Massage & Bodywork

November/December 2013

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education CLASSROOM TO CLIENT | PATHOLOGY PERSPECTIVES | BODY AWARENESS | FUNCTIONAL ANATOMY | SOMATIC RESEARCH What a Headache! Get a Handle On a Moving Target By Ruth Werner Who hasn't had a headache? Headaches (or cephalalgia, if one wants to sound erudite) are one of the most common pathological human experiences. They are rarely related to a serious underlying disorder, and most of the time they are essentially benign—a signal that it is time to get some rest, or to be more careful about what we consume, or that we are dealing with an infection of some kind. But, whether serious or benign, headaches can be more than a minor annoyance; they can be chronic and debilitating, causing people to miss work, skip school, and radically curtail their daily activities. TRIGEMINAL PATHWAYS The trigeminal nerve provides sensation for most of the head (including the corneas, meninges, sinuses, skin, and teeth), so it makes sense that this nerve is a key operator in most headache etiology. When pain sensors within the trigeminal nerve are active, they can trigger a motor response of vasoconstriction, usually on the surface of the brain's cortex. Vasoconstriction may then be followed by extreme and prolonged vasodilation that spreads across the cortex. In typical vicious-circle fashion, changes in blood flow to the brain can cause the release of pain-sensitizing neurotransmitters that irritate the trigeminal nerve and reinforce the sensation of pain. The link between trigeminal activation and motor response in cranial blood vessels is called the trigeminovascular pathway. Other parts of the trigeminal nerve reach deep into the brain stem, connecting this key sensory nerve to many processes in pain sensation and management. ICHD-II The International Classification of Headache Disorders-II (ICHD-II), produced by the International Headache Society, is a comprehensive guide to headache identification and terminology. The goal of the project 44 massage & bodywork november/december 2013

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