Thanks to everyone who participated in the live chat Dec. 15 on headache pain. Read the transcript below.

Expert: Dr. Paul Christo, director, Multidisciplinary Pain Fellowship Training Program, Johns Hopkins University School of Medicine

Can't make the chat? E-mail questions in advance to

Note: Comments made here are for informational purposes only and do not represent or substitute as medical advice. Patients are advised to consult their own physician or pharmacist for advice, diagnosis and treatment.

Dr. Christo's previous chat Dec. 1 on lower back pain can be viewed here.

 HealthChat: Headaches(12/15/2010) 
Baltimore Sun Health: 
Hi, Dr. Christo will be here at noon EST to take your questions, but you can start submitting them now for consideration.
Wednesday December 15, 2010 10:59 Baltimore Sun Health
Hello, Happy to take your questions today.
Wednesday December 15, 2010 12:03 drchristo
Baltimore Sun Health: 

Welcome Dr. Christo. Let's begin.
Wednesday December 15, 2010 12:03 Baltimore Sun Health
[Comment From KrozicKrozic: ] 
I seem to have headaches every single day for the last month or so. Sometimes severe enough that it bothers my neck. It's mostly Sinus related pressure under the eyes & temples. Disturbs my sleep to the point of fatigue. I have tried the following medications: Aleve D- cold/sinus (which keep me up), Zrtec D - Zrtec reg (liquid gel) & Sudafed PE. Nothing reallly helps but perhaps relieve some pain temporarily. I keep switching to see if any of them will help. I use an air cleaner in the house... nothing is working. Is there any other remedy? Thanks
Wednesday December 15, 2010 12:03 Krozic
Sinus headaches are commonly diagnosed, but are often an uncommon cause of persistent headaches. Many patients actually have symptoms related to migraine: throbbing, pulsating one sided pain associated with either nausea or light and sound sensitivity. If the headaches continue, I would recommended seeing your primary care doctor or neurologist for an evaluation. In the meantime, you could consider another over the counter agent like ibuprofen or aleve without any additives. If you have non-infectious sinus symptoms, then a trial of nasal steroids under the direction of a physician may also be helfpul.
Wednesday December 15, 2010 12:10 drchristo
[Comment From AnnaAnna: ] 
I suffered for over 6 years with debilitating headaches and migraines, with little relief from pharmaceuticals. These migraines and headaches lasted in the beginning from 4 to 9 days a month to as many as 22 days a month. In the end I was desperate and was seeking any treatment to stop the constant pain and I stumbled onto Neruofeedback after watching a PBS special on the neuroplasticity of the brain. I have remained migraine and headache free since a short round of neurfeedback treatment in September and October of 2009 (roughly 15 treatments). Thats roughly 14 months of pain free existence and I am curious as to why more people don't know about this treatment and what you think of it. I'd also like to know why it is not covered by insurance with many pharmaceutical drugs are.
Wednesday December 15, 2010 12:12 Anna
First, I'm glad that you have found an effective treatment for your migraines. The non-pharmacological treatments (relaxation, thermal biofeedback, EMG biofeedback, cognitive behavioral therapy) are often not covered by insurance. There is evidence that these are useful, however. The public and even physicians tend not to be aware of less traditional therapies because they aren't studied to the same degree as the pharmacological treatments.
Wednesday December 15, 2010 12:16 drchristo
[Comment From SandraSandra: ] 
Greetings Dr. Christo, Are there any studies on how traditional/whole foods diets and lifestyles may affect incidence of headache and migraine? (I suffered nearly daily severe migraines going through menopause and only eliminated them once I adopted an Ayurvedic lifestyle, diet, and daily routine).
Wednesday December 15, 2010 12:18 Sandra
I'm unaware of studies on whole foods and headaches. However, dietary triggers only affect certain patients with migraines and each person often has a separate set of triggers. These triggers often include alcohol, red wine, processed meats containing nitrites, MSG, aspartame (sweetner), chocolate, aged cheeses, and acidic foods. If you are avoiding processed foods by consuming whole foods, then this may contribute to the relief of your headaches triggers and therefore your headaches.
Wednesday December 15, 2010 12:24 drchristo
[Comment From LindaLinda: ] 
I have suffered from headaches just about all my life, for thirty year, they told me it was Sinus, I even had the sinus surgery. hahaha. anyway, I have been to so many drs and had Mri's Mra's. Which showed irregularities in my white matter. My dr prescribed me with Antidepressant, effexor it seems to work, but I really don't like taking them, any suggestions?
Wednesday December 15, 2010 12:25 Linda
Many sinus headaches are actually migraine headaches and will respond to migraine medications. The antidepressants are used to help prevent migraines and other classes include the tricylic antidepressants (amitriptyline). Other preventive medications are propranolol, timolol, topiramate, divalproex. If you want to try non-medication treatments for migraine, then botox has recently been approved. Acupuncture, hypnosis, TENS (transcutaneous electrical nerve stimulation) are also used with less evidence supporting their effectiveness.
Wednesday December 15, 2010 12:30 drchristo
[Comment From CindylouCindylou: ] 
I'm waking up everynight with headaches--anywhere from 1:00am to 5:am. I have for years but only periodically. Now they are every night. I suffer with migranes twice a year that begin with an Aura. The nite time headaches are unlike a migrane...they stem from my neck all the way through both sides of my head. Asprin immediatly helps but then I'm awake once I take one because of the caffine. I'm 54 yrs. old and post-menapause. Thank you in advance for your help.
Wednesday December 15, 2010 12:32 Cindylou
I would strongly suggest an evaluation by your physician to help sort out other causes of your headache at night. Headaches that wake you up are not typical and should be assessed. Acetaminophen (tylenol) can be helpful or an agent like ibuprofen that does not contain caffeine.
Wednesday December 15, 2010 12:39 drchristo
[Comment From KevinKevin: ] 
Dr. Christo: My wife suffers from tension headaches. Since becoming pregnant, she's been unable to take the over-the-counter pain relievers that usaully resolved her pain. Besides Tylenol (which has been largely ineffective), do you have any recommendations for relieving her pain from tension headaches during pregnancy?
Wednesday December 15, 2010 12:40 Kevin
I would consider the non-pharmacological therapies: relaxation, thermal biofeedback, congitive behavioural therapy, hypnosis. If the headaches are extreme,then your doctor will have to weight the benefit of pain relief with any risks to the fetus when selecting a medication.
Wednesday December 15, 2010 12:46 drchristo
[Comment From Steve SlessSteve Sless: ] 
I was diagnosed with viral meningitis a few weeks back. I was in the hospital for 3 days, treated and released. I have had severe head and neck pain since being released, and my primary care doctor does not seem very concerned. Some days the pain is so bad that I cannot get out of bed. I am wondering if this is normal, and if so how long the symtoms are expected to last, or if this could be as a result of the spinal tap that was performed to determine if it was meningitis. Your expertise would be greatly appreciated. Thank You
Wednesday December 15, 2010 12:47 Steve Sless
Spinal taps can cause a headache called a "postdural puncture headache" (spinal headache). Patients typically say that the headache is worse when standing or sitting up and eases when lying down. The headache is associated with light and sound sensitivity. Spinal headaches will get better without any treatment, but it can take weeks. If you have a spinal headache, certain medications plus caffeine intake can help. Otherwise, we do a procedure called a "blood patch" (remove a small amount of your blood and inject it into the epidural space) that usually resolves the headache.
Wednesday December 15, 2010 12:52 drchristo
[Comment From lavernelaverne: ] 
i have suffered from headaches all my life. i was diagnosis with a brain bleed about 10 years ago. i now have trigimenal neuralgiaof the head and face. i'm currently taking carbazepine and butalb-apa-caff for pain. the pain is now unbearable. are there any new medications or procedures to relieve the pain that i can make my neurologist aware of?
Wednesday December 15, 2010 12:53 laverne
You're taking the common and approved medication for trigeminal neuralgia. Other medications that are used are: baclofen, clonazepam, oxcarbazepine, phenytoin, and depakote. Surgical options include microvascular decompression. Radiation surgery has some success as well. Radiofrequency procedures that place a needle near the trigeminal nerve to heat the area and create a lesion can ease the pain, and something called glycerol rhizolysis that involves placing a nerve-altering agent around the trigeminal nerve can be an effective treatment. All of these procedures can cause side effects which you should discuss with your doctor before proceeding.
Wednesday December 15, 2010 1:04 drchristo
Thank you for your questions today.
Wednesday December 15, 2010 1:04 drchristo
Baltimore Sun Health: 
That's all the time we have for today. Thanks for your great questions. We'll back in the second week of January on another pain topic.
Wednesday December 15, 2010 1:05 Baltimore Sun Health