What is NDPH?
Recently I have seen an increasing number of people with a diagnosis of new daily persistent headache – NDPH.
NDPH tends to be diagnosed when a headache develops suddenly in a person with no previous history of headaches or migraines. The symptoms can mimic migraines and/or chronic tension headaches and, as the name suggests, they occur daily. The symptoms usually have a sudden onset, often following a flu-like virus, and sufferers can sometimes pinpoint the exact day or time when the condition started.
To call NDPH a headache is an understatement. The symptoms are often severe and constant, causing the sufferer to become extremely light- and sound-sensitive, nauseous, and unable to hold conversations for more than a few minutes before losing the thread as words become jumbled in their head. As well as sensitivity to external stimuli, people can develop a tender scalp, painful and stiff neck and shoulders. They tend to restrict their movement in case this triggers more pain. In many cases the symptoms are so severe that sufferers are no longer able to work as an office or other work environment creates sensory overload. As with many chronic conditions, NDPH can disappear as quickly as it starts, or it can linger for months or years without change.
Medical treatment for new daily persistent headache NDPH
Medical treatment of the condition is focused on drugs such as amytriptiline, gabapentin or botox, all designed to interrupt the pain signals to the brain and/or mask the symptoms. The side effects of these drugs can often worsen the situation, heightening short-term memory loss and ‘brain fog’ which reduces an individual’s ability to function normally, without particularly reducing the pain symptoms. And, as the body becomes accustomed to the medication, any benefits reduce over time.
So why does the condition develop, and can myofascial release help alleviate the symptoms without distressing side-effects?
Looking at NDPH holistically
Looking at NDPH from a holistic point of view, people who develop the condition often have a history of chronic neck and shoulder tightness, poor posture and even back or pelvic issues. In many cases they will have put their symptoms down to too much computer use or desk work. They may have a history of regular exercise but generally they didn’t stretch much. Often they had been experiencing quite a lot of stress in their work and/or home life in the period before the virus that triggered the onset of their symptoms.
To a myofascial release practitioner NDPH results from a mind/body system that has been under prolonged physical and emotional pressure. This pressure is reflected in the changing health and quality of fascia in the body.
Any kind of sustained physiological or psychological pressure will create changes in the fascia as it tightens in a reflex protective motion, dehydrates, and becomes damaged. Unable to fully release, the fascia gradually becomes tighter and more stuck and, as fascia is interconnected at every level in the body, the effects of a local restriction in one area affect the rest of the body. So, for example, the effect of sitting hunched over a computer at work every day can create an imbalance in the pelvis which leads to sitting in a tilted forward position. This imbalance can then pull up through the fascia along and through the spine, which in turn affects the neck, head, and shoulders.
Sometimes, all that is needed for this to tip into the sort of headaches experience in NDPH is a temporary change that weakens the already stressed system – like a virus, for example.
Which means that any ‘sudden onset’ of symptoms is never just that. Your mind/body can only cope with so much before it rolls over and gives in, at which point you develop chronic symptoms. For many clients confused by their diagnosis of NDPH and the causes of their symptoms, starting to explore their lifestyle, medical, and work history is a revelation even before the hands-on work begins.