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Page 37
 Emotions.
Common negative emotions such as depression, anxiety, a sense of letdown, frustration as well as positive pleasant excitement can trigger headaches.
 Muscle tension.
Almost all individuals with chronic headache have some degree of muscle irritation at the upper back, neck and face. The muscle irritation is most often associated with chronic but subtle muscle tension, nothing very dramatic but going on regularly day after day. This is true for both migraine and tension-type headaches. Muscle irritation should be considered a trigger of headache pain. The type of pain triggered reflects a variety of factors, not the least of which is the type of headache to which an individual is prone. Muscle irritation can produce local pain, pain around the site of the muscle irritation, or it can refer pain to sites away from the irritated muscle. For example, muscle irritation at the back of the neck may be felt as severe pain at the temple on the same side of the head. This is called referred pain.
Chronic muscle tension may arise from a variety of causesregular poor posture, repeated muscle strain or overuse, tightening up under stress, mannerisms such as frowning or grinding the teeth, or even bracing against headache pain itself. Eventually this tension may lead to very tender muscles, aching with normal movement, stiffness from being in one position for a long time, pain when lying in bed for a prolonged period or even restriction in the mobility of the neck or jaw.
 Diet. Between 8 and 25 percent of people with migraine can point to a particular food as a source of their attacks. See next page.
 Change In the weather, seasons, altitude or time zones.

 
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