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Known in headache clinics by such terms as “Vascular Relaxation through Temperature Biofeedback,” this self-regulation technique has shown a high success rate in aborting migraine and in preventing both migraine and tension headaches.

Biofeedback training comes well recommended. Originally developed during the 1960s by Elmer Green, Ph.D. and other pioneers at the Menninger Foundation in Topeka, Kansas, it has since been elaborated on and endorsed by researchers at the Mayo Clinic, Johns Hopkins and just about all of the top university medical schools. Biofeedback training is widely available and its success as a headache treatment and stress-managing technique is unquestioned.

In some situations, professional biofeedback training may be available at quite affordable cost. If it is, by all means take it. Or if your doctor prescribes biofeedback training, you must attend the professional biofeedback clinic that he recommends.

Biofeedback clinics are equipped with supersensitive, state-of-the-art monitoring devices, and with their trained instructors, they can obviously produce swifter results than you can hope to achieve on your own. The snag is that biofeedback training can typically cost from $350 to $1,000 or more for a few sessions of training.

Yet if there is no medical urgency, anyone with some self-motivation and commitment can easily achieve almost equal results with do-it-yourself biofeedback training at home.

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Developed in the early 1980s by neurologists at Loma Linda University in California, this technique has successfully ended chronic tension headache in 90 percent of sufferers.

The tension technique is simplicity itself. You merely sit upright in a chair and:

1. Turn your head to the left as though looking back over the left shoulder.

2. Place your left index finger on the right cheek with palm and thumb under chin. Very gently, push the head to the left.

3. Simultaneously, place the right hand on top of the head with the middle finger touching the top of the left ear.

4. Very gently, exert pressure with your right hand to pull the head down towards the chest. Just before you feet any discomfort, stop at that point and hold for ten seconds. Then release.

5. Repeat on the right side.

6. Repeat twice more on each side for a total of six neck stretches, three on each side.

Be very gentle. Do not push or pull hard or force anything. Simply apply very gentle, steady pressure and do not go beyond the point where discomfort begins. Should you experience any pain or discomfort, or feel dizzy, discontinue the technique.

Neck stretching was developed after neurologists discovered that taut neck muscles are the mechanical cause of most tension headaches. As you exert gentle pressure with your hands, you should feel the taut muscle and fibrous tissue in your neck being stretched and released.

To relieve chronic tension headache, one series of six neck stretches as just described should be done once every two hours during the day. After the headache is relieved, neck stretching can be continued twice a day as a prophylactic measure. The complete technique takes only two minutes to accomplish.

Headache clinics report that most people with chronic tension headaches usually feel much better after only a single week of neck stretching. And within three months, all but the most stubborn cases have usually disappeared.

Neck stretching can also provide quick relief from acute tension headache—the occasional tension headaches experienced by millions daily. It has also helped victims of common migraine.

Alternatively, any combination of neck rolls, or moving of the head from side to side, or up and down, or turning from left to right and vice versa, plus shoulder shrugs and shoulder rotations, can benefit tension headaches. However, people with arthritis or stiff necks may prefer to use massage, brushing, or heat or cold treatment.

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Caffeine is a legal form of speed that can both constrict and dilate arteries, and can also cause a painful rebound headache. In moderate quantities, say two to three cups a day, coffee it a powerful vasoconstrictor. Yet in larger amounts, such as five or more cups per day, it becomes a potent vasodilator.

In moderate quantities, coffee will relieve certain vascular headaches by constricting already dilated arteries. But in larger amounts, it causes blood vessels to dilate. It can also cause a rebound headache.

A rebound headache occurs when a caffeine addict misses a fix and begins to experience withdrawal symptoms. The dilated arteries will constrict again as soon as another cup of coffee is consumed. And the coffee-withdrawal headache swiftly disappears. Unfortunately, migraine headaches do not respond as readily to coffee, though tension headaches occasionally do.

When suffering from rebound headaches provoked by caffeine, the solution is to gradually reduce intake of not only coffee but of tea, cocoa, cola drinks and any other caffeine-containing beverages or medications. Otherwise, it’s best to keep coffee intake down to not more than two or three cups per day. Besides causing headaches, caffeine has been implicated in causing insomnia and restlessness and in heightening risk of heart disease and bladder cancer.

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Fight-or-flight is a hair-trigger response that evolved in primitive times to prepare the body to meet imminent physical danger. The sympathetic nervous system, the emergency branch of the autonomous nervous system, takes over and all systems are Go. The adrenal glands squirt hormones into the blood stream to speed up body functions. Nerve fibers signal the smooth muscles to constrict every artery and arteriole. Blood pressure shoots up, and blood is shunted from the digestive system to the brain and muscles. Glycogen (sugar) is released from the liver, filling our muscles with energy and tensing them for action. Meanwhile, the clotting ability of blood platelets increases in preparation for a possible wound.

The problem is that this response, a legacy from pre-caveman days, can be turned on by any kind of feeling that the hypothalamus and pituitary glands interpret as negative. All too many people have such inappropriate belief systems that a letter from the IRS can trigger the same emergency stale that their ancestors would have experienced on being confronted by a saber-toothed tiger.

If we act out the fight-or-flight response by either fighting or fleeing (or by jogging, bicycling, briskly walking or doing pushups), we release the pent-up muscular tension and the other stress mechanisms swiftly fade away. But if, as is so often true in modern society, physical action is impossible, we remain tensed-up and uncomfortable and we live through the day in a state of distress.

Trying to repress a negative emotion, which means concealing or burying or denying our discomfort, only intensifies our stress. Many people live in a continuously low-level emergency state with all their stress mechanisms constantly simmering. It is these stress mechanisms—the release of adrenal hormones, tensing of muscles, and heightened clotting ability of the platelets—that set off the remaining stages in the headache process.

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The focus of this chapter is on minimizing dependency on nonessential headache medications. It is not intended to dissuade you from taking drugs prescribed by your doctor, or drugs which may be essential to your health.

With this caveat in mind, the first step in freeing yourself from headaches is to take a cue from the headache clinics. Their prime concern is to get patients off painkillers as quickly as possible, and then off any other drugs.

If you are taking a prescription drug, or an OTC drug on your doctor’s recommendation, or are under medical treatment for any reason at all, you must seek your doctor’s approval and cooperation before reducing the dosage, and phasing out, any drug. Drugs prescribed for dysfunctions such as hypertension or heart disease may also precipitate chronic headaches. Your doctor may consider such drugs to be essential.

Even if your doctor does agree to phase out a drug, you may have to do it under medical supervision because you may already be addicted to the drug.

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