Updated PM Oct. Information posted is an estimate. Your personal experience may vary. You know the feeling all too well. Your eyes feel tired, and you get easily distracted.
Can Coconut Oil Treat Constipation? Therefore, our group has developed a new therapeutic approach that involves headache self-massage by the patient. Chronic pain sufferers are using our Gay blaack specialist directory to find pain specialists in your area. All Rectal massage headaches were taking NSAIDs at the beginning headachee the study, and the median pain score was 8 out of Call your doctor immediately if you experience any of the following: A headache that comes Rectal massage headaches without notice or suddenly becomes severe.
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Switch the hot and cold items on your face every five minutes. You should write in your journal every time you experience a headache, and track the following items:   When the headache occurred. It has been shown to be helpful in bringing relief for both tension and vascular headaches. Sophie Lynx workout massage and anal sexApply pressure Rectal massage headaches the occipitalis muscles. Because many migraine sufferers experience extreme sensitivity to touch, and many find any movement increases pain headachfs, deep tissue massage during an attack would be out of the question. You can move your arm higher and lower Nude sex massage Rectal massage headaches different parts of the same muscle. Stay Up Recyal Date. Updated: March 29, Start at the top of your back and work your way down. Put your right index and middle fingers on your right cheek, just on top of your teeth. Find your jaw muscles. More Girls Chat with x Hamster Live girls now! The number of fingers you can get in depends on the receiver, how open they are mentally and how often you practice. Method 7.
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Migraine headaches are a common cause of disability in the United States, affecting approximately 60 million American adults, or Chronic migraine, which affects 3. This is in contrast to episodic migraine, which causes symptoms on fewer than 15 days per month.
A recurring headache that is of moderate or severe intensity and is triggered by migraine-precipitating factors usually is considered to be migraine. Precipitating factors can include stress, certain foods, weather changes, smoke, hunger, fatigue, hormones, and so on. Migraine without aura is a chronic idiopathic headache disorder with attacks lasting 4 to 72 hours.
Status migrainosis applies to migraine headaches that exceed 72 hours. Migraine features often include a unilateral location and a throbbing or pulsating nature to the pain. There may be associated nausea, photophobia, phonophobia, or dizziness Table 1.
Further characteristics include a positive relationship with menses, decreased frequency during pregnancy, increased pain with physical activity, and history of migraine in first-degree relatives. Patients who suffer from migraines often have colder hands and feet compared with controls, and the prevalence of motion sickness is much higher in migraine patients. Although most patients will not have all of these characteristics, there are certain diagnostic criteria that have been established by the International Headache Society for the definitive diagnosis of migraine.
Physical examination and magnetic resonance imaging MRI or computed tomography CT scans are helpful only in ruling out organic pathology. Recent-onset headaches need to be investigated with an MRI scan to rule out other organic disorders, particularly brain tumors. In addition to physical exam and imaging, a check of intraocular pressure IOP may be warranted. With new-onset headaches, an eye exam is always warranted. The pain may be in the facial or the cervical areas, and often will shift sides from one occurrence to another.
Most patients, however, suffer the severe pain on one favored side from attack to attack. The typical migraine patient suffers 1 to 5 attacks in a month, but many patients average less than 1 episodic or more than 10 per month chronic. The attack frequency varies with the seasons, and many patients can identify a time of year when their headaches increase significantly. The pain of the migraine often follows a bell-shaped curve, with a gradual ascent, a peak for a number of hours, and then a slow decline Table 2.
Occasionally, the pain may be at its peak within minutes of onset. Many patients with migraine suffer some degree of nausea during the attack, and many patients experience vomiting as well. The nausea is often mild, and some patients are not bothered by it. Many patients state that the headache is lessened after they vomit. Diarrhea may occur and usually is mild to moderate. The presence of diarrhea renders the use of rectal suppositories impossible. Lightheadedness often accompanies the migraine, and syncope may occur.
Between migraine attacks, many patients retain the photophobia, and it is common for migraine patients to wear sunglasses most of the time. Sensitivity to bright lights is a distinctive migraine characteristic. Pallor of the face is common during a migraine; flushing may occur as well but is seen less often.
Patients complain of feeling excessively hot or cold during an attack, and the skin temperature may increase or decrease on the side with pain.
Patients with migraines often experience tenderness of the scalp that may linger for hours or days after the migraine pain has ceased. This tenderness actually may occur during the prodrome of the migraine. Both vascular and muscular factors contribute to the scalp tenderness. Autonomic disturbances, such as pupillary miosis or dilation, runny nose, eye tearing, and nasal stuffiness, are relatively common.
These also are symptoms of cluster headache, including the sharp pain about one eye or temple. Alterations of mood are seen in many patients before, during, and after migraine attacks. Patients are usually anxious, tired, or depressed. Rarely, euphoria or exhilaration may precede a migraine. Weight gain due to fluid retention may occur prior to the onset of the migraine. The weight gain is usually less than 6 pounds, and is transient.
At some point during the migraine, patients often experience polyuria. The visual symptoms usually last 15 to 20 minutes, and most often will be followed by the migraine headache. Most migraine sufferers experience the same aura with each migraine, but, occasionally, one person may have several types of auras. The visual hallucinations seen most often consist of spots, stars, lines often wavy , color splashes, and waves resembling heat waves. The images may seem to shimmer, sparkle, or flicker.
These visual occurrences are referred to as photopsia. Fortification spectra are seen much less often than photopsia. They usually begin with a decrease in vision and visual hallucinations that are unformed.
Within minutes, a paracentral scotoma becomes evident and assumes a crescent shape, usually with zigzags. There often is associated shimmering, sparkling, or flickering at the edges of the scotoma.
Some patients suffer complete visual loss, usually for some minutes. Photopsia may be experienced at the same time as the gray out, white out, or visual loss.
Numbness or tingling paresthesias commonly are experienced by patients as part of a migraine. These are experienced most often in one hand and forearm, but may be felt in the face, periorally, or in both arms and legs. Like the visual disturbances, they often last only minutes preceding the pain, but the numbness may continue for hours, and at times the paresthesias are severe.
Paralysis of the limbs may occur, but this is rare. This occasionally is seen as a familial autosomal dominant trait, which is termed familial hemiplegic migraine. With the weakness, aphasia or slurred speech may also occur, and sensory disturbances are seen ipsilateral to the weakness.
Vertigo occasionally is experienced during migraine, and may be disabling. Ataxia may occur, but it is not common. Rarely, multiple symptoms of brain stem dysfunction occur, with the term migraine with brainstem aura previous called basilar migraine being applied to this type of syndrome. The attack usually begins with visual disturbances most often photopsia , followed by ataxia, vertigo, paresthesias, and other brain stem symptoms.
These severe neurologic symptoms usually abate after 15 to 30 minutes and are followed by a headache. This type of migraine often stops over months or years, and the patient is simply left with migraine headaches without neurologic dysfunction.
As noted, when patients present with a long history of typical migraine attacks, and the headaches are essentially unchanged, scans of the head may not be necessary. Sound clinical judgment, based on patient history and a physical exam, is crucial in deciding which exams a given patient needs. A magnetic resonance angiogram MRA allows the detection of most intracranial aneurysms.
The problems that need to be excluded in a patient with new-onset migraine include sinus disease, meningitis, glaucoma, brain tumor, arteritis, subarachnoid hemorrhage, idiopathic intracranial hypertension, hydrocephalus, pheochromocytoma, stroke or transient ischemic attack, internal carotid artery dissection, and systemic illness. With migraine and chronic daily headache sufferers, avoidance of triggers should be emphasized.
The most common triggers are stress both during and after stress , weather changes, perimenstruation, missing meals, bright lights or sunlight, under- and oversleeping, food sensitivity, perfume, cigarette smoke, exercise, and sexual activity. Some foods can be headache triggers, but foods tend to be overemphasized. In general, headache patients do better with regular schedules, eating 3 or more meals per day, and going to bed and awaking at the same time every day.
Regarding stress as a trigger, it is not so much extreme stress but rather daily hassles that increase headaches. When patients are faced with overwhelming daily stress, particularly when they are not sleeping well at night, headaches can be much worse the next day.
Psychotherapy is extremely useful for many headache patients with regard to stress management, coping, life issues, family-of-origin issues, and so on. Managing stress with exercise, yoga, and Pilates, often will reduce the frequency of headaches. The ideal would be for the patient to take a class weekly, then do the stretches and breathing for 10 minutes per day. Relaxation techniques such as biofeedback, deep breathing, and imaging also can be helpful for daily headache patients, particularly when stress is a factor.
Many migraine patients have accompanying neck pain. Physical therapy may help, and acupuncture or chiropractic treatments occasionally help as well. Massage may be effective, but the relief often is short-lived. Although caffeine can help headaches, overuse may increase headaches. Patients must limit total caffeine intake from all sources eg, coffee, caffeine pills, or combination analgesics. The maximum amount of caffeine taken each day varies from person to person, depending on sleep patterns, presence of anxiety, and sensitivity to possible rebound headaches.
In general, caffeine should be limited to no more than or mg per day Table 3. As noted, multiple food sensitivities are not common.
Patients tend to focus on food, because it is a tangible trigger that one can control as opposed to weather, for example. However, most people are sensitive to only 2 or 3 types of food in the diet.
If a particular food is going to cause a headache, it usually will occur within 3 hours of eating that food. Table 4 provides a list of foods to avoid. The most common first-line treatment for migraines includes triptans.
More than million patients worldwide have used triptans. The most effective way to use triptans is to take them early in the headache—the earlier a patient takes these agents, the better the effect. Sumatriptan is an extremely effective migraine-abortive medication with minimal side effects. The usual dose is 1 tablet every 3 hours, as needed; maximum dose, 2 tablets per day.
However, clinicians do need to limit triptan use ideally, 3 days per week to avoid rebound headaches or medication overuse headaches MOH. Triptans are helpful for moderate as well as more severe migraines.
Pregnant women should also consult their doctor before undergoing massage. Start with massaging the lower back, glutes, backs of the thighs and the place where the thighs meet the groin. One method is to place your left index finger inside the right side of your mouth. Applying an ice pack to the base of your skull and top of your neck can help headaches radiating around the front of your head and face. Treat your muscles with respect. It is easier to get the erection going and keep it up during the rest of anal play because sometimes when there is increase pressure on the prostate it is harder for the penis to become erect.
Rectal massage headaches. Top Reasons Why Massage May Help Migraines
9 Natural Strategies for Headache Relief (Infographic)
An anal fissure AF is a tear in the epithelial lining of the anal canal. This is a very common condition, but the choice of treatment is unclear. The use of anal dilators is effective, economic, and safe. The aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures. Fifty patients with a clinical diagnosis of AF were randomly assigned to one of the treatments, self-massage of the anal sphincter group A, 25 patients or passive dilatation using dilators group B, 25 patients.
All patients were evaluated at baseline, at the end of treatment, and after 12 weeks and 6 months. Pain was measured using a visual analog scale. The use of anal self-massage with a finger appears to induce a better resolution of acute anal fissure than do anal dilators, and in a shorter time. The anal fissure is an extremely common proctologic disease, but the choice of the most appropriate therapy is still difficult. Because of the high rate of recurrence that afflicts conservative therapy and the risk of serious complications, such as bowel incontinence and bleeding that can affect surgical therapy, it is not yet possible to determine which the best treatment is.
The conservative treatment of anal fissure relies on the observation of hygienic-dietary measures, obtaining a regular bowel movement, and the use of muscle relaxants or anesthetics. The use of nitroglycerine creams or botulinum toxin appears to be a palliative treatment, with rapid loss of effectiveness, and it is often poorly tolerated because of unpleasant side effects [ 4 - 8 ].
Therefore, our group has developed a new therapeutic approach that involves anal self-massage by the patient. The purpose of this study was to evaluate the effectiveness of anal self-massage in the treatment of anal fissure, comparing it to traditional therapy with dilators. Fifty patients suffering from acute anal fissure were enrolled in this prospective randomized study.
All patients agreed to be included in the study and gave their signed, informed consent to randomization. Inclusion criteria were age ranging from 18 to 70 years, presence of anal pain during bowel movements, detection of acute posterior anal fissure.
Exclusion criteria were concomitant anal pathology anorectal fistulae, abscesses , previous surgery on the pelvic floor, inflammatory bowel disease, and therapy with nitrates. The patients were randomized using a number table to treatment with self-massage of the anal sphincter group A, 25 patients or passive dilatation of the anal sphincter using dilators group B, 25 patients.
Patients were evaluated before treatment by digital rectal examination performed with the patient in the left lateral position at rest and during different times of functional decline and straining. Patients were also administered a personal questionnaire about their quality of life analyzing the results according to the Agachan-Wexner score [ 13 ].
The intensity of pain was assessed by visual analog scale VAS. At the end of treatment, all patients underwent a clinical revaluation physical examination, rectal examination and interviews with a standardized questionnaire regarding medical history, information on symptoms such as itching, anal pain, anal burning, bleeding, quality of life, and the VAS scale for pain.
Follow up was scheduled at the end of the treatment and at 3 and 6 months. During follow up, the following variables were taken into account: anal fissure epithelialization, pain, bleeding, side effects, quality of life and recurrence at 6 months. Descriptive continuous variables are expressed as mean and standard deviation SD.
Of the 50 patients enrolled, 27 were women and 23 men, with a mean age of All patients had an acute posterior anal fissure. Bowel movements were normal in 34 patients, 12 patients complained of constipation and 4 reported diarrhea. There were no side effects in any of the two groups. The analysis of the questionnaire on quality of life showed an average of 6 on a scale of Table 1 summarizes the characteristics of patients and the symptoms and signs before treatment.
At the end of the treatment, 20 patients in group A anal self-massage and 15 in group B showed resolution of symptoms and disappearance of the anal fissure. At 3 months after the end of treatment, no patient in group A had recurrence of the disease, whereas 2 relapses were observed in group B.
The subsequent evaluation was at 6 months. Recurrence was observed in one patient in group A and in 3 patients in group B. The average quality of life was similar, being 9 in group A and 8 in group B. Table 2 summarizes the characteristics of patients and symptoms after treatment, and at 3 and 6 months after the procedure. Signs and symptoms of patients at the end of their treatment, and at 3 and 6 months after treatment.
The analysis of the VAS score showed a progressive decrease during the follow up, but there were no significant differences in the two groups. At 6 months after treatment, a significant difference in terms of reduction in anal pain was observed between the two groups A vs. There was no significant difference in the other symptoms. The cause of this disease still remains unclear, although it is considered that an increase in the internal anal sphincter tone may lead to a local reduction in the blood flow, causing damage especially posteriorly, where the perfusion is physiologically lower than in the other areas of the anal canal.
From this perspective, the anal fissure can be regarded as an ischemic disease [ 14 - 16 ]. Hard stools can be the primary cause of this complex background. Therefore, a first therapeutic approach is habit regularization, especially as a preventive maneuver.
Once, however, the anal fissure has presented, the choice of therapy to be implemented cannot be simple: noninvasive treatment, represented by the use of nitroglycerin-based creams or calcium channel antagonists, is often burdened with side-effects such as headache. Moreover, the long-term efficacy of these medical treatment has not been proven [ 17 - 20 ]. Regarding the use of botulinum toxin, a still expensive approach, the dose and the site of injection have still to be defined clearly, and its long-term efficacy is not supported by clinical evidence [ 21 ].
However, this method required a long application time and duration of treatment for effective results. To overcome these limitations, we developed a new therapeutic approach: anal self-massage performed by the patient.
These results show the long-term superiority in the effectiveness of the massage method. At the end of both treatments, we obtained a statistically significant reduction in anal pain and bleeding, though the reduction in anal itching and burning did not reach statistical significance. It is possible that anal itching and anal burning are less specific symptoms of anal fissure and represent accompanying symptoms, especially due to the presence of hemorrhoids.
This new approach represents an evolution of anal dilators. The success rates are higher and the rate of recurrence is lower compared with anal dilator therapy. In addition, the duration of the therapy is drastically reduced: 7 days versus Through anal self-massage, the patient modulates the action of dilating, making the therapy more effective and performing real biofeedback compared to therapy with anal dilators.
This approach also has a significantly lower cost. Our hypothesis is that the massage of the anal sphincter, in addition to the passive dilatation obtained by the finger, induces a relaxation of the hypertrophic and hyper-contracted anal sphincter, through a negative central feedback mechanism.
From this perspective, the tactile sensitivity of the finger would have a key role. However, the sample of the population analyzed in this study do not fully describe the applicability of the method.
In fact, all randomized patients of the study could have performed anal self-massage, but problems could arise in some patients, such as the frail elderly, morbidly obese, or those with functional limitations neurological diseases, orthopedic diseases, muscular diseases, etc. Another consideration is that cultural differences make it impossible to apply the method in certain socio-cultural contexts. In these patients this method should not be proposed because of poor compliance.
In conclusion, in our study, both treatments, anal self-massage and anal dilators, were equally effective in inducing and maintaining remission of anal fissure. However, anal self-massage involves lower treatment times and costs. To the best of our knowledge, this is the first study in the literature to describe and compare these techniques for the treatment of anal fissure. The widely held belief is that internal anal sphincter hypertonicity is a determining factor in the development of an anal fissure.
Uncontrolled anal dilatation is not recommended because of the risk of anal incontinence. Anal self-massage can be an effective treatment in the management of acute anal fissure. The method is cheap, provides a simple solution to the problem, and offers higher success rates than conventional dilators, without the risk of anal continence.
Conflict of Interest: None. National Center for Biotechnology Information , U. Journal List Ann Gastroenterol v. Ann Gastroenterol. Published online May Author information Article notes Copyright and License information Disclaimer. Received Jan 17; Accepted Apr 6. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC. Abstract Background An anal fissure AF is a tear in the epithelial lining of the anal canal.
Methods Fifty patients with a clinical diagnosis of AF were randomly assigned to one of the treatments, self-massage of the anal sphincter group A, 25 patients or passive dilatation using dilators group B, 25 patients. Conclusion The use of anal self-massage with a finger appears to induce a better resolution of acute anal fissure than do anal dilators, and in a shorter time.
Keywords: Anal fissure, anal massage, anal dilator, proctologic disease, anal pain. Introduction The anal fissure is an extremely common proctologic disease, but the choice of the most appropriate therapy is still difficult. Patients and methods Fifty patients suffering from acute anal fissure were enrolled in this prospective randomized study.
Open in a separate window. Figure 1. Figure 2. Circular motion of the finger for 10 min twice a day for a further 5 days. Results Of the 50 patients enrolled, 27 were women and 23 men, with a mean age of Table 1 Patient characteristics. Table 2 Signs and symptoms of patients at the end of their treatment, and at 3 and 6 months after treatment.
Summary Box. Footnotes Conflict of Interest: None. References 1. Aetiology and treatment of anal fissure. Br J Surg.