Headaches
Headaches are a common source of pain, distress, and disability, and guided imagery can help relieve them, whether they are tension or migraine type., When practiced regularly, research shows that relaxation and imagery can prevent migraines as well as any of the most commonly prescribed medications, and of course, without the accompanying side effects of expense. We have developed a single CD called "Headache Relief" for this purpose, and if you want a more in-depth immersion into the healing potential of imagery, use the "Guided Imagery for Self-Healing" book and 4 CD set that will teach you all the fundamental skills of using guided imagery for health. The book will explain the process, review the science behind it, and coach you through the common questions that people have, while the CD set guides you through the 9 essential guided imagery skills taught in the book.
RESEARCH
GUIDED IMAGERY-BASED FOR HEADACHE
November, 2005
Prevalence and Costs of Headaches
Over 45 million Americans have recurring headaches and 28 million of them have chronic migraines.1 The incidence of headache increased 60% in the years 1988-1998.7 Headaches cause 329,000 school absences per month and cause Americans to miss more than 150 million workdays a year. 7 These missed workdays and their associated medical costs represent a loss to industry of $50 billion annually.17 Headaches are also responsible for 10 million physician visits a year in the U.S.A.
Headache Causes
Headache pain can occur in the muscles and blood vessels of the scalp, face, or neck, in the tissue around the brain, or in the attaching structures at the base of the brain. There are many classifications of headache, but there are three most common types. Tension or muscle contraction headaches are usually caused by fatigue, stress, or environmental factors.1,7 Migraines are throbbing headaches that can last for hours or days, usually affecting one temple or side of the head, and are often accompanied by nausea, vomiting, and light/noise sensitivity. 7 Cluster headaches, appropriately named because they occur in clusters, are often the most painful type. They are characterized by short periods (usually 30 to 40 minutes) of excruciating head pain that often recur several times a day, sometimes for months at a time.
Medical treatment of headaches
Over-the-counter analgesics (aspirin and NSAIDS) are often a first line of treatment for tension headaches. For more severe recurrent headaches, medications include analgesics including acetaminophen and codeine, antidepressants, NSAIDS, antihistamines, anti-emetics, serotonin receptor blockers and vaso-constrictors, serotonin 1-D receptor agonists, triptan drugs, beta-blockers, ergot alkaloids, lithium, corticosteroids, calcium channel blockers, and anti-seizure medications. All these pharmacologic treatments have significant risks and side effects and are only variably effective in relieving headaches.
Guided Imagery and Mind/Body Studies
Guided imagery, which combines deep relaxation with positive suggestion, was shown to be a cost effective way of decreasing the intensity, number, or duration of headaches; it was also helpful in increasing patient ability to cope with headaches. 4-6, 9-16, 18-23, 25-27
When Mannix et al. studied a group of 260 patients with tension-type headaches14, 21.7% of those in the imagery group reported their headaches ìmuch improved,î compared to 7.6% of the control group (p = 0.04). The authors of a 2003 review of the literature concluded that ìconsiderable evidenceî exists for the efficacy of mind-body techniques such as imagery, relaxation, hypnosis, and CBT in the treatment of headaches2.11 In their review of the literature, University of Mississippi researchers concluded that regular practice of relaxation and stress reduction is as effective in reducing frequency of headaches as taking medication, with far fewer side effects.17
References
Andrasik, F. (1990). ìPsychologic and behavioral aspects of chronic headache.î Neurol Clin, Nov;8(4):961-76.
Astin, J.A., Shapiro, S.L., Eisenberg, D.M., Forys, K.L. (2003). ìMind-body medicine: state of the science, implications for practice.î J Am Board Fam Pract, Mar-Apr;16(2):131-47.
Blanchard EB Steffek BD Jaccard J Nicholson NL., Psychological changes accompanying non-pharmacological treatment of chronic headache: the effects of outcome., Headache, 31(4), 1991 Apr, 249-253
Blanchard, E.B., Andrasik, F., Appelbaum, K.A., Evans, D.D., Myers, P., Barron, K.D. (1986). ìThree studies of the psychologic changes in chronic headache patients associated with biofeedback and relaxation therapies.î Psychosom Med, Jan-Feb;48(1-2):73-83.
Blanchard, E.B., Jaccard, J., Andrasik, F., Guarnieri, P., Jurish, S.E. (1985). ìReduction in headache patients' medical expenses associated with biofeedback and relaxation treatments.î Biofeedback Self Regul, Mar;10(1):63-8.
Center for Disease Control, reported on headachecare.com/news.cmf, 2001.
Devineni, T, Blanchard, EB, A randomized controlled trial of an internet-based treatment for chronic headache, Behav Res Ther. 2005 Mar;43(3):277-92
Holroyd KA, Penzien DEB, Pharmacological versus non-pharmacological prophylaxis of recurrent migraine headache: a meta-analytic review of clinical trials. Pain, 42(1), 1990 Jul, 1-13
Ilacqua, G.E. ìMigraine headaches: coping efficacy of guided imagery training.î Headache 1994 Feb;34(2):99-102.
Ilacqua, G.E., Migraine headaches: coping efficacy of guided imagery training. Headache,1994, Feb: 99-102
Labbae, EE, Electromyographic biofeedback witrh mental imagery and home practice in the treatment of children with muscle-contraction headache, J Developmental and Behavioral Pediatrics, 11(2) 1990 Apr 65-68
Larsson, B, Varlsson, J. Fichtel, A. Melin, L, Relaxation treatment of adolescent headache sufferers: results from a school-based replication series, Headache. 2005 June:45(6)692-704
Mannix, L.K., Chandurkar, R.S., Rybicki, L.A., Tusek, D.L., Solomon, G.D. Effect of guided imagery on quality of life for patients with chronic tension-type headache. Headache, 1999 May;39(5):326-34
Milne, G, Hypnotherapy with migraine, Australian J Clinical & Experimental Hypnosis, 1983 May 11(1) 23-32
National Headache Foundation web site, 2001 (headaches.org/factsheet.html).
Olness, K., MacDonald, J.T., Uden, D.L. (1987). ìComparison of self-hypnosis and propranolol in the treatment of juvenile classic migraine.î Pediatrics, Apr;79(4):593-7.
Penzien, D.B., Rains, J.C., Andrasik, F. (2002). ìBehavioral management of recurrent headache: three decades of experience and empiricism.î Applied Psychophysiology and Biofeedback, Jun; 27 (2): pp 163-81.
Primavera JP, 3d , Kaiser RS., Non-pharmacological treatment of headache: Is less more? Headache, 32(8), 1992 Sep, 393-395
Reid GJ; McGrath PJ. Psychological treatments for migraine. Biomedicine and Pharmacotherapy, 1996, 50(2):58-63
Reid, G.J., McGrath, P.J. (1996). ìPsychological treatments for migraine.î Biomed Pharmacother 1996;50(2):58-63.
Smith, MS, Anxiety and depression in the behavioral treatment of headache in children and adolescents, Int J Adolescent Medicine & Health, 1991 Jan-Mar 5(1) 17-35
Solomon, G.D., Cady, R.K., Klapper, J.A., Ryan, R.E. (1997). ìStandards of care for treating headache in primary care practice.î National Headache Foundation. Cleve Clin J Med, l64:373-83.
Tsao, JC, Zeltzer, LK, Complementary and Alternative Medicine Approaches for Pediatric Pain: A review of the State-of-the-science, Evid Based Complement Alternat Med, 2005 June 2(2):149-159
VanDyck, R, Autogenic training and future oriented hypnotic imagery in the treatment of tension headache: outcome and process, Int J Clin & Exp Hypnosis, 1991 Jan 39(1) 6-23
Womack, WW, et al, Behavioral management of childhood headache: a pilot study and case history report, Pain, 1988 Mar 32(3) 279-283
The Healing Mind RESEARCH REVIEW
© Martin L. Rossman, M.D. 11/05
Posted in Health Issues