Various things trigger headache

Dear Dr. Gott: Three neurologists have diagnosed my headaches as migraine and another diagnosed them as migraine variant. It seems that some of my headaches are muscular in origin, while others are vascular. Most of them seem to radiate from the base of my skull upward. CT scans and an EEG have been normal. Is there any help for me? Is my hypertension a cause?

Dear Reader: From the sound of your predicament, you may have several kinds of headaches, ranging from migraine to the muscle-contraction variety. Yet I hesitate to second-guess four neurologists.

Hypertension can certainly cause headaches. And it’s for this reason that I believe your family physician can sort out the pieces of the puzzle.

If you have high blood pressure, your doctor might consider prescribing a beta-blocker such as metoprolol. Not only will this drug lower your blood pressure, but it’s also useful in preventing migraine. Therefore, if your headaches improve on this therapy, your problem is solved.

Should you occasionally experience the pain of migraine, your physician can follow the neurologist’s advice about analgesics, such as sumatriptan, which is a self-administered injection that is very helpful in relieving migraine once the pain has started.

Your doctor may also choose to prescribe a muscle relaxer (Flexeril and others), as well as physical therapy to prevent muscle spasm. Even some stress counseling may help you.

To give you related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: I have poor circulation in my legs and feet, and it’s getting hard for me to walk, which I love to do. My doctor says not to use a heating pad, yet this seems like the only way to relieve the pain.

Dear Reader: When leg pains are due to poor circulation, doctors hesitate to endorse heating pads. Such artificial warmth may damage tissue, because the heat increases the metabolic demands of the extremity, which already suffers from deficient circulation. Therefore, I side with your physician.

This is not to say that you cannot be helped, however. Some forms of poor circulation, especially in the elderly, are caused by arterial blockages that can be eradicated by a technique called balloon angioplasty. During the procedure, a catheter surrounded by a deflated balloon is passed into the artery. Once in position, the balloon is forcefully inflated. This cracks and disintegrates the blockage, improving blood flow.

Before considering angioplasty, you will need an arteriogram to determine the location and extent of the arteriosclerotic plaque.

Ask your doctor about this procedure.