An “anvil” on your head may not exactly be an exaggeration when you are experiencing a severe headache….!!! In the present day busy and stressful life, the term ‘Headache’ holds greater weightage. It may often be colloquially to express ‘an utmost misery’ or literally the disease as such. It is one of the most common locations of pain and has ‘n’ number of causes from childhood to old age it is impossible to point out even a single soul who has not gone through the phase of headache ‘atleast once’ in the lifetime. Ranging from mild tension headaches to severe life threatening ones, there are over 200 headaches identified.

What does the word ‘Headache’ means?
Headache or ‘ Cephalgia’ is a term commonly used to denote “pain felt anywhere in the region of head and neck”. It is observed as a symptom in quite a number of diseases. The signs, symptoms, nature, severity, duration, and prognosis depend upon the aetiology, the specifically affected site.

Ayurveda says. . . . .
As per ayurvedic classics, head or ‘Siras’ is considered as the prime organ of the body. The science has grouped all the diseases in which headache or ‘Sira Soola’ is presented is the main feature under the heading ‘Siro Roga’.

||”Siro roga sabdena Sirogatha Soola roopa ruja abhidheeyate”||

What causes headache. . . .
There are various factors which results in headache. Human brain tissues are not sensitive to pain, as they lack pain receptors. Rather pain is caused by the disturbance of pain sensitive strictures around the brain. These structures are broadly grouped under 2 headings
a) Within the cranium – It includes blood vessels, meninges and cranial nerves.
b) Outside the cranium – Includes outer covering of skull, muscles, nerves, arteries, veins, eyes, ears, sinuses, and mucous membranes.

Any abnormality or deviation from the normal functioning of the above quoted pain sensitive areas eventually lead to headache.

To be more elaborate, headache can occur due to:-

• Spastic contractions of neck and scalp.
• Inflammation of nerves to head and neck.
• Irritation to meninges as in meningitis, encephalitis etc.
• Dilatation and contraction of blood vessels as in migraine.
• Tumors and blood clots in the vessels supplying brain.
• Mental faculties, ranging from mild tension headaches to serious psychiatric conditions like Schizophrenia.
• Unwholesome diet, dehydration, allergic manifestations, constipation, alcohol, indigestion etc.
• Refractive errors.
• Other abnormalities of eyes, ears, nose etc.
• Systemic diseases like Disorders of uterus and testicles, fever, hypertension, hypotension, epilepsy, anaemia, sun stroke, congestive heart failure etc.

Ayurvedic view on aetiology. . .
While enumerating the causative factors, Ayurvedic classics take an upper hand, as they have elaborately given the activities which can lead to head ache or “Sira Soola”.

• Smoking, exposure to smoke, dust, sun, snow, strong wind, strong odours.
• Excessive swimming, exercise, sexual activity, alcohol, weeping and talking.
• Night outs as well as day sleep.
• Suppression of urges to cry, sneeze, evacuate bowels and urine.
• Indigestion and worm infestation.
• Lack of purificatory measures of the body and lack of usage of oil over head.
• Mental factors like grief, anger, fear, anxiety etc.
• Diseases of eye, ear, nose etc.
Ayurveda quotes much more examples of systemic diseases leading to headache like kaasa(cough), antrika jvara(typhoid), masoorika jvara(measles), dushta pratisyaaya(chronic rhinitis),vaatarakta(gout), madhumeha(diabetes mellitus) etc.

How are head aches classified. . . . . . .

International headache society has framed the international classification of Headache disorders (ICHD), accepted by Who in 2004. It classifies headaches into 13 groups. Among them,
• Group 1 – Group 4 – belongs to Primary Headaches.
• Group 5 – group 12 – secondary Headaches.
• Group 13 – includes Cranial Neuralgia, facial pain and other headaches.

Primary Headache

These are headaches which arise out of a cause which lies within itself. Migraine, Tension headaches, and Cluster Headaches are the examples.
Tension headaches are the most common types of primary headaches, occurring in about 92% of the adults, more common in women than men.
Migraine headache is the second common one, which affects children as well as adults. Its prevalence is equal in both sexes before puberty, but in later stages of life, women are more succumbed.
Cluster Headaches mostly affect males in 20’s though women and children are also affected.

Secondary Headaches

These are caused due to some structural problems in head or neck region. Bleeding in brain tissues, tumours, meningitis etc can lead to such headaches.

Yet another classification groups headache under 5 headings, namely,
a) Vascular
b) Myogenic
c) Cervicogenic
d) Traction
e) Inflammatory

Classification as per Ayurveda. . .

Ayurveda the science of life believes that human body rests on 3 pillars namely vaata, pitta, and kapha. The derangement in these entities brings about diseases to the body. On the basis of predominance in vitiation of these 3 doshas, Caraka, one of the great triors of Ayurveda classified ‘SiraSoola’ or headache into 5, namely:-

a) Vaataja SiraSoola - Predominance of Vaata dosha
b) Pittaja SiraSoola - Predominance of Pitta dosha
c) Kaphaja SiraSoola - Predominance of Kapha dosha
d) Tridoshaja SiraSoola - Combination of all 3 doshas
e) Krimija SiraSoola - Due to worms

Investigations to be done. . . .

After proper systemic examination, depending upon the conditions, the most appropriate investigation has to be advised for. Below are some of the examples,

• Urine - routine examinations.
• Blood for Hb%, ESR, and serological examination.
• Stools for ova and microbes.
• X ray for nasal sinus – brain and ear.
• CT scan of brain and EEG.
• ECG and Echo.
• Vision tests – Ophthalmoscopic examination.
• Audiometry.
• Rhinoscopy.
• Pharyngoscopy and laryngoscopy.

How can a headache be treated. . . .

Major percentage of headaches resolve with rest, a short nap or sometimes without any medication. Treatment of headache depends on underlying aetiology, severity and complications. Line of treatment involves mainly analgesics. Non medication therapies like usage of ice, biofeedback and relaxation may be helpful to a greater extent. Sleep may be the best medicine if possible. Avoiding certain foods especially those high in tyramine such as sharp cheeses or those containing sulphites like wine, beer etc or those containing nitrates like nuts, pressed meat can reduce the frequency of attacks. Generally leading a healthy lifestyle with good nutrition, an adequate intake of fluids, sufficient sleep and exercise can effectively control headache.

Ayurvedic way to self-management of headache. . . .

• The first and formost line of management of ‘SiraSoola’ or headache is avoidance of causative factors or so called ‘triggering factors’.
• Regular practice of head massage with medicated oils to prevent diseases of head, eye, nose etc.
• Care should be taken to manage other infections, allergic conditions, stress, strain, ophthalmic problems etc which can cause headache.
• Protecting ‘Siras’ or head from trauma and other disease causing factors.

What forms a healthy diet. . .

Taking into consideration, the condition of the disease and the diseased, a healthy diet should be planned, which can control headache to a greater extent. Foods containing preservatives, caffeine, artificial colours and sweetening agents, chocolates, cheese, beer, red wine, groundnut, junk foods etc can provoke headache and hence has to be avoided.
A practice of taking atleast 6-8 glasses of water per day can reduce the attack of headache. Fibrous vegetables, fruits, pulses, cereals, garlic, oats, olive oil and almonds occupying the major part of the meals can work effectively over headache.

How helpful is Yoga. . .

Simple yoga techniques can serve as an alternative or supplement for other remedies for dealing with headaches as both preventive and curative aspect. Yogic posture, breathing techniques and relaxation methods can reduce the severity and frequency of attacks of headaches. These methods are found to be more effective in tension headaches and psychogenic headaches.
Certain yogic postures are given hereunder which are found to be effective in controlling headache.
• Eka pada seershaasana
• Pavana muktaasana
• Savasana
• Ardhamatsyendriyasana
• Sooryanamaskara
• Padmaasana
• Vajraasana

Some home remedies. . .
• Paste of nutmeg applied on forehead reduces headache.
• Paste of coriander seeds with rose water.
• Paste out of sandal wood and ginger.
• Paste made of mustard and water.
• Paste made of cinnamon powder and water.

How fatal is a headache. . .

A headache that occurs everyday or strikes with great intensity can be a feature of life threatening disease. Headache associated with vomiting and convulsions can be treated as fatal as well. On the other side, even hunger or a heavy night party can lead to a headache, which is much more irritating, but never turns to be fatal. . .
Adequate rest, sleep , healthy diet and proper exercises along with seasonal purificatory measures of the body controls from the affection of headache and reduces the severity of the condition. Above mentioned factors helps to maintain the equilibrium of the three doshas, which inturn moulds out a healthy individual. . .

References
• Susruta Samhita - Uttara Tantra - 25
• Ashtanga Hrdaya - Uttara Tantra -23
• Caraka Samhita - Cikitsa Sthaana
• Caraka Samhita - siddhi Sthaana
• Text Book on Shalaakya Tantra

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