Headache is a gas problem

High tension brain

Broken head


Quite a few researchers have racked their brains about how migraines develop. There are many hypotheses. Scientists are currently assuming that the brain stem is over-excited. This cannot be found in healthy people. The parents pass this predisposition on to their offspring.


Due to its hyperactivity, the brain stem can no longer adequately fulfill its physiological filter function. Instead, a multitude of insignificant sensory stimuli then act on the cerebrum. The trigeminal nerve is particularly overactive. Its numerous ramifications then release many neuropeptides such as CGRP (calcitonin-gene-related-peptide), VIP (vasoactive intestinal peptide), substance P and nitric oxide (NO) in the meninges and the base of the brain in a kind of short-circuit reaction. These then cause inflammation and widening of the blood vessels. This in turn stimulates the trigeminal neurons. Because the pulsating blood constantly presses against the inflamed vessel walls, the migraine manifests itself with rhythmic throbbing and pounding pains. It has not yet been clarified why the attack subsides on its own.


Triggers blow to attack


Migraine researchers have identified a multitude of factors that can trigger an acute attack - if the nervous tissue of the brain is sensitive to it. These migraine risk factors can be easily identified with the help of a headache diary. But there are also new findings about the most common migraine triggers, as the box shows:


Stress at work, enormous psychological stress

Hormonal changes such as menstruation. Some women only have migraines during their period, others just before it (premenstrual migraines)

Disturbances in the usual daily routine: irregular meals, sleep deficit, but also sleeping too long, for example on the weekends.

External stimuli such as bright light, noise, changes in weather

Consumption of certain foods containing tyramine as well as alcoholic and caffeine-containing beverages (see also box), but also prolonged starvation, for example during therapeutic fasting.

Physical overexertion: carrying objects that are too heavy, running too fast, watching TV for too long, bathing too hot, strenuous trips, jet lag.


Tension to pain


Tension headache is the most common type of headache. Those affected describe the pain as dull and pressing on both sides of the head. You feel like you have an overly tight helmet on your head or you feel like you are in a vice. It is not uncommon for the pain to radiate to the neck and shoulders, sometimes even to the back. An aura and pronounced accompanying symptoms are missing. Sometimes these headaches only make the situation unbearable for half an hour, other times they last for days. Experts speak of episodic tension headache when it occurs only occasionally, at most every other day (sporadic or frequent episodic tension-type headache). However, if the pain breaks through for more than 15 days and has persisted for the last three months, it is considered chronic.


Pain processing out of control


The word tension headache comes from history when it was still believed that muscle tension would be the culprit. But muscles probably only play a subordinate role. Because not all patients with typical tension headaches can such tension be detected. What actually causes the pain is not known. The Classification Committee of the International Headache Society considers further scientific research on the pathophysiology and treatment of tension-type headache to be desirable.