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Sunday, July 20, 2014

TENSION HEADACHE

                                                                                            -DR. ARVIND DUBEY
Though the word ‘tension’ is a very commonly used word, it is one which cannot be easily defined.  Its literal meaning is given as ‘stretched tight’.  In common parlance the word is used for mental condition arising out of nervous strain.  Scientifically, it is defined as a state of increased motor and psychological activity, which is unpleasant.

It is generally accepted that headache and emotional stress are interconnected.  Headache is the expression of conflicting emotions and anxiety.  It may be the result of a complicated biochemical alteration.  Usually the origin of anxiety is rooted deeply in an individual’s past interpersonal conflicts.  Feeling of inadequacy, guilt, shame, helplessness, envy, loneliness or fear of abandonment, all of which may contribute to resentment or hostility towards a loved person.  Such feelings are usually repressed or rejected at conscious level, may emerge as bodily symptoms. 
Headache is the expression of conflicting emotions and anxiety (Courtesy- Wikipedia)
The severity of these headaches ranges from minimal discomfort, commonly experienced followed fixed attention, a prolonged car drive or long periods of intensive studies; to incapacitating headaches or pains that are totally disabling and thereby precluding physical activity.  Such headaches are said to be the consequence of eyestrain or concentration, but perhaps, the necessity to perform an unpleasant task or to continue an emotionally repugnant involvement may be the more likely cause.
These headaches ranges from minimal to incapacitating discomfort (Courtesy-Wikipedia)

Treatment
Treatment of tension headaches can be very frustrating.  Mild analgesics such as aspirin and paracetamol are generally preferred in treating headaches.  As is the usual practice, during self-medication, the patient keeps on increasing the dosage while the headache persists.  But contrary to the belief, the amount of drug taken, over and above its optimal dose, does not relieve the discomfort but adds to its side effects.  Self-medication should be avoided as many drugs for headaches contain caffeine, the stimulant action of which may be undesirable when a large amount of the drug is consumed.  Besides, these drugs cause gastric irritation, nausea and vomiting and even gastric ulcer and other blood coagulation disorders.
          
Anxious patients with tension headaches also use sedatives, viz. Diazepam, but these too are accompanied by problems of over dosing, psychological dependence and side effects, when taken beyond the optimal level.  However, to date, no drug is available to treat tension headaches.  Despite the uncertainties surrounding the exact relationship of psychological disturbances to headaches, certain types of psychotherapies and behavioural alterations appear to be curative in many patients.  The value of simple reassurance should never be underestimated.
          
The unconscious choice of headache as an expression of anxiety is probably governed by many factors, the most common amongst which is the concept and image of one’s body and its functions that develop early in life.  Along with the growth of the though process, the importance of the head and its function get impressed on the mind.  Headache is often one of the earliest words related to bodily ailments that children recognise when unsuspecting mothers choose headache as a physical expression of anxiety.  Thus a child begins to associate a state of anxiety with a headache.
          
Tension headaches are caused when the skeletal muscles contract about the face (top of head, neck and shoulders).  The arteries supplying blood to the above muscles contract too when they respond to generalised noxious stimuli.  This decreases the blood supply to the muscles.  Often, headaches are associated with fatigues tensions.
          
There is no fixed pattern for headaches.  It is a dull aching pain and is expressed as tightness, pressure, drawing or soreness of the head.  It is usually in both sides of the head and, more so on the back of the head.
          
Use of physical therapy for tension headaches has a long history.  Heat and massage have been used as muscle relaxants since antiquity.  Often there is a prompt relief but it is usually short lasting.  There are some techniques by which within a few weeks, the patient learns to relax his head muscles on his own will.  Biofeedback therapies are also tried but they need the help of a trained psychiatrist.
 Remember that it is just an outward symptom of an inner tension.  The real culprit is deep-seated anxiety about anything between unpleasant involvements to fear of loneliness.         
The above modalities do not treat the underlying tension that may be causing the symptom.  To alleviate the tension, the approach should be to provide the patient with the necessary understanding and insight into how he translates his anxiety into muscle tautness, which manifests as tension headache.  Change in atmosphere and stimulus, which brings about these tensions, should be tried.  Though it is very difficult to implement, yet sometimes, by minor changes, tension can be alleviated.  But this also has individual variability.  Yoga, meditation can also offer hope in this direction.

HEALTHY SKIN : INDICATOR OF YOUR PERSONALITY

-DR. ARVIND DUBEY
Skin is the largest organ of our body– it protects, regulates temperature, provides oil and transmits sensations-but, still, often, the skin is given step-motherly treatment by us!  We abuse it with neglect and rough treatment.

You are gifted with a unique covering for your body viz. skin.  When you encounter any noxious stimulus, it is the skin which faces it first. On entering a warm or cold room, it is the skin which finds it pleasant or intolerable. It is self-sufficient and can repair all wear and tear by itself provided it is healthy.  It is always with you, walking or sleeping, working or resting, all through your life.

The total skin in an adult could weigh up to 6 pounds.  It is made up of 2 main layers- Epidermis and Dermis, which in them are made up of several layers. The outer layers are hard and horny and the inner ones are soft.  The horny layer of skin, forms nails, over the fingers.

                                          Cut section of skin
On the fingertips and on the palms, parallel ridges can be seen which form patterns of fine lines.  Rows of tiny swellings or papillae are found with ends of nerves and loops of tiny blood carrying capillaries.  The size of these capillaries is controlled by the nerves, which respond to changes in temperature.

There are several glands found in the skin but the important ones are the sweat and oil secreting glands.  The sweat glands play an important role in maintaining body temperature.  The oil glands open into pits from which the hairs grow.  Oil secreted by these glands makes skin soft and keeps it from drying.

ROSY CHEEKS: NATURE’S GIFT 
Rosiness of cheeks and skin depends on the number and arrangement of the blood vessels, the thinness of outer layer of skin and the quality of blood.  A thin outer layer permits the colour of the tiny blood vessels to be seen through it. Tiny grains of brown or reddish yellow colouring material or pigment are buried in the inner layers of the epidermis.  In light coloured persons, the amount of this pigment is lesser than in the dark complexioned. Primarily, the amount of pigment in the skin is determined by heredity, though this pigment may vary greatly with exposure to sunlight.

CLEANLINESS OF THE SKIN 
Cleanliness helps to maintain a good complexion and improve personal appearance.  To be clean is not only healthy but it makes one more attractive to others.
Baths-  
  • Ordinarily one thinks of a bath only as a means to clean the skin but it provides more advantages.  It soothes the nerves and tones up the muscles or relaxes them.  By stimulating the skin, a bath speeds up the circulation of the blood.
  • Correct bathing at the right time improves health.  The water should be at or a little above body temperature.  The warm water dilates blood vessels and the blood is diverted away from the brain to skin, often making one feel comfortably sleepy.  Such a bath is best taken at bed-time.
  • A hot bath, with water above body temperature should be taken only when one is chilled.  The warmer the water used for a bath, the more necessary is the protection against chilling after the bath.  Otherwise, the bath may do more harm than good.
  • Bathing with cold- water first contracts the blood vessels in the skin; so the blood is diverted to internal organs.  It acts as a powerful tonic to the skin and makes one feel alert.  The cold bath can also train the blood vessels to respond quickly to changes in temperature.  So, healthy people who take cold baths regularly are generally more hardy and less susceptible to cold a chill than others who do not.
  • The cold bath should be followed by a reaction in which the surface blood vessels dilate again, so that the skin becomes warm and glowing.  Brisk rubbing with a dry and rough towel will help to secure this reaction.
  • A bath should not be taken within an hour after eating. During this period digestive organs need more blood .So it is unwise to disturb circulation at this time.  A bath should always precede a visit to your doctor for physical examination and follow a vigorous exercise.
  • The face and hands should be washed many times in a day and especially in the morning and evening.  Persons with oily skins should use a lot of soap and water.  When washing the face, do not neglect the back of the neck and the area behind the ears.
Use of soap
  • For those who always insist that old is gold, the soap may seem useless or even harmful for the skin.  This is not really true.  Soap is made up of oil and alkali.  The lesser the amount of alkali, the milder the soap but the lesser is the cleansing action.  A mild soap, makes enough lather on application and does not irritate the skin, can be used. 
  • Soap coming for the first time in the market from a non-reputed company should not be tried easily. Highly coloured or scented soap should be avoided because in such soaps the colours and odours are often used to mask ingredients which should not be tolerated even in laundry soap!
  • Contrary to belief, no medicine put into soap, can give it a special advantage over an ordinary mild soap of good quality.   Similarly, the benefits of glycerin, lime, lemon, lanolin, etc is questionable ; at times these may be harmful.
  • Some manufacturers claim that their soap is better for oily skin; it is at times a baseless claim.  Any soap having even a mild cleaning action (which soap always has) is able to remove that minute quality of so called, “excess oil” from the skin.
  • Due to some misconceptions, especially in the middle income group, the harder soaps containing more alkali or even laundry soaps are used to clean the hair and scalp.  This results in hair loss.  Ideally, good mild shampoos should be used.   Some mild soap used for bathing can also serve as an alternative to shampoo.
Use of bath oil
This is a greatly misunderstood topic.  Usually bath oil is applied before the bath, or sometimes mixed in the bath water.  In both the conditions, it is of no use.  It only increases the soap price and increases the lather produced by it. Bath oils are indicated only in certain dry skin conditions where it should be used just after a bath, before drying the skin.  Alternatively, a moisturizer can be used after the bath.

MASSAGE OF THE SKIN
Massaging of skin plays an important role in maintaining its youth especially after 35 years of age.  The movement of the fingers in this process should be from down upwards for the face massage.  This maintains the tone and circulation in facial muscles and prevents appearance of wrinkles.  This fact is true for the skin of arms and any other part of the body too.
 
COSMETICS AND SKIN
  • It has been estimated that during the period in which the population of our country has doubled, the sale of cosmetics has gone up 15 times.  To the public, cosmetics are artificial aids to charm.  While ordinarily, no harm should result from the moderate use of cosmetics (provided these are not cheap); no real benefit to the health of skin is derived.
  • Girls misguided by advertisements often ruin a good, clear, natural skin with the unwise use of cosmetics.  At best, the use of cosmetics can attempt to imitate the natural hues of a healthy complexion.  It must not be forgotten the shutting out the sun rays with cosmetics may actually mar the skin and therefore the complexion less healthy.
  • However, there are few ingredients which are present in cheaper or sometimes even in good quality cosmetics, can cause allergic conditions.
  • There is no substitution for the healthy hair, white teeth and clear, firm complexion which come from a proper diet, rest, exercise and optimistic mind.  A good complexion cannot be bought from a box or a bottle.

SUNLIGHT AND SKIN
Sunlight induces some kind of a chemical reaction in the skin.  .  Usually, it causes tanning of the skin but in few susceptible persons, it may lead to sunburn.  In our country, tanning is not needed.  In fact, it is difficult to avoid the darkening of the complexion especially for those who work in the sun.  A cream containing ‘SUNSCREEN’ should be used to avoid darkening of the skin.

ROLE OF GOOD DIET AND EXERCISE IN SKIN HEALTH

Good diet, good sleep and exercise can be called, “real cosmetics.”  A good protein-rich diet with added vitamins and minerals, especially of the B-complex group, keeps skin charming, lively and healthy.  Early to bed and early to rise with sound sleep of not less than 8 hours keeps wrinkled eyes away and the skin healthy.  Similarly, a routine mild exercise maintains adequate blood circulation in the skin and keeps it fresh and glowing.