DEAR DR. DONOHUE: My wife and many others suffer from what is commonly called tension headaches for much of their lives. Treatment for migraine headaches is available, but there is little available for just plain tension headaches. What do you suggest as treatment? – F.C.

ANSWER:
Tension headaches are the most common kind of headaches. Perhaps because they are so common and because they’re not a sign of imminent catastrophe, they don’t get the respect they should. They can sabotage a person’s life. Most tension headaches are mild to moderate in severity. A tension headache, unlike most migraines, is felt on both sides of the head. And unlike migraine, physical activity doesn’t worsen it. People describe it as feeling like a band is tightening on their head.

Aspirin, Tylenol (acetaminophen) and nonsteroidal anti-inflammatory medicines (NSAIDs) are the medicines most often used to control tension headaches. Nonsteroidal anti-inflammatory drugs are things like Advil, Aleve, Motrin and Naprosyn. Many headache sufferers find that caffeine combined with aspirin, Tylenol or an NSAID in a single tablet works better for tension-headache pain control.

A common trap people fall into is overuse of medicines. People take medicine quite often and in high doses, and when they try to stop, the headaches worsen — rebound headaches. Those who are taking pain medicines regularly should see a doctor for help in decreasing their use without developing rebound headaches.

People with chronic tension headaches have to be examined for dangerous conditions, like brain tumor. Another cause of frequent headache is temporal arteritis, an inflammation of arteries. If there is no underlying disorder causing the headaches, then a different approach to treatment might be needed. Amitriptyline, an antidepressant drug, is prescribed not for depression, but for control of pain.

The headache booklet deals with the more common kinds of headaches and their treatment. Readers can order a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have a neuroma in my foot, and I have had it for about five years. No matter what kind of shoe I wear, it’s like I have a piece of cardboard in my shoe. Pads don’t work. If I could wear flip-flops all the time, I would be happy. Is there help for me? – H.P.

ANSWER:
A Morton’s neuroma is scarlike tissue that wraps around one of the foot’s nerves and squeezes it. The nerve most often involved is one between the third and fourth toes at the ball of the foot. Taking a step sends a sharp, burning or shooting pain when the sole hits the ground.

Even though you say pads were no help, it does help to wear shoes with lots of space in the front of the shoe and with a sole that is cushioned. A podiatrist can fashion a pad, specially designed for your foot and your problem. An injection of cortisone in the area around the neuroma relieves inflammation and swelling, and takes pressure off the nerve.

If all else fails, a doctor can remove the neuroma. Often, that can be done right in the doctor’s office.

DEAR DR. DONOHUE: You wrote that sun rays passing through the windshield of a car would not cause sunburn because it filters out ultraviolet B rays. Not so. I wear short-sleeved shirts, and I drive directly in the direction of the sun. I get a minor sunburn on my uncovered arms. I have to use a sunscreen product. – R.B.

ANSWER: Ultraviolet sun rays come as UVA and UVB. Glass filters most UVB rays, and they are the ones responsible for sunburn.

It’s true that some people have skin that is sensitive to UVA rays. Those people get some reddening of the skin when sunlight hits them through glass windows. They don’t get a real sunburn.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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