system is the best way to

improve health with any disease.

4. Food allergies can be tested for as well or detected by going on an elimination

diet. "Sensitive" food allergies can be identified that can make pain symptoms

worse. Be careful with cleansing diets as I have found most people need building

foods first due to poor eating habits. Urine tests for milk- or wheat-derived opioid

peptides can pinpoint digestive abnormalities that lead to toxic by products. We

have found most people are allergic to dairy products as well as to gluten found in

wheat products.

5. We used to do hair analysis or DMSA provoked urine testing to detect high levels

of toxic metals like mercury or lead. Now we have many other systems for

diagnosing and finding problems of that nature.

6. Checking the liver functions and enzyme levels is another way to find problems

as the liver is a key organ for cleansing the body.

7. Ordering a screening T4/TSH is a good first approach as well. Many of the

symptoms of fibromyalgia mimic hypothyroid muscular disease. Your doctor should

order a screening thyroid test as part of the initial workup of fibromyalgia.

8. Checking for hyperthyroid is also done quite easily in the laboratory. Just make

sure you are working with someone that takes the time to eliminate other potential

problems that could appear as FMS.

Body-Therapy and Mind-Body Therapies

Great relief may come with just getting massage, however, it can also aggravate

your condition so usually gentle massage is recommended and not deep tissue

work. One of the best techniques for these painful bands is DTF (Deep Transverse

Friction), made popular by Dr. James Cyriax. You should see a professional massage

therapist trained in this technique.

Trigger point therapy is another technique that helps reduce the stress in the

tissues and also should be done with great care. As you will find, within these taut

bands of muscle are extraordinarily sensitive pain points.

There is in the realm of body-mind techniques several that have proven effective in

neurological balancing. The most popular and widely used are Traggering and

Feldenkrais created by two extraordinary people who were pioneers in body-mind

therapy. Milton Tragger was an M.D., a neurosurgeon who created a movement type

of treatment that is gentle and achieves deep levels of relaxation through rocking

motions. He was a friend and I got to know him in Honolulu and experience his

work directly. We exchanged a few sessions with each other. It is very great, gentle

system of work, soothing to the nervous system.

Feldenkrais was once associated with Ida Rolf, the mother of Rolfing. Rather than

doing deep body work on the fasciae like Rolfing, Feldenkrais worked with certain

body postures and movements to free up the patterns in the body since it often falls

into poor posture and pain. Using movement and re-education of the body was his

approach. His theory was to break up the neurological patterns of pain and

restrictive movement.

There are a few others that are similar: Aston patterning, Alexander Technique, and

certain types of polarity therapy can all be helpful. Often it's not the technique as

much as the belief of the effectiveness of the therapy by the patient.

More Mind Techniques

Of course, one of the best mental treatments for chronic pain and chronic illness,

which takes a psychological toll on the mind as well as the body, is bio-feedback

training, or some kind of relaxation or meditation techniques. These systems have

been around for thousands of years, and only in their application do we think they

are new.

There is a very useful technique call Neuro-Linguistic Programming or NLP, another

mental tool that changes the physiology by focusing on a positive new pattern

rather than on the old problem. And all of Tony Robinson's work is very powerful for

transformations. I was lucky to have met him in the old days when I gave him a

treatment and took all his seminars.

Just good old-fashioned deep breathing can do wonders for the pain and the stress

level of any individual. Yoga and all the many forms of movement as we talked

about before, tai chi or ballroom dancing, for anyone for that matter, may be

helpful.

What To Do If You Have FMS

In the long term, the most important thing you need to understand is that the first

step is to understanding your fibromyalgia syndrome. We know that it can be

chronic, but the symptoms or your episodes may flare up - or mellow out. This, we

feel, can depend on your stress level, as well as what you have been doing to work

on improving your condition. The impact that FMS has on daily living as well as

activities is going to be different with each individual. It is commonly accepted that

FMS can be as serious as rheumatoid arthritis in disabling people from working

fulltime jobs.

Many patients have felt helpless or hopeless, and generally get very little relief or

poor results. We must remember the best results come from using all the tools and

methods available. It takes knowledgeable people as well as your commitment to

becoming informed to begin getting better. Know that FMS is not a life-threatening

disorder, although we can't say it's harmless. Some on the far end of the spectrum

may feel like they can't live like this, but on the other side, some people can do well

and live a good life.

Get your doctor to do the laboratory tests to rule out other possible maladies that

can overlap or appear as FMS. One is hypothyroidism; it can be over-diagnosed but

most commonly it's misdiagnosed. Fibromyalgia patients must have a good and

thorough clinical diagnosis. Qualified medical doctors or osteopaths must make this

diagnosis and ideally rule out other possibilities.

This disease can be confused with or be similar to MS (multiple sclerosis), lupus,

osteoarthritis, rheumatoid arthritis, and even heart problems. You may have TMJ

(temperomandibular joint syndrome), candida, Epstein-Barr syndrome, or CFS

(chronic fatigue syndrome), or even Lou Gehrig's disease, a brain tumor, spine

disease or a whole bunch of other problems. The only way to know it's FMS is to

rule out some of these others, and only a qualified medical or osteopathic doctor

can do this.

Fibromyalgia Network for a listing of patient contacts and physician referrals.

www.fibromyalgia.com The phone number is: (800) 853-2929.

For Othon see http://www.molinamassage.com for more information and other

articles.

May health be with you in all ways. . .

Othon Molina Ph.d. c LMT has been involved in the health field as a manual therapist and personal trainer for over thirty five years. He has studied with some of the top doctors and healers of our times. His specialty is treating sports injuries, back problems, and teaching others how to improve their health or athletic competition using nutrition and fitness technologies.

One of his specialties is Kinesiology, and sports training. He has been a runner all his life, and competed in many triathlons, 5k's, 10k's and marathons. Competing at an elite level gave him the experience to help train others. Recently he coached and worked with the female champion of the German team of triathletes.

Some of his clients include: Bob Hope, Jane Seymor, Essam Kashoggy, Jim Nabors, Tony Robbins, Mark Victor Hansen, Carol Burnett, San Francisco Ballet, Allvin Alley Dance troupe, some of the top Olympic and international elite athletes, team doc and new trainer for the German professional triathletes. He also trains massage teams as well as health professionals worldwide.

Headache Types and Treatment Options

What is headache?

Headache is a term used to describe aching or pain that occurs in one or more areas of the head, face, mouth, or neck. Headache involves the network of nerve fibers in the tissues, muscles, and blood vessels located in the head and at the base of the skull.

Almost everyone has occasional headaches, especially when they are sick, tired or otherwise under stress. Headache is the result of pain signals caused by interactions between the brain, blood vessels, and surrounding nerves. During a headache, the pain comes not from the brain. It comes from specific nerves surrounding the skull, head muscles, and blood vessels that are activated and send pain signals, interpreted by the brain as a headache. The reasons why these nerves are activated are not clearly understood. Most headaches go away on their own or are easily treated with over the counter (OTC) drugs.

Headache types

There are two main categories of headache: primary and secondary.

The major types of primary headaches include:

• Tension headache



• Cluster headache



• Migraine

Primary headaches are not caused by other underlying medical conditions. More than 90% of headaches are primary.

Secondary

Secondary headaches result from other medical conditions, such as cerebrovascular disease, head trauma, infection, tumor, and metabolic disorder. These account for fewer than 10% of all headaches. Head pain also can result from syndromes involving the eyes, ears, neck, teeth, or sinuses. In these cases, the underlying condition must be diagnosed and treated. Also, certain types of medication produce headache as a side effect.

Many people have occasional headaches that get better on their own or go away with OTC drug treatment. Most of these people never see a healthcare provider for their headaches, however, there are several circumstances in which an evaluation by a physician may be useful or important:

• Headaches that are getting worse over time



• Severe headaches that start suddenly



• Headaches that start after a head injury



• Headaches that always occur on the same side of the head



• Headaches that are not responding to treatment



• Severe headaches that interrupt work or the enjoyment of daily activities



• Daily headaches



• Aggravated by exertion, coughing, bending, or sexual activity

Tension Headache

Tension headaches are the most common type of headaches. They affect up to 75% of all headache sufferers. Tension headache is usually episodic but may be chronic, occurring daily or almost daily for more than 15 days a month. This type of headache is linked with tension in neck and scalp muscles, affecting blood flow within the skull.

Tension headaches often start in the afternoon or early evening. The pain is typically on both sides of the head, pressing or tightening. Some people get tension headaches in response to stressful events. Tension headaches usually do not get worse with physical activity (such as walking or climbing stairs).

Treatment

The occasional tension headache can be alleviated by a hot shower, massage, sleep, and through patient recognition and avoidance of stress factors.

For episodic tension headaches that occur less than three times per week, OTC pain relievers such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are convenient and effective. Combination products of pain medication with caffeine may help some people, but also may be habit forming. Use of any OTC pain reliever should be limited to no more than two or three days per week. If pain medications are overused, rebound headaches may occur on the days that medications are not taken.

Chronic tension headaches are more difficult to treat, because rebound headaches are common when pain relievers are stopped. The most effective medications for treatment of chronic tension headaches are tricyclic antidepressants (amitriptyline HCl, doxepin HCl, nortriptyline HCl). However, it is often more effective to prevent these headaches than to treat them.

Some people are able to treat their tension headaches without medications. An ice compress, a heating pad or a massage to any tight areas in the neck and shoulders can be extremely helpful. Relaxation techniques, such as deep breathing exercises or acupuncture, may help to decrease the frequency of headaches.

Cluster Headache

Cluster headaches are relatively rare, affecting about 1% of the population. They are distinct from migraine and tension headaches. Cluster headaches primarily affect men between the ages of 20 and 40. Attacks usually occur in a series, or "clusters" of 1 - 8 headaches per day over a period of several weeks to months. The pain is extremely severe but the attack is brief, lasting 15 minutes to 3 hours. The pain of cluster headache almost always occurs on one side of the head. During cluster headaches, the eye on the same side as the pain may become teary or droopy or develop a small pupil. There may also be nasal congestion on the affected side of the face.

About 80% of cluster headaches occur at night, and in about 70% of patients, drinking alcohol can trigger a cluster headache. Unlike migraine sufferers, those with cluster headache often feel better if they keep moving during the headache.

Treatment

It is difficult to stop the pain of a cluster headache that is in progress, because the headache usually disappears by the time the patient reaches the emergency room or doctor's office. Because the onset of cluster headache attacks is rapid and may occur several times a day, the best approach to treatment is with daily preventive drugs to decrease the severity and frequency of headaches. Lithium (Carbolith, Duralith, Lithane, Lithobid, Lithonate and others) and Verapamil (Isoptin, Calan, Chronovera, Verelan, Novo-Veramil) are the two drugs that are most effective at accomplishing this. Other drugs used for this purpose include prednisone (Deltasone, Meticorten, Orasone 1, Winpred and others), cyproheptadine (Periactin) and methysergide (Sansert). Prophylactic medications usually are begun early during a cycle of cluster headaches and continued for two weeks longer than the usual cycle.

Abortive treatments include inhalation of 100% oxygen. Inhaling 100% oxygen for about 15 minutes through a facemask has proven to be helpful when it is done at the first signs of an attack. This oxygen must be prescribed by a doctor and obtained through a medical supplier. Other types of drugs that may be effective when used at the outset of cluster pain include the triptans (Imitrex, Maxalt, Zomig, Axert, Amerge), ergotamine (Cafergot) and indomethacin (Indocin).

Migraine Headache

Migraine headaches are less common than tension headaches. About 6% of all men and 18% of all women experience a migraine headache at some time. Migraine headache occurs on one or both sides of the head. The pain is typically pulsating or throbbing in nature. Nausea, with or without vomiting, as well as sensitivity to light and sound often accompany migraines. Migraines are made worse by activity, bright lights and bright noises. In most cases, migraine attacks are occasional, or sometimes as often as once or twice a week, but not daily. Women who have migraines often find that their headaches occur or worsen around the time of their menstrual periods.

One unique feature of migraines is an unusual sensation that a migraine is about to occur. This sensation is called a prodrome. Prodrome symptoms can include fatigue, hunger and nervousness. Not all people who get migraines have prodromes.

An aura is a complex of neurological symptoms that occur just before or at the onset of migraine headache. An aura involves a disturbance in vision that may consist of brightly colored or blinking lights in a pattern that moves across the field of vision. Most patients with migraine have attacks without aura. About one in five migraine sufferers experiences an aura.

Treatment

How your migraines are treated will depend on the frequency and severity of attacks. People who have a headache several times per year often respond well to nonprescription pain relievers.

There are two types of medications to treat migraines:

• abortive medications - drugs that are taken when a headache starts



• preventive medications - drugs that are taken every day to prevent migraines

Abortive Medications

Migraine-specific abortive medications usually are necessary for moderate to severe migraine headaches. When possible, an abortive medication should be taken immediately after an aura or migraine headache starts. However overusing abortive medications can lead to chronic headaches, that occur day after day without a specific cause or diagnosis. Several prescription and nonprescription drugs are used as abortive medications: aspirin, ibuprofen (Advil, Apsifen, Motrin, Nuprin and other brand names) or naproxen (Aleve, Anaprox, Naprosyn)

Effective agents available by prescription include:

• Triptans - sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig) and rizatriptan (Maxalt). Triptan drugs are effective in 60% to 65% of patients, completely or significantly relieving migraine pain and associated symptoms within 2 hours of administration. Triptans reduce inflammation and constrict the blood vessels. The triptan with the longest history of use is sumatriptan (Imitrex).



• Ergots - sublingual ergotamine (Ergomar) and dihydroergotamine (Migranal). Ergots cause constriction of blood vessels, but ergots tend to cause more constriction of vessels in the heart and other parts of the body than the triptans, and their effects on the heart are more prolonged than the triptans. Ergots are not as safe as the triptans.



• Midrin. It is a combination of isometheptene (a blood vessel constrictor), acetaminophen (a pain reliever), and dichloralphenazone (a mild sedative)

Preventive Medications

Preventive medication are prescribed when migraine attacks that don't respond well to abortive medications or adverse reactions to abortive medications occur, migraine attacks occur too often, complicated migraines. Many drugs are listed as potentially useful to prevent recurrent migraine attacks. The drugs in the following classes are useful to prevent recurrent migraine attacks:

• Beta-blockers. Propranolol (Inderal) and nadolol (Corgard) have a good track record of being safe and effective. Metoprolol (Lopressor) and atenolol (Tenormin) are reasonable alternatives. Beta-blockers have been used for many years to prevent migraine headaches. It is not known how beta-blockers prevent migraine headaches.



• Tricyclic antidepressants. These medications are very effective, but often have troublesome side effects such as sedation, blurred vision, dry mouth and constipation. The first choice is often amitriptyline (Elavil). Nortriptyline (Pamelor, Aventyl), doxepin (Sinequan), imipramine (Tofranil) also can be tried.



• Anticonvulsants. Of the drugs in this class, valproate (Depakote, Epival) has the best evidence to support using it for prevention. Gabapentin (Neurontin) and topiramate (Topamax) also are effective. It is not known how anticonvulsants work to prevent migraine headaches.



• Serotonin antagonists. Methysergide (Sansert) has been available for many years and is very effective. Methysergide prevents migraine headaches by constricting blood vessels and reducing inflammation of the blood vessels. However, this medication has side effects that are potentially very serious and therefore is not widely used.

Rebound Headache

Increasing headache over time with repeated use of pain medicines can lead to a rebound headache. The headache is typically located on both sides of the head and is described as a pressing or tightening type of pain. When headache sufferers use too much pain medicine, their headaches often recur. This leads to a repeated cycle of taking more medicines and still having headaches. Rebound headache may appear if:

• taking analgesics on 15 or more days per month for more than 3 months



• taking opioid or combination medication 10 or more days per month for more than 3 months

When analgesics are discontinued, the headache may get worse for several days and it may take up to 30 days to recover from the rebound process. Non-drug approaches, such as biofeedback, relaxation therapy, and exercise, can be helpful in reducing both headache frequency and need for medication.

Headache Triggers

Triggers are not direct causes of the headache, but they facilitate or provoke the beginning of an attack. Anything that stimulates the pain receptors in the head and neck can cause a headache. Some of the more common triggers for headache:

• Emotional triggers: problems at work, success at work or school, anticipation, anxiety, an emotional crisis, a new job. Emotions can bring on headaches, keep them going, and make them worse. Emotions don't cause your headaches, they just make you more vulnerable to them.



• Environmental triggers: bright light, different kinds of aromas like perfume, tobacco, odors (such as gasoline), loud noises, altitude, barometric pressure changes.



• Stress triggers: strenuous exercise, excessive physical work at the work place or at school, physical sickness, not enough sleep or too much sleep



• Chemical triggers: changes in hormone levels (that occur during the premenstrual period, during the post-menstrual period), low blood sugar.



• Food and beverage triggers: caffeine, alcohol (especially red wine), hard cheese, vinegar, hot dogs, chocolate, nuts, MSG (monosodium glutamate), pizza, pork. Foods containing nitrites as preservatives can also trigger headaches. Fasting or missing meals is a major headache trigger.



• Changes in the weather can change body chemistry, and have been known to trigger headaches.



• Heavy cigarette smoking.

Yury Bayarski is the author of Price-RX.com - a prescription drug price comparison website. Please follow this link if you would like to read more about headache relief prescription drugs.

Chronic Headaches and Pain Alleviated by Dentistry

You may not immediately think of your dentist the next time you suffer from a migraine, but you might be surprised to know that there are many causes of headache, face, neck and shoulder pain that can be relieved by dental treatments. If this is not something you've tried, consider scheduling a consultation to find out if you suffer from temporomandibular joint disorder, a condition in which the upper and lower teeth are misaligned, causing muscle contractions in the jaw joint that lead to tension and pain.

A number of treatment options are available, depending on the cause of your pain. For example, you may not know it, but you might be clenching and unclenching your teeth many times throughout the day or night. This can wear down your teeth and create tension in your jaw, creating your headaches and other pain. If your dentist finds this is the case, he or she will prescribe useful home exercises and physical therapy, to be used in combination with a mouth guard that reduces the intensity and frequency of your oral stress and protects your teeth from further wear and destruction. This will restore the muscles of your head and neck area to normal length, function, posture and full range of motion, helping to reduce your symptoms.

The following treatments may also be helpful for treating chronic headaches and related pain:

Occlusal Splint - Also called a night guard, the Occlusal Splint protects the teeth from further wear and reduces the severity of grinding at night, allowing the muscles to rest. In severe cases, the splint may need to be worn all day to allow the joints and muscles to rest.

Jaw Rest - You must rest your jaw for it to heal. Do not:

- chew gum


- bite your nails


- clench your teeth together


- chew on pencils


- eat excessively chewy and crunchy foods during treatment

Moist Heat - penetrating moist heat promotes blood flow, aiding in healing and relaxation of the muscle and helping pain medications work more effectively. A wet washcloth with a hot water bottle will do, or purchase moist heating pads.

Exercises - Some simple jaw and neck exercises may be recommended to help the muscles stretch. A good time to do some of these is in the warm, moist environment of the shower or bath, particularly in the morning and/or before bedtime.

Physical Therapy - Physical therapy can help relax the muscles and increase joint flexibility. We can teach you some simple stretching therapies during your office consultation. If necessary, you will be referred to a physical therapist.

Stress Management - Stressed-out muscles that are contracted and cramped lead to pain. Emotion and stress can cause your muscles to become stressed-out. Any stress reliever that works for you is helpful. Reading, exercising, listening to music, going for a walk are all ways people reduce the stress in their lives. You may want to consider counseling to learn stress management. The point is, it is almost impossible to get relief from TMJ if your underlying emotional issues are not addressed. If you can't do it yourself, don't be afraid to ask for help.

Anterior Deprogrammer - A less well known treatment method is an anterior deprogrammer. This device contacts the four lower incisors when you close your mouth, and reduces resistance when the lower jaw moves back and forth, reducing muscle contraction intensity and helping teeth the become properly aligned. An anterior deprogrammer is meant for short term use and emergency situations.

Medication - Pain medication may be prescribed. Often, over the counter analgesics such as ibuprofen are enough. These medications relieve pain and reduce inflammation during the healing process. Occasionally a mild muscle relaxant may be prescribed.

The most effective drugs for TMJ management include:


1. Non-narcotic analgesic drugs such as acetaminophen (Tylenol).


2. Non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, Trilisate, ibuprofen, Naproxen and prescription strength NSAIDS.


3. Muscle relaxant drugs such as Carisoprodol (Soma) and Cyclobenzaprine (Flexeril).


4. Tricyclic anti-depressant medications such as Amitriptyline (Elavil), Nortriptyline (Pamelor), and Doxepin (Sinequan).

Referral - In some cases, a specialist may be needed from physicians, oral surgeons, orthodontists, psychotherapists, physical therapists, or prosthodontists. Very severe cases may be referred from the start to a pain center or a dentist whose main focus is the treatment of temporomandibular disorders.

Dr. Michael Iott has the education, training and experience to diagnose and treat the cause of your chronic headaches and pain. Why not schedule a consultation and allow Dr. Iott to offer you the very best options to relieve your symptoms? Click here to contact Dr. Iott's office now.

What can you do to help yourself at home?

- Limit your jaw opening (yawning, etc.) to no more than 2 finger widths.


- Rest your jaw by avoiding heavy chewing (e.g. gum, bagels, tough meats).


- Avoid grinding and clenching your teeth by keeping the teeth slightly apart and the jaw relaxed.


- Avoid leaning or sleeping on the jaw.


- Avoid tongue thrusting and chewing fingernails or non-food objects.


- Avoid playing wind, brass and string instruments that stress, retrude or strain the jaw.


- Use cold/ice packs or moist heat compresses as directed by your doctor or therapist.


- Use over-the-counter medications such as aspirin, ibuprofen, Naproxen, Tylenol or Percogesic, as directed by your doctor or therapist.

If you are experiencing chronic headaches, pain in your face, neck, shoulders and upper back, or any of the other symptoms described here, call our office to schedule a private consultation.

Home Remedy for Hives

Hives also known as urticaria. Allergic reaction to a drug or food is a cause of hives. They range in size from a few millimeters to several inches in diameter. Hives can be round, or they can form rings or large patches. Hives can occur on any skin surface, but usually spare the palms and soles of the feet. Hives are classified as acute or chronic depending on the length of the episode. Hives are raised, often itchy, red welts on the surface of the skin. Hives may be associated with dramatic swelling reactions; swelling of the lips, eyes, and ears can suddenly and grotesquely alter the appearance of an allergy victim. Swelling of the lips and tongue may occur immediately after eating a food and may be life-threatening because of airway obstruction. Some patients get hives occasionally only when they ingest a specific food or food additives. Other get hives as a chronic problem which can go-on for years. Most studies of chronic hives suggest a low % of food allergy causes usually because diet revision attempts were inadequate to reveal the hidden food causes. Swelling from angioedema can also occur around your hands, feet, and throat.

Hives and angioedema form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Hives and angioedema can happen at any age. Angioedema typically causes swelling of the lips, larynx (producing hoarseness or shortness of breath), or the lining of the stomach and intestines (causing abdominal pain). Symptoms include muscle soreness, shortness of breath, vomiting, and diarrhea. Urticarial disease is thought to be caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin. Histamine causes fluid to leak from the local blood vessels leading to swelling in the skin. In rare cases urticaria and angioedema are accompanied by shock and difficulty breathing. This is called anaphylaxis. Ordinary hives may be widespread and disturbing to look at, but the vast majority of cases do not lead to life-threatening complications. Sometimes hives are caused by a physical stimulus like contact with heat, water, or pressure. Hives can also be caused by contact with substances that are irritating. Just about any substance has the potential to be irritating.

The treatment of hives depends on the severity of the symptoms. Psychological treatments such as stress management can sometimes lessen severity and occurrence. The most commonly used oral treatments are Non-sedating antihistamines, including Allegra, Claritin, Clarinex, and Zyrtec, are also used to treat hives, expecially hives that last longer than 6 weeks. Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don't provide relief, oral corticosteroids may be prescribed. Oral steroids (prednisone, Medrol) can help severe cases of hives in the short-term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments can sometimes include doxepin (Sinequan), an antidepressant that can work as a potent antihistamine, montelukast (Singulair), and medications such as ranitidine (Zantac) or cimetidine (Tagamet), which are more commonly used to treat reflux. To mangage hives and swelling avoid hot water (use luke warm), gentle or mild soap, apply a cool compress or wet cloths to the affected areas, enter a cool room, wear light weight clothes. Avoid irritating the area with tight-fitting clothing. Apply calamine lotion.

Home remedy for Hives Tips

1.Calamine lotion-applying this lotion it can grant you relief from the itchy feeling.

2.Milk of magnesia on the lesions, provides some relief. As milk of magnesia is an alkaline solution it helps in removing the irritating itchy sensation

3.Stop the itching get 1/2 a tub filled with warm water, add 1/2 cup cornstarch and 1/2 cup baking soda. Soaking yourself at least once a day can make a lot of difference.

4.Applying aloe vera gel or vitamin E oil to the affected area at least twice a day can benefit you a lot.

5.Have nettle tea which is made by 2 tsp. powdered stinging nettles. You can add honey or lemon to add flavor your tea.

6.Consume cayenne pepper capsules to help the healing procedure. You can also have vitamin C, vitamin E or zinc for quick relief.

7.Herbal tea is very good for health. To soothe your nerves, go in for peppermint or passionflower tea. Other good options include chamomile, valerian and catnip

8.To relieve pain, apply cool compression on the affected area.

9.Make a paste with 2 cups of oatmeal and 3 tablespoons of cornstarch. Add a little water to make it into a paste. Apply to affected area for 15-30 minutes. It dries the hives up within a couple of hours.

10.Take cayenne pepper in capsule form to aid the healing process.

11.Take an Ice cold shower or bath and sit in front of a fan on high for about five minutes.

Juliet Cohen writes articles for health care clinic and home remedies. She also writes articles on beauty tips.

Depression Medication

Depression can affect any one of us at any time of our lives and is more than just feeling a bit fed up or down in the dumps. When you cannot just snap out of it and the symptoms of depression persist for more than a couple of weeks, and interfere with your ability to carry out your normal routines on a daily basis, then your health care provider or GP may prescribe some form of medication to help you combat the depression.

There are many different types of anti-depressants available and the earlier ones include Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Newer types include Selective Serotonin Reuptake Inhibitors (SSRIs) and others, which may not fall into one specific category but which all work by impacting on the chemicals in the brain that are responsible for our mood and how we feel.

The following list represents the most commonly prescribed drugs for depression, their brand names and the name of the pharmaceutical company producing them (in brackets), as well as a brief description of how the different types are believed to work.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants are so called because of their molecular structure in that they contain three rings of atoms. Although no one understands exactly how they work, it is thought that the beneficial effects are due to their ability to balance the natural neurotransmitter chemicals in the brain. The most common side effects are dry mouth and drowsiness and possibly blurred vision, sweating, and a slight hesitancy when passing urine. The following list represents some of the most commonly prescribed Tricyclic antidepressants:

- Doxepin - Brand names: Adapin (Lotus Biochemical Corporation) and Sinequan (Pfizer Inc)


- Clomipramine - Brand names: Anafranil (Geneva Pharmaceuticals)


- Nortriptylene - Brand Names: Aventyl (Eli & Lilly) and Pamelor (Novartis Pharmaceuticals)


- Imipramine - Brand Names: Tofranil (Novartis Pharmaceuticals)


- Protriptyline - Brand Names: Vivactil (Merck & Co)


- Trimipramine - Brand Names: Surmontil (Wyeth-Ayerst Pharmaceuticals)

Monoamine Oxidase Inhibitors (MAOIs)

This type of medication works by inhibiting the activity of the enzyme monoamine oxidase, which in turn increases the levels of the neurotransmitters serotonin and norepinephrine. They are not prescribed as often as they used to be as the newer type of medication known as SSRIs have become more popular. MAOIs would usually be prescribed when other medications have proved ineffective. MAOIs can interact with foods containing tyramine and raise blood pressure; they can also interact unfavourably with many other drugs and over the counter preparations. Some MAOIs include:

- Isocarboxazid - Brand Name: Marplan (Oxford Pharmaceutical Services)


- Phenelzine - Brand Name: Nardil (Pfizer Inc)


- Tranylcypromine - Brand Name: Parnate (Glaxo Smith Kline)

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs work by selectively inhibiting the reuptake of the neurotransmitter serotonin in the brain so that levels of serotonin are increased. They are generally considered safer than other types. Side effects include nausea, anxiety, sleep disturbances and sexual dysfunction. They can also interact with other drugs. Some of the more commonly prescribed SSRIs include:

- Citalopram - Brand Name: Celexa (Forest Pharmaceuticals)


- Escitalopram - Brand Name: Lexapro (Forest Pharmaceuticals)


- Fluoextine - Brand Name: Prozac (Eli & Lilly)


- FLuvoxamine - Brand Name: Luvox (Solvay Pharmaceuticals)


- Paroxetine - Brand Name: Paxil (Glaxo Smith Kline)


- Setraline - Brand Name: Zoloft (Pfizer Inc)

Some other types of medication

There are other types of medication available for depression which are not included in the previous categories but which all work in various ways to alter the balance of chemicals in the brain to alleviate depression. For example:

- Bupropion - works by inhibiting the reuptake of both norepinephrine and dopamine. Often used to treat the type of depression known as Seasonal Affective Disorder (SAD), as well as ADHD and as part of a stopping smoking programme. Brand Name: Wellbutrin (Glaxo Smith Kline)

- Duloxetine - works by inhibiting the reuptake of both serotonin and noradrenaline (SNRI). Brand Name: Cymbalta (Eli & Lilly)

- Venlafaxine - Also an SNRI. Brand Name: Effexor (Wyeth-Ayerst Pharmaceuticals)

- Maprotiline - Known as a tetracyclic antidepressant because its molecular structure consists of 4 rings in a T shape. Brand Names: Ludiomil (Novartis Pharmaceuticals)

Which type medication is most suitable?

The type of medication prescribed by your GP will depend on many factors including the kind of depression diagnosed, the severity of the symptoms, other medication that you may be taking and of course the potential risk of any side effects.

It is not possible to predict with any degree of accuracy which one will be most effective and it can take a number of weeks for any effects to be noticed. If after six weeks or so there is no improvement, then another medication may be prescribed until you find the most appropriate one for you.

Regardless of the type of depression diagnosed, the right medication can alleviate the symptoms of depression and help you get back to your old self again.

Depression is a serious condition that can strike anyone at anytime. For more information about depression and self help come and visit =>Fighting Depression.

All You Need To Know About Antidepressants

Many people often have misunderstandings about what antidepressants are capable of.

First of all, they are not pick me up pills; they don't artificially bring on a feeling of happiness, euphoria, or unrealistic well-being. Nor do antidepressants insulate you from life, make you not care about vital things, or make you oblivious to sorrow or loss.

What antidepressants do is avert depressed persons from sliding into the blackest depths of depression when something awful happens. They can still feel wounded, pain, and apprehension, but they feel these the way people normally do when they don't have depression. They also can help depressives sleep soundly, increase their energy, and improve their ability to concentrate.

The way antidepressants work is interesting. There are two chemicals, serotonin and norepinephrine, that have to do with the transmission of impulses between nerve cells in the brain and seem to be allied with depression. It would appear as if depressed people use up these chemicals at an accelerated rate than other people. Antidepressants help to retain these chemicals, apparently leading to feelings of reduced anxiety, more security, increased self-worth, assertiveness, and resilience.

There are a mixture of types of antidepressants, but they fall into a number of straightfoward categories. These are tricyclics, MAOIs, and lithium, and the newer medications: hetereocyclics and Prozac and Prozac-related drugs.

Until rather recently, tricyclics were the normal treatment for depression. These medications include imipramine (Tofranil), amitriptiline (Elacil), Vivactil, Norpramin, Pamelor, and Sinequan. Still in conventional use today, 40 to 70 percent of depressed patients improve substantially with tricyclics.

Although they are quite efficient medications, there are some negatives to their use. They generally take several weeks of constant administration to be successful, which is difficult to handle when people are sincerely distressed. Also, it is relatively easy to take a disastrous overdose. In general, tricyclics should only be used on a short-term basis. They are not addictive, but they must be used with care, especially with people who have cardiovascular disease.

Monoamine oxidase inhibitors (ie. MAOIs) include Marplan, Parnate, and Nardil. They are a different class of drugs and cause a different reaction in the brain. These drugs are helpful from some people who do not respond to tricyclics. These drugs can have disagreeable side effects, but the main disadvantage of MAOIs is that they can also cause a stroke if certain foods containing the compound tyramine (cheese, red wine, pickles) are consumed while they are being used.

Lithium is generally the treatment of choice for bipolar disorder (the cycle of manic highs with depressed lows). In the correct dose, lithium reduces by about 50 percent the chances of another manic episode within a year. Mood swings become fewer, shorter, and less harsh. The success rate for lithium treatment is 70 percent, and 20 percent of people become symptom-free. It is generally seen as a maintenance drug. Once the patient is on Lithium, they are on it for life.

One of the most well-known drugs on the market today is Prozac. It has been followed into the marketplace by many other new antidepressant medications like Zoloft and Paxil, two near cousins, Effexor and Serzone, and some more distant cousins, notably Wellbutrin, Desyrel, and Buspar.

Unlike tricyclics, which affect the levels of both serotonin and norepinephrine in the brain, Prozac, Zoloft, and Paxil affect only serotonin. Hence they are known as selective serotonin reuptake inhibitors, or SSRIs, meaning that they prevent or slow down the reabsorption of serotonin. Effexor and Serzone affect both serotonin and norepinephrine, and the others have more complex effects. All, however, have been shown to be effective in the treatment of depression. The choice of which of these medications to use for a particular person has to do with their dosage and side-effect profile. Paxil, for example, seems to have a soothing effect on anxiety that Prozac lacks. Effexor has the reputation of being more energizing than Prozac.

Compared with tricyclics, the side effects of Prozac and its cousins are usually small. Tricyclics can give you dry mouth, make you constipated, and actually slow you down, whereas Prozac has none of these problems and gives you a little more energy. However, there are some side effects with the newer antidepressants which should be mentioned. Most notable among these is a reduction of interest in sex and complications maintaining an erection. Although the male performance problems usually go away after a few weeks, many people on SSRIs report a continued diminished interest in sex, which can certainly add to marital problems.

For more info on antidepressants visit All you need to know about Antidepressants

The Usefulness Of Light Therapy In The Treatment Of Fibromyalgia

FM has no known cause as there is little evidence supporting any of the theories suggested by researchers. It is however thought to be triggered by,

1. Sleep disorders


2. Injury and Muscle Trauma


3. Genetic predisposition


4. Immune System Abnormalities, and


5. Infectious agents, including viruses and bacteria

FM has two main components, pain and fatigue. Pain is felt throughout the body (ligaments, tendons and muscles) and can range from mildly uncomfortable to excruciating. It can also continue for months and even years. Fatigue can be experienced as anything from feeling a little tired to feeling absolutely exhausted, and can make the pain of the illness harder to bear.

Symptoms include:


1. Morning stiffness


2. Wide spread pain


3. Sleep disorders


4. Chronic headaches


5. Dizziness


6. Nausea


7. Depression


8. Facial and jaw pain


9. Irritable bowel, frequent bouts of diarrhoea or constipation and irritable bladder


10. Cognitive dysfunction including lack of concentration and mixing up words

(To mention a few)

Patients often feel they are aching all over, with muscles feeling sore, stiff and overworked. Muscle twitching is also not rare in FM and can sometimes feel like they are burning.

Treatment for FM tends to be very comprehensive and can involve a number of health care providers including physicians, physiotherapists, psychiatrists, chiropractors and occupational therapists. Common treatments include pharmaceutical treatments such as the use of Lentizol, Sinequan or Seroxat. Other treatments include relaxation techniques, therapeutic massage, gentle exercise program, acupuncture, change in diet and cognitive behaviour therapy, to mention a few.

Light therapy is an alternative therapy, which can be used for treating symptoms of fibromyalgia. It can help reduce muscle pain, depression, fatigue and sleep disorders. Three different types of light therapy can be used for treating symptoms of fibromyalgia: Bright Light Therapy, Colour Therapy and Low Laser Light Therapy (LLLT).

Based on the idea that our body is specifically attuned to light, bright light therapy uses high powered fluorescent lights to help trigger the release of specific hormones, which help to restore the body's natural rhythm and overall health. Bright light therapy for fibromyalgia is typically carried out using a light box, which is typically placed in front of you at eye level. Depending on the intensity of the light box, treatment time could be between 15 minutes to 3 hours. You remain seated in front of the box without staring at the light box, but absorbing the light while carrying out other activities such as reading, eating, etc.

Colour therapy is a form of phototherapy, which delivers coloured beams of light to various parts of the body and its usage is becoming more popular among chronic pain sufferers. As the eyes see the coloured beams of light, the light energy is converted into electric impulses, which travel through the brain, triggering the release of hormones such as serotonin and endorphins, which help to improve your mood and ease pain. The four colours typically used are red, blue, violet, and white. Colour therapy is very relaxing and typically lasts between 15 minutes and 1 hour.

Also known as Cold Light Therapy or Soft Laser Light Therapy, Low Laser Light Therapy (LLLT) helps to reduce pain and promote healing by increasing the energy levels of certain cells in the body. Low-frequency laser light beams are applied to various painful areas of the body, once the photons emitted by these beams are absorbed by the body; they are converted into cellular energy by the energy power houses within the cells (the mitochondria). Consequently, this helps to increase the rate at which your body heals thereby eliminating pain.

Various studies have suggested that light therapy is highly effective at reducing symptoms of chronic pain, fatigue and depression, and as such is worth a try for fibromyalgia patients who yearn to be relieved of their symptoms. Read more about light therapy in our brand new Light Therapy Learning Centre. As effective as light therapy is for various disorders, certain individuals are advised against using it especially those suffering from epilepsy, skin sensitivities, glaucoma, bipolar disorders, cataracts and other eye diseases.

Start shopping from our range of Light Therapy products.

Disclaimer

This article is only for informative purposes. It is not intended to be a medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Kindly follow any information given in this article only after consulting your doctor or qualified medical professional. The author is not liable for any outcome or damage resulting from any information obtained from this article.

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