Chapter 2

THE TENSION HEADACHE / COMMON MIGRAINE PUZZLE

Medical researchers estimate that at least 10% and as much as 20% of the population suffer from daily or weekly tension headache and common migraine. At one time, the medical community assumed that the muscles of the scalp somehow developed into a dysfunctional state which felt like a tight hatband around the head, with the most pressure at the temples. The medical community later realized that the scalp muscles didn't participate in the kind of strenuous activity that would normally result in muscle dysfunction (raising the eyebrows and wiggling the ears are hardly perpetual strenuous activities). Several studies demonstrated that the muscles of the scalp showed no increased activity during a headache, compared to the normal state. Researchers then concluded that either some dysfunction in the blood vessels or in nerve conduction to and from these muscles must be the cause of the intense muscle pain. Thus, researchers have concentrated their studies on blood vessel activity and nerve conduction.

Recently, neurological research has isolated the temporalis muscle as the primary center of tension headache pain and possibly common migraine pain. Although the temporalis muscle is located on the skull, it is technically a jaw muscle and not a scalp muscle, since its sole function is to close the jaw. Medical schools, therefore, leave the study of the temporalis muscle to the dental schools. Dental schools leave the study of headache to the medical schools, so the temporalis muscle and even more importantly, the nerve that services the temporalis, the Trigeminal,  has been largely overlooked as a causative and/or perpetuating source of headache and migraine.

The temporalis muscle has a large fan shape that covers the entire side of your head, known as the temporal area, extending from above the ear to just behind the eye. The temporalis is actually much thicker than you might imagine, but it is not readily detectable because it resides in a deep indentation in the skull. That's why it's not very obvious. While the broad, fan-shaped end of the muscle covers the entire side of the skull, the other end tapers down and reaches under the cheekbone and attaches to a special projection of the lower jawbone.

The temporalis' sole function is to close the jaw during chewing. To demonstrate how it works, place a pencil between your molar teeth as far back as you can and bite down hard, repeatedly. If you rest your fingers along the temporalis muscle, you'll feel it bulge in and out. The temporalis is considered the strongest and most powerful muscle of the body, able to crush bones, crack hard nuts, and fracture teeth! Researchers haven't been able to determine whether the temporalis muscle itself is dysfunctional and, therefore, the cause of the headache, or if the blood vessels and nerves that service the temporalis are dysfunctional and cause pain to appear in the temporal region. If the temporalis muscle can be a source for all these headaches and migraines, how can it become so painful? (Perhaps, as well shall see later, there is one more component to the puzzle…)

There are basically two theories. The theory of those practicing in medicine (i.e., internists and neurologists) suggests a malfunction in the central nervous system. Think of it as a computer malfunction. Medicine's view is that there is a problem with the software system (computer lingo). The pathways that carry information and data to and from the temporalis muscle have somehow been altered. This mis-information can result in headaches, usually in the temporal region. Various medications are then prescribed to cover up the problem. The other theory, the one proposed by physical therapists, orthopedists, dentists, and chiropractors, suggests a defect in the hardware, that is, a problem with the physical body that can be remedied by therapy, surgery, or chiropractic adjustment.

"I was a bi-monthly visitor to our local urgent-care facility for mega-shots of Demerol, Toredol, etc., for vicious migraines...no doctor, surgeon, dentist or other medical person I had dealt with for all those years had actually had the problem I did...except for Dr. Boyd. If I could turn back time, Dr. Boyd would have been there before things got so very bad for me...but to be headache-free after 10 years of pain and frustration is just wonderful!"

Dawn Alegre, Los Angeles, CA

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