EMDR and Headaches

Headache disorders are among the most common disorders of the nervous system. Headache is a painful and disabling feature of a small number of primary headache disorders namely migraine, tension-type headache, and cluster headache. Headache can also be caused by or occur secondarily to a long list of other conditions, for example medication overuse headache.

According to the World Health Organization, it has been estimated that the prevalence among adults of current headache disorder (symptomatic at least once within the last year) is 47%. Half to three quarters of the adults aged 18–65 years old in the world have had headache in the last year, and among those individuals, more than 10% have reported migraine. Headache that occurs on 15 or more days every month affects 1.7–4% of the world’s adult population. Despite regional variations, headache disorders are a worldwide problem, affecting people of all ages, races, income levels and geographical areas.

Not only is headache painful, but also disabling. In the Global Burden of Disease Study, updated in 2004, migraine on its own was found to account for 1.3% of years lost due to disability (YLD).  Headache disorders impose a recognizable burden on sufferers including sometimes substantial personal suffering, impaired quality of life and financial cost. Repeated headache attacks, and often the constant fear of the next one, damage family life, social life and employment. The long-term effort of coping with a chronic headache disorder may also predispose the individual to other illnesses. For example, depression is three times more common in people with migraine or severe headaches than in healthy individuals. Sadly, for 60% of sufferers, medications are of little to no help in alleviating the headache.

Types of headache disorders

Migraine

• A primary headache disorder.
• Most often begins at puberty and most affects those aged between 35 and 45 years.
• It is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.
• Migraine is recurrent, often life-long, and characterized by attacks.
• Attacks include features such as
  • headache of moderate or severe intensity;
  • nausea (the most characteristic);
  • one-sided and/or pulsating quality;
  • aggravated by routine physical activity;
  • with duration of hours to 2-3 days;
  • attack frequency is anywhere between once a year and once a week; and
  • in children, attacks tend to be of shorter duration and abdominal symptoms more prominent

Tension-type headache (TTH)

• TTH is the most common primary headache disorder.
• Episodic TTH is reported by more than 70% of some populations; chronic TTH affects 1-3% of adults.
• TTH often begins during the teenage years, affecting three women to every two men.
• Its mechanism may be stress-related or associated with musculoskeletal problems in the neck.
• Episodic TTH attacks usually last a few hours, but can persist for several days.
• Chronic TTH can be unremitting and is much more disabling than episodic TTH.
• This headache is described as pressure or tightness, like a band around the head, sometimes spreading into or from the neck.

Cluster Headache (CH)

• A primary headache disorder.
• CH is relatively uncommon affecting fewer than 1 in 1000 adults, affecting six men to each woman.
• Most people developing CH are in their 20s or older.
• It is characterized by frequent recurring, brief but extremely severe headache associated with pain around the eye with tearing and redness, the nose runs or is blocked on the affected side and the eyelid may droop.
• CH has episodic and chronic forms

Medication-overuse headache (MOH)

• MOH is caused by chronic and excessive use of medication to treat headache.
• MOH is the most common secondary headaches.
• It may affect up to 5% of some populations, women more than men.
• MOH is oppressive, persistent and often at its worst on awakening.