, Newburyport, MA

May 17, 2013

Health and Well-Being: What you need to know about headaches

Health and Well-Being
Dr. Jim Manganiello

---- — Headaches cause a lot of pain and inconvenience for large numbers of people. They are one of the most frequent complaints that bring individuals to health professionals for help.

Dr. Donald Bakal, a psychologist and the director of headache research at the University of Calgary, conducted an in-depth, eight-year, mind-body study on chronic headaches. The results are of interest to both health service providers who treat chronic headaches and to the millions of people who are plagued by them.

Bakal’s study presents strong evidence that challenges the widely held belief that muscle-tension and migraine headaches are really different disorders. His research found clear evidence that they both share many common features. The differences between them seems quantitative rather than qualitative. Migraine sufferers simply have more severe variations of the psychophysiological conditions that generate muscle-contraction headaches.

This finding is a very important one because for years the notion that muscle-tension headaches and migraine headaches represent two distinct problems has been a kind of dogma. This dogma has persisted today even in the face of clear evidence to the contrary. Some headache sufferers even assume that only migraines are legitimate disorders, whereas muscle-contraction headaches are not. Unfortunately, many people plagued by chronic headaches tend to think badly of themselves because of their problem.

Many, if not most, traditional efforts to treat headaches have involved giving medications that provide symptom relief. When absolutely essential, such medications are a blessing. They do, however, involve the unnecessary risk of side effects that can take their toll on the mind and the body. Pain medications, for example, impact our physiology, and they can lead to dependence and negative personality changes.

Moreover, this approach to treating headaches does nothing to identify or alter the causes of headache pain, it simply aims to cover up their effects. A clear finding in Bakal’s study shows that excessive reliance on medications to control headaches prevents sufferers from seriously considering the possibility that they can learn to gain non-drug control over their symptoms. In recent years, many thousands of headache patients have learned how to eliminate troublesome headaches without having to rely on pain-relief medications.

Headache susceptibility and headache attacks can best be understood and treated as a mind-body problem. The mind-body is an interdependent unit that involves a complex variety of psychophysiological activities. Headache symptoms can be understood and controlled through a variety of behavioral medicine and mind-body interventions. These interventions are meant to train headache sufferers to alter the physiological conditions responsible for their problem.

To illustrate, muscle-tension headaches are associated with muscle contractions in the head, neck and shoulder regions. Muscle fibers shorten and tighten when they become tense. If fibers in these regions are chronically contracted, headache pain can result. Muscle tension results from a variety of sources including stress. Our body’s stress response involves complex biochemical reactions that can lead to muscle contractions that occur outside of our awareness.

Many tension-headache sufferers have headache pain daily while not being aware of the role that muscle contraction plays in their symptoms. Muscle-contraction headaches are often relieved quickly through mind-body treatment, including computerized biofeedback. Biofeedback allows patients to learn how to become increasingly conscious of muscle tension in the neck, head and shoulder areas. Biofeedback mind-body training then enables them to avoid and control muscle contraction in these areas.

Migraine-headache sufferers usually have severe symptoms one or two days a month. Migraines have a definite muscle-tension component. They involve, as well, a blood-flow component whereby the smooth muscle fibers lining the blood vessels constrict in ways that restricts blood flow. Migraine sufferers often have cold hands and feet as a result of such constriction.

Migraine headaches can develop as a consequence of additional blood-flow changes in the neck and cranial areas. Many migraine-headache sufferers can learn to control and eliminate their symptoms through a combination of mind-body interventions. Some of these are aimed at training patients to dilate or keep their blood vessels open by their own efforts. This is a skill that can be readily learned with computerized biofeedback and other self-regulatory tools.

Muscle-contraction headaches can be improved and/or eliminated in a surprisingly short amount of time. Migraine headaches often take longer to treat, but once the headache sufferer achieves voluntary control over muscle contraction and blood-flow constriction, relief from symptoms is often dramatic.

If you suffer from chronic headaches, learn how to lower your stress hormone levels and flush them out of your system. Stress hormones cause small muscle fibers to contract and spasm, and they also cause headache-triggering changes in blood flow.


Dr. Jim Manganiello is a clinical psychologist and diplomate-level medical psychotherapist based in Groveland and West Boxford. He is also an author and teacher focusing on stress, personal growth, meditation and “inner fitness.” His book “Unshakable Certainty” is available on Amazon. Email him at or visit