2) Hormonal deficiencies. Blood tests for hormonal deficiencies are very unreliable. The normal range often the only picks up late stage deficiencies, and often is simply based on your not being on the lowest 2% of the population. Because of this (and for a number of other reasons) it is usually necessary, albeit controversial, to treat with thyroid, adrenal (very low dose cortef; DHEA), and ovarian and testicular hormones -- despite normal blood tests! These hormones have been found to be reasonably safe when used in low doses.

3) Unusual infections. The most important ones to treat exude sinusitis and nasal congestion – which are usually caused by fungal infections. Although the concept is controversial, fungal infections are one of the most common causes of chronic sinusitis and spastic colon. Avoiding sweets (stevia is OK) and taking Acidophilus Pearls (healthy milk bacteria –2 pearls twice a day for 5 months) can be very helpful. We usually also add prescription antifungals as well if chronic sinusitis or spastic colon are present.

4) Nutritional supplementation. Because the western diet has been highly processed, nutritional deficiencies are a common problem. The most important nutrients include: a) vitamins -- especially the B vitamins (most at 25-50 mg/day), vitamin B12 (50-3000mcg/day), and antioxidants (e.g. -- vitamin C and E). b) Minerals -- especially magnesium, zinc, and selenium and c) amino acids (proteins). To replace the 25 - 35 tablets that people needed to take, I developed a good tasting product that contains 50 key nutrients in 1 capsule and 1 scoop of a good tasting powder taken daily. It is called "Energy Revitalization System" by Enzymatic Therapy, and is available at health food stores or on my web site.

While you are treating the underlying causes of your muscle pain, many medications can also be used to prevent chronic tension headaches. Anti-depressants can help headache and other pains as well as depression. In one study comparing Elavil® 25 mg at bedtime with Remeron 30 mg at bedtime, both groups had less headaches but the Remeron® group had fewer side effects Both of these medications are likely to be more effective for tension headaches than Paxil 40 mg daily, which had only a mild effect. Overall though, I much prefer using the “SHIN protocol” to eliminate the underlying causes of your headaches.

What Can I Do for the Acute Pain?
Herbal remedies such as the End Pain formula, which contains willow bark, Boswellia, and cherry, can be very helpful for acute attacks as can the natural and prescription pain gels. Although the "End Pain" directions say to take 1-2 tablets, for acute pains 3-4 tablets at a time can be more helpful. Adding the muscle relaxant herbs found in the "Revitalizing Sleep Formula" can also be very helpful. A physical therapy technique called stretch and spray, which approximately 10 percent of physical therapists are familiar with, is also an excellent and pain free way to release your muscles and eliminate a tension headache. When the underlying metabolic (e.g. infections, sleep, nutritional and hormonal deficiencies) and structural factors have been treated, stretch and spray may result in permanent relief of the pain. In addition, there are, of course, the old standbys of chiropractic and body work. Unless the underlying metabolic causes are treated with the "SHIN protocol" and underlying structural problems are treated, relief from chiropractic and bodywork is likely to be short-lived – requiring repeated treatments. This is why I recommend combining metabolic and structural therapies. Over-the-counter remedies such as Tylenol® and Motrin®/Advil® can offer short-term relief. Other medications that can be quite helpful include Midrin® and Ultram®. I would begin with the natural therapies first, however, as I find that these are both more effective and much safer.