Andrew Huberman· PhD
all headache is neural that you'd want to go after some sort of neural mechanism to treat them but of course we now know that there are three types of neurons there are motor neurons Sensory neurons and modulatory neurons so we have choices we can say okay do we want to turn off the muscles in the head jaw and neck that are hyper contracted for instance you want to take a muscle relaxer or relaxedant or would you want to try and change the sensory input itself maybe don't change the way the muscles are behaving but shut off the sensory part of it your ability to sense it there are certainly ways you can do that or would you want to adjust the modulatory neurons would you want to make it such that you have the headache but you don't perceive the headache that is you cut off communication between the sensor and the motor so that the muscles relax turns out there are treatments and approaches for each and every one of those each and every one of those has different advantages and disadvantages but as you can quickly see we are going to have different types of headaches and different approaches to treating headache but if you keep in the back of your mind that you have neurons that contract muscles to create movement or tension of muscles remember you can turn off those neurons and allow those muscles to relax you have Sensory neurons that sense input and actually sense the pain and you have modulatory neurons which can allow you to adjust the relationship between the sensory neurons and the motor neurons and of course some of you are probably screaming at me by now saying wait why would you ever want to deal with the motor neurons or or the modulatory neurons once you want to just go straight to the source and just cut off the pain ah well the problem there is that many painkillers have other issues as well in particular they can be sedative many of them can be habit forming or even addictive and for many people not all but many people they don't want to take drugs whether or not they're over-the-counter or prescription drugs or even more natural supplement based type treatments and they would rather use for instance a behavioral approach in which they can modulate they can deliberately turn off the communication between Sensory neurons and motor neurons and turns out those approaches exist as well okay so at this point I promise you that I'm not going to give you any more of a biology lesson in terms of pain sensing and headaches as a more uh conceptual phenomenon instead what I'd like to do next is talk about the different types of headaches and I think this is something that's very important and not often discussed except for those people out there that unfortunately suffer repeatedly from certain kinds of headaches like migraine or cluster or tension headache but I think for most people out there who experience headache and again that is everybody at some point experiences headache rather than just think of headache as one thing understanding the major types of headache and how they differ from and are similar to one another will really help you identify what the best source of treatments for those are so I'd like to talk about what the different types of headache are now the first type of headache we're going to discuss is the tension type headache again tension type headaches tend to start off not always but tend to start off as more or less a Halo or a headband around the forehead in the area above the eyes often also include the jaw the neck muscles and can extend even into the upper back again this can be caused by some low level of infection but more often than not tension type headaches are going to come on because of some chronic psychological stress usually combined with lack of sleep usually combined with lifestyle issues and of course without getting into a long discussion about it anytime you have lack of sleep you're going to have excessive stress anytime you have excessive stress you're going to have to make sure you're offsetting that by getting proper sleep most people don't when they're under excessive stress by the way we have excellent tools we're grounded in excellent science available to you at zero cost if you are experienced chronic stress or even short-term stress we have a master stress episode of the human Lab podcast again just go to hubermanlab.com and all that's time stamped for you tension type headaches begin in a more or less a headband pattern but can really extend to other tissues as well not so often in the face but really the head and often will start to climb up toward the top of the head they are not always in this Halo pattern sometimes they can be localized to one area such as the you know the back of the head or the front of the head or one side of the head more than others and that's often the case because of tension within muscles of the neck that tend to bias the ache towards one side of the head I'd like to take a quick break and acknowledge one 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