DR. HOOK- Up tight: Reduce stress to cure headaches

Tension can be a good thing. A tightrope walker needs a good tense rope. Tension in the theater can make the difference between a B movie and an A movie. The View became more popular with all the tension that occurred with Rosie O'Donnell. Personally, I'm wound so tightly that if I relax, I'll look like an amoeba– people would think my doggie peed on the floor.

Okay, I guess everything needs balance. Yin and yang, Abbott and Costello. What happens when the neck and head muscles become too tense?

About 40 percent of Americans suffer with tension headaches every year. (Too bad we can't buy stocks in it, though I'm sure Donald Trump will figure out a way.) They are the most common types of headache, but they are not life-threatening.

The muscles of the neck become tight, and the pain radiates up the skull muscles and into the temples. So people often complain about pain around their temples and classically rub them with their fingers in a circular motion. Most people with tension headaches don't even realize their necks are tight. (I'm sure they don't even rubberneck at an accident site.)

A lot of people mistakenly believe that only tense people have tension headaches. "Doc, I can't have tension headaches because I'm cool as a cucumber. Dip me in vinegar, and I'll come out a dill pickle." 

Well, stress can cause people to tense up their neck, shoulders, and jaw to create a tension headache. But more often than not, the way a person carries herself can lead to the tense muscles. 

Gum chewers can tense up the temporal muscles (which is why you shouldn't crack your gum!). Stooped over in front of a computer like a 120-year-old creates a lot of stress on the neck. If you ice skate like me with your shoulder up into your ears, the trapezius muscles can tense up. (See, you shouldn't put anything into your ear smaller than your elbow.)

Pain from a tension headache can last from minutes to hours to days. But normally, it subsides sometime during the day. It normally doesn't wake a person up. Most people with tension headaches wake up without the headache (unless they grind their teeth or sleep in a poor position), but the headache comes on with work. 

I often hear, "My work is too stressful, and I have a headache by 3pm everyday." (Whatever happened to the three-martini lunch?)

If the headache is painful enough, nausea and/or vomiting can occur, which makes people think they're having a migraine. But usually light doesn't hurt the eyes and sounds don't hurt the ears with tension headaches. Also neurological symptoms don't occur, such as numbness or focal weakness (like the hand or leg). 

Massage, heat, and stretches often alleviate the pain. Anti-inflammatories like Tylenol and ibuprofen can be effective in reducing pain. For chronic tension headaches, prescription medicines can be used. Muscle relaxants are good, but they usually knock the person out, and who has pain when they're knocked out? Some prophylactic medicines used for migraines can be effective as well.

I'm a huge fan of physical therapy and yoga for tension headaches because they can correct the underlying problem. Also stress reduction is often needed.

A good neurological evaluation is needed for chronic headaches, so be prepared to have your reflexes tested. But if you're a really tense person, please don't wear steel-toed boots while having your knee reflex checked. 

Ouch! That would make me very tense.