HEADACHES
A headache-health book by Egilius L.H. Spierings, MD, PhD
About Dr. Spierings
Dr. Spierings is a neurologist with specialty training in the diagnosis and treatment of headache and face pain. He is also a pharmacologist with extensive experience in the development of migraine medications.
He was an associate clinical professor of neurology at Brigham & Women’s Hospital and Harvard Medical School and a clinical professor of neurology and craniofacial pain at Tufts University Schools of Medicine and Dental Medicine in Boston, Massachusetts. He is currently the medical director of the Greater Boston Headache Center and MedVadis Research at Boston Advanced Medicine in Waltham, Massachusetts.
He wrote this book primarily for those afflicted by headaches, particularly intense headaches like migraine. However, it also deals with other headache conditions, such as cluster headache, concussion headache, headache in pregnancy, and face pain. He wrote it for all audiences – easy to read and understand – but it provides informative reading for health care practitioners as well, including physicians.
After addressing the brain tumor question, always a concern among patients with headaches and their physicians alike, he introduces headache as a part of life as much as fatigue is. He presents headache as a secondary symptom to fatigue, which he sees as the biological reason for its existence. In addition to fatigue, anything that strains us, mentally or physically, causes headache, coming from the outside or from within. There is more to it when headaches occur frequently or are intense, and there are medical reasons for both.
The most common reason for someone to have intense headaches is migraine, a genetically determined and inherited condition. Frequency is not a feature of migraine and the headaches can occur anywhere from sporadically to daily. In women, it is often the menstrual cycle that determines their frequency. With frequently occurring migraine headaches, persistent muscle tightness is the culprit, manifesting itself in tight neck, shoulder, and upper back muscles and often jaw muscles as well.
Dr. Spierings attributes the persistent muscle tightness, the driver of headaches when they happen frequently, to the fatigue that comes along with it. Neither are due to stress; a lack of metabolic energy causes them, making you feel tired, on the one hand, and rendering it difficult for your muscles to relax, on the other.
The muscle tightness particularly impacts the so-called postural muscles, that is, those in the back of the neck, shoulders, and upper back and in the lower back, calves, and jaws. It also affects the functioning of the muscles in the gut, particularly the stomach and the large bowel, accounting for the disorders of those organs often encountered with frequently occurring headaches, including migraine.
Dr. Spierings emphasizes that the treatment of migraine is with prescription medications specifically developed for it. Whether patients take them to treat individual headaches or in an effort to prevent them, they should tolerate them well without side effects. They should fully relieve headaches within 2 hours when taken as needed abortively and reduce their overall frequency of occurrence by at least half, when used preventively.
