Headache Worksheet

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Headache Worksheet

Written By: Denice Moffat, Dr.
7-30-2007
Categorized in: Headaches

It's amazing what one can do for headaches of all types once you have fully described what you are experiencing and have determined the core cause and the best treatments for them.

This is the worksheet I have developed over the years that has helped countless clients in my own practice. I hope you see things on this page that will help you.

What causes your headache to come on?

Altitude, High	Hat Pressure	Riding Against Wind
Bathing	Hemorrhage	Riding in Cars
Beer	Hemorrhoids	Sexual Excitement
Bright' Disease	Ice Cream	Sleeping in Dampness
Candy/Sweets	Ice Water	Spinal Disease
Catarrh (mucous)	Influenza	Stomach Pain
Catarrh, suppressed	Ironing	Sunlight or Heat
Coffee	Lemonade/Wine	Suppressed Emotions/Eruptions
Constipation	Liver Disease	Suppressed Breathing
Dancing	Loss of Sleep	Syphilis
Diarrhea	Lumbago-Back pain	Tea
Exhaustion	Malaria	Tobacco
Eye Strain	Mental Exertion	Trauma
Fasting	Mercury Fumes	Uremia (Kidney)
Gastro-Intest. Probs	Narcotics Abuse	Uterine Disease
Haircuts	Nervous Exhaustion	Vaccinations
Hard Liquor	Over Lifting	Weather Changes

When does the headache happen?

When you are anemic?

When the barometer changes quickly?

When you have stomach problems?

If female, when you have your period?

If female, do they cycle with your periods?

When you are nervous?

Are your headaches associated with weather changes?

Does the headache come on, peak then gradually go?

Does the headache come on gradually?

Does emotional upset bring a headache on?

Do they happen when you feel congested?

Do you have a history of having kidney problems?

Associated with gouty arthritis?

Are your headaches chronic?

Are you in school?

Are you over the age of 65?

Would you consider yourself a sedentary person?

If female, have you had a hysterectomy?

Where does the pain start and extend to?

Along the sutures of the head

Back and neck

Back of head (base of head or occiput)

Behind the eyes Left Right or Both?

Ear to ear in line with the temples

Front extending to eyes, root of nose, or face

Frontal

Frontal extending to back of head, neck or spine

On one side only Left Right (Circle which one)

On the crown of the head

On the temples

Other:

Characterization of the pain:

	Dull, aching		Every 8th day
	Boring, digging		Every week or two
	Bruised, battered, sore		Every two to three weeks
	Burning, hot		Every 6 weeks
	Bursting, splitting		Last days with pain flux
	Constrictive, band-like		Piercing as from a nail
	Distensive, full		Pressing
	Drawing		Pressing like a vice
	Electric like stabbing		Pressing in small spots
	Excruciating, violent		Shifting
	Heaviness		Shooting
	Periodic and intermittent:		Stinging
	Alternating days		Stitching or sticking
	Every third day		Stupefying
	Every 7th day		Throbbing, pulsating, hammering or pulsating

Things or experiences that happen with my headaches include:

Abdominal Pain		Hunger
	Alternating Back Pain		Sharp Low Rib Pain Rt Side
	Anguish		Irritability
	Anxiety		Liver Problems
	Arteries Throb		Talking Excessively
	Back of Head is Sore		Muscles Sore
	Bad Breath		Nausea
	Blindness		Nose is Dry
	Bowel Problems		Nosebleeds
	Can't Hear		Not Thinking Straight
	Cold Hands/Feet		Numbness
	Coldness in Back of Head		Overly Sensitive
	Colic		Pain in Low Back
	Constipation		Pain in the Limbs
	Cough		Profuse Sweating
	Delirium		Respiratory Problems
	Depression		Restlessness
	Diarrhea		Roaring in the Ears
	Dizziness or Vertigo		Salivating Excessively
	Ears Burn		Scalp Feels Bruised
	Emotional Excitement		Scotoma(DarkVisionAreas)
	Empty Feeling in Stomach		Sexual Excitement
	Exhaustion		Sleeplessness
	Eyelids Feel Heavy		Symptoms vary or not there
	Eyes Feel Big		Sore, Painful Eyes

	Eyes Feel Heavy		Spine Burns
	Eyes Feel Injected		Stitching Pain in Ears
	Face Feels Flushed/Hot		Stomach Pain
	Face is Pale		Tearing of Eyes
	Faintness		Temporal Veins Engorged
	Fever		Thirst Increases
	Flatulence		Tingling Lips, Tongue,Nose
	Gouty nodules on Scalp		Tongue is Coated
	Hair Falls Out		Toothaches
	Head is Retracted		Urinate w/ Increased Freq.
	Head Nods		Vision Returns Afterward
	Heart Beats Harder		Visual Disturbances
	Heart Palpitations (define)		Vomiting
	Hemorrhoids		Yawning

When does the pain seem worse?

	Certain times of day:		When Riding in Cars
	After Sleep		When Rising Up in Bed
	With Certain Drugs		When Sitting
	At Night		When Stooping Over
	At Noon		When Talking
	During Menses		When Waking + Opening Eyes
	In the Morning		When Walking
	In the Open Air		Working in the Dark
	In the Winter Months		With Stimulant Abuse
	Walking to a Higher Place		With Bright Objects
	When Angry		With Certain Odors
	When Bending Head Back		With Drafty Cold Air
	When Closing Teeth		With Light
	When Concentrating Hard		With Mental Exertion
	When Coughing		With Jarring Motions
	When Drinking Coffee		With Motion
	When Drinking Milk		With Muscular Strain
	When Drinking Wine		With Narcotics
	When Eating		With Noise
	When Hearing Clocks		With Nosebleeds
	When in Warm Areas		With Over Heating
	During a Bowel Movement		With Physical Exertion
	When Laying Down		With Pressure
	Laying on Pained Side		With Sunshine
	Laying on Right Side		With the Sight of Water

	Laying on Back of Head		With Touch
	Laying on Left Side		With Weather Changes
	When Moving Eyes

When does it feel better?

	After Rising		When Stooping
	During Menses		When Talking
	During Mental Exertion		With Colder Environments
	In the Open Air		When Thinking of Pain
	Partially Closing My Eyes		Turning Head Forward
	Upon Raising the Head		Uncovering the Head
	Bending my Head Back		When Urinating
	Bending my Head Forward		Bandaging/WrappingHead
	When Closing my Eyes		With Nose Bleeds
	When Eating		With Gentle Motion
	With a Bowel Movement		With Hard Continued Motion
	With Hands on/near Head		With Pressure
	When in a Dark Room		With Quiet Rest
	When Lying Down		With Rubbing
	When Lying on Painful Side		With Semi-Erect Posture
	Above + Head Elevated		With Sleep
	Above + Head Lowered		With Coffee/Stimulants
	When Perspiring		With Tea
	When Smoking		With Warmth in General

Types of headaches I usually experience are:

Cluster (Vascular)

Migraines

Pinpoint

Sinus

Stress and Tension

Common causes of headaches.

	Aneurysm		Intense Anger
	Anxiety		Liver Disease
	Barometric Changes		Menstruation
	Birth Control Pills		Muscle Tension
	Bladder Problems		Not Validating the Self
	Brain Tumors		Not Going w/ Flow of Life
	Control Issues		Not on God Path
	Dehydration		Over Work
	Emotional Let Down		Ovulation
	Emotional Changes		Perfectionist Attitude
	Exhaustion		Poor Posture
	Exposure to Sunshine		Pounding Heart
	Exposure to Fumes/Chem.		Sinus Problems
	Fear		Spinal Tap Anes. Injury
	Glare or Eye Strain		Stress
	Head Trauma		Feeling Something's Wrong
	High Blood Pressure		Too Little/Too Much Sleep
	Hormonal Changes		TMJ Disease/Bruxism
	Hurt Feelings Unexpressed		Weather Changes
	Inability to Face an Issue		Whiplash
	Injury to the Tail Bone		Food Associated See Below:

Foods and chemicals commonly associated with headaches.

Alcohol (Esp. Beer/Wine)		Low Serotonin Levels
	Apples		Melon
	Aspartame/Nutrasweet		Mono Sodium Glutamate
	Bananas		Nitrites/Sulfites
	Beef		Nitroglycerin
	Benzoic Acid		Nuts
	Cane Sugar		Oats
	Carrots		Onions
	Cheese (Yellow or Smelly)		Oranges
	Chicken		Peaches
	Chocolate		Peanuts
	Coffee		Pork
	Corn		Potatoes
	Cow's Milk		Rice
	Eggs		Rye
	Fish		Soy, Soy Sauce, Miso
	Goat's Milk		Strawberries
	Grapes		Tartrazine
	Histamine ContainingFood		Tea
	Histamine Releasing Food:		Tomatoes
	Chocolate		Walnuts
	Beer		Wheat
	Cheese		Withdrawal from Coffee
	Wine		Yeast

Note: Detection of food allergies depends on whether your body is allergic, intolerant and what time it was eaten. Some symptoms can show up within minutes, other symptoms within 36 hours. Muscle-testing will pick up those foods that are a problem for you lately, but not always from way back in the past. I can muscle-test out an approximate time period when the headache will come on after you eat a specific food.

If you know what foods are causing your headaches, you can rotate your diet appropriately and be your own Sherlock Holmes in knowing what you ate that triggers pain. After you get used to this identification process, you will know what you can get away with and what you can't. That helps a lot, say my clients.

Treatments for headaches including natural and allopathic forms are listed below under supplements, herbs, aroma therapies, homeopathics, alternative therapies and "real drugs":

Supplements that may be useful for your headache treatment.

5-HTP

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