4 Headache Triggers and Contributing Factors

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From the course by University of Minnesota

Preventing Chronic Pain: A Human Systems Approach

84 оценки

University of Minnesota

Preventing Chronic Pain: A Human Systems Approach

84 оценки

Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.

From the lesson

Common Pain Conditions and their Mechanisms (Week 4)

1 What You Can Do to Prevent Headaches: An introduction 2:25

2 Understanding Your Headache 8:41

3 Headache Diagnosis 6:43

4 Headache Triggers and Contributing Factors 5:45

5 What About Muscle Dysfunction? 7:26

6 Transformation of Episodic to Chronic Heachache 18:44

7 Managing Headaches: An individualized treatment plan 8:23

8 Treatment Planning: Simple to complex 6:55

Last Scroll: The Vacation v25:22

Meet the Instructors

Dr. James Fricton, DDS, MS
Professor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic

Now that we've covered a little bit about the classification and diagnosis of

headache, I'd now like to talk about preventing chronic headaches.

A good place to start here is identifying headache

triggers, and what I will refer to as contributing factors.

I will cover contributing factors in greater detail as we move forward.

So what about headache triggers?

This slide gives a list of different triggers that are important

for triggering, that are important and can trigger a headache.

This list includes conditions that will

trigger both tension type headaches and migraines.

Hormonal changes tend to be mainly associated with migraine headaches.

But otherwise there's an overlap, and certainly dietary factors, are

much more associated with, migraine

headaches than with tension type headaches.

I think it's important when we think about triggering a headache, we think about,

and this is the discussion I often have with my patients, is a bucket.

If you have an empty bucket and you start

throwing in triggers, eventually your bucket begins to fill up.

And you do okay with many triggers, and, without experiencing a headache.

But if the bucket overflows, then one has, it will experience a

headache and it will be a signal that the bucket is full.

So one of the things we try to do in managing people with

headaches, is to help them empty out their bucket, keep their bucket open.

And so that they can if such factors in life

occur, they have some reserve before a headache is triggered.

Now, a few years ago a patient came to me and

said, Dr. Clavell, and this was for someone who is having migraines.

Said, you know, Dr. Clavell, I think chocolate triggers my migraine.

And I of course said, well why do you think chocolate is a headache trigger?

And she goes, well last week I had a candy bar at 2 o'clock.

And at 4 o'clock I had a horrible migraine.

It was one of the worst I ever had.

And I think it was that, that candy bar.

I said, well that's, it's very

possible the chocolate contributed to your headache,

but I'm curious why did you have a candy bar at 2 o'clock?

And her response was, well, I missed lunch.

Oh, okay.

Why did you miss lunch?

Well, I had this very important meeting at 1:00,

that I had to prepare a presentation for, and

I was so worried about it that I was

practicing, and I just didn't have time to eat.

I said, okay.

Do you think that could have been another contributing factor to your headache?

Well, I, I guess maybe it could have.

And I go, just out of curiosity

when did you start worrying about this presentation?

Well, I, I couldn't sleep the night before, I was I

was tossing and turning all night long, worrying about this, my presentation.

And this is a typical example one hears when talking with a patient that has

episodic headaches, is that triggers do not just occur by themselves.

They occur in a setting of the

individual's life, the individual's lifestyle, and you

really have to understand the pattern of

these triggers and when they become important.

In this particular case, this individual was able

to recognize that at other times in her

life, when she had gotten a good night's sleep, she wasn't in a lot of stress.

And she hadn't missed meals, that she could

actually eat a candy bar without triggering a migraine.

And

so this slide, well, brings together about how

this kind of works together in an individual's daily life.

When we think about triggers such as stress, daily hassles, hectic schedules.

Issues of tension, vigilance, anxiety, or fatigue.

A pattern sometimes emerges.

And this is a classic pattern for migraine, where the

person will either have stress, busy hectic schedule in the morning.

As the day builds, they experience a sense of stress,

maybe some tension in their shoulders, tension in their jaw.

In the evening, their experience is one more of continued stress and fatigue.

The body's actually worn out, so to speak,

and then something magical happens at that point.

Either they recover, ie, they get home, they have

dinner, they relax, they rejuvenate themselves and do well.

Or, if the stress and tension continues, they often will go to bed, go to sleep and

clench their teeth during the night and often

wake up, feeling fatigued, restless with a throbbing headache.

And so, we think about these patterns and we help people, identify patterns on how

they fit together in their individual life,

as a way of managing and preventing headaches.

Obviously, some people can go from being relaxed to being under

stress, tension, fatigue, and a severe headache in a matter of hours.

So, this whole time frame here can be

condensed into a very short period of time.

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