might be necessary to use other pain relievers , such as narcotics or ultram . Any decisions involving treatment should be discussed with your physician , who will weigh the risks and benefits of each therapy .
– Vincent Martin , MD , University of Cincinnati College of Medicine , Cincinnati
Pumping Iron
I get headaches whenever I lift weight above my head or strain my shoulder muscles in any way with weight lifting . What do you recommend ? – Steven T . Your headaches likely represent exertional headaches . These are typically throbbing
The typical treatment options for benign exertional headaches are NSAIDS or beta-blockers prior to exercise .
and last from five minutes to 24 hours after exertion . Most of the time , these headaches are benign and are not associated with any underlying diseases . However , I usually recommend an MRI of the brain and an MRA ( magnetic resonance angiograph ) of the blood vessels of the brain to be absolutely sure you don ’ t have other causes for your headaches . The typical treatment options for benign exertional headaches are NSAIDS or beta-blockers prior to exercise .
Another possibility is thoracic outlet syndrome . This occurs when the muscles in the shoulders contract and tighten down on nerves or blood vessels . The most common symptoms are pain and numbness in the arms . Headaches are rare in this syndrome and typically occur in the back of the head . Your physician can diagnose this by putting your arms and shoulders in different positions , and it can often be treated using physical therapy .
– Vincent Martin , MD , University of Cincinnati College of Medicine , Cincinnati
Hazy Outlook
I have had chronic migraine for 17 years after getting a complete hysterectomy . I have a hyperexcitable nervous system with two main triggers . One is environmental — such as air flow , wind , cold , heat , humidity , etc .— and the other is certain visual stimuli — such as attempting to wear prescription eyeglasses or contacts , using a magnifying glass , watching a flatscreen TV , using a computer screen , etc .
I have natural monovision and diminishing vision in each eye due to aging . Plus , I now have cataracts in each eye .
Is cataract surgery feasible for a person with a hyperexcitable nervous system and visual triggers ? Looking through prescription glasses , contacts or a magnifying glass — for literally only minutes — causes a migraine , so I am afraid having a permanent unclouded lens implanted will also trigger a migraine . And since this lens is permanent , I am afraid the migraine will be 24 / 7 with no way to stop it .
My ophthalmologist says my brain might adjust after surgery , but there is no guarantee , and the surgery is permanent . My neurologist and neuro-opthalmologist are aware of my problem but don ’ t have a solution .
Do you have any recommendations regarding the feasibility of cataract surgery or other options for a patient such as myself ?
– Maureen B . The response to surgery is completely unpredictable . If vision is well corrected , surgery might give you less visual strain . At the same time , change in anything , including vision , can trigger attacks . Your best bet is to get optimal migraine treatment , and then get the vision corrected if you need it to see better , not for headaches .
– Mark Green , MD , Mount Sinai School of Medicine , New York City
www . headwisemag . org | National Headache Foundation 9