This infection also produces rashes on the skin similar to chick-enpox. It also severely damages the entire nervous system from the skin right through to the brain along the affected nerve pathways.

In some the onset of the rash is preceded by severe pain. This sometimes persists after the rash leaves. Because the nerve fibres damaged in this condition are usually the thick coated fibres, the pain ‘gate’ is left open, so to speak, in the nervous system and pain messages are sent either unmodified or in an abnormally modified way to the brain.

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Surgeons cut nerves or remove vertebral discs, according to their special interest. Psychiatrists either use psychotherapy or tell patients they are imagining the pain. Doctors often prescribe narcotic-based, or derived, drugs.This carries the consequent risks of drug toxicity,addiction and other complications. The result has often been hopelessness, disappointment, frustration and anger by patients, their families and for that matter the whole community.

The hope is that further education will lead to earlier referral to an appropriate treatment centre and so prevent many such problems.

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The heart of the matter?

Five hundred years before Christ, the sensation was thought to be experienced in the blood vessels and the heart — and not the brain. Until modern times this was also a common belief throughout the Eastern world. Pain was recognised as a sensation by the ancient Hindus and Buddhists in India, but they gave greater significance to its emotional aspects. They believed it was experienced in the heart.

In The Yellow Emperor’s Canon of Imperial Medicine,published in approximately 500 BC and dating back possibly 2000 years before that, the Chinese attributed the causes of pain and disease to imbalances of the life force called Qi. They believed it could be corrected using acupuncture or by the application of heat or herbs.

In Ancient Greece there was also a lively debate about whether the brain was the centre of sensation and reason, and not the heart. Some philosophers believed pain was due to changes in extremes of sensation. Furthermore, they were convinced that pain could be caused externally as well as by emotional response. Around 300 BC pain was perceived in the brain, with two kinds of nerves said to exist — ‘sensation’ and ‘movement’.

It was not until the second century AD that these concepts were rediscovered. A third type of nerve was described as carrying the sensation of pain. As well as witch-burning and dunking, fear and superstition, the Dark Ages in Europe saw a shift of the centre of medicine to Arabia. Philosophers and pain practitioners described fifteen different types of pain including their causes and mechanisms.

The Renaissance in Europe brought more significant advances in chemistry, physics, physiology and anatomy.These advances were particularly seen in the nervous system, with many considering pain to be a sensory event carried by the nerves of touch, to be experienced in the brain.

For twenty-three centuries Aristotle’s belief persisted that pain was a passion of the soul felt in the heart. Even the great seventeenth century English anatomist, William Harvey, believed the heart was the site of pain.

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Caffeine is present in coffee and cola drinks, and there are surprisingly large quantities in tea. Two cups of tea equals roughly one cup of coffee in terms of caffeine content. As most of the population of England drink several cups of either tea or coffee each day, this amounts to a sizeable daily dose of caffeine. Some people are much more addicted to caffeine than this and drink ten or twenty cups a day, to say nothing of additional cola drinks.

In many people this causes no effects whatsoever, but those taking large quantities of caffeine may get a condition called caffeinism which comprises agitation, restlessness, difficulty with sleeping, tremors and a headache. Reducing the dose of caffeine helps considerably; but those who regularly and often take in a lot of caffeine will get a withdrawal headache if they suddenly stop their consumption.

If you’ve got a headache from suddenly stopping caffeine, have a caffeine-containing drink. Then plan to reduce your intake to a more sensible level, doing so slowly and progressively. Be aware that as well as being addicted to the caffeine (pharmacologically) you can also be allergic to the coffee or tea that goes with it. If you are really having problems with caffeine then you may need to cut out coffee, tea and cola drinks altogether and to try fruit squashes and mild herbal teas instead.

Complementary treatment

Caffeine acts directly on the nervous system, bringing about an almost immediate sense of thinking more clearly, and relieving fatigue. Caffeine stimulates the release of stored sugar from the liver, which accounts for the sudden, uplifting experience. Through this reaction, however, enormous strain is placed on the system.

Like any other drug, caffeine can be toxic if taken in quantity. And for the record, decaffeinated coffee is not an ideal substitute. The process by which the caffeine is removed from the coffee involves a number of chemicals and soaps, and these additives are notorious for causing headaches.

Peppermint tea is stimulating, and a tonic (although it shouldn’t be taken with homoeopathic remedies). Mu tea can increase vitality, and dandelion root coffee is a delicious alternative to regular coffee – and a mild diuretic as well. Guarana is a popular supplementary pick-me-up with the healthfood gurus.

Acupuncture can increase energy, and relieve the headache associated with caffeine.

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Because menstrual headaches occur as a result of a general debility of the whole system, rather than a specific hormone defect, with the exception of menstrual migraines, there is no specific treatment for them. Instead, the type of treatment used is related to the cause of the headache itself. It is very important to appreciate the difference – pre-menstrual headaches are treated by treating the pre-menstrual syndrome directly, while menstrual headaches are treated by treating the cause of the headache.

Menstrual migraine

Menstrual migraine is defined as migraine which occurs on the first day of the period (or on the day before or the day after). It is caused by the sudden drop in oestrogen levels that occurs at this time, and may respond to treatment with extra oestrogen – for example, in ‘patch’ form.

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A small amount of dental decay (otherwise known as caries) at the bottom of an otherwise normal-looking and well-filled tooth can cause tremendous pain when it extends to infect the pulp space deep within the tooth (the pulp space is the only live bit of the tooth). In turn, infection of the pulp space can track down to the very bottom of the tooth and cause infection in the jaw. Infection here is called an apical abscess. The pain of an infected or decaying tooth can be referred into the head or the neck, and in some cases can mimic headaches, particularly tension headaches and sinusitis.

Toothache can be diagnosed where there is obvious infection or decay in a tooth; or where the tooth is tender on being knocked or touched. One of the first features of a pulp space infection is that the tooth feels as though it has lifted up slightly, and is more easily banged by the opposing set of teeth when clenching the teeth together. An apical abscess can also make the gum tender at the level of the top of the root of the tooth, about a quarter of an inch below the gum margin. In the very late stages of an apical abscess there may be an obvious boil or discharging abscess at this site. This is called a gum boil.

What else could it be?

Dental pain can be confused with sinusitis, especially as dental pain (particularly where there is pulp space infection or an apical abscess) is often made worse by putting the head between the knees; dental pain and the sinusitis pain behave identically in this situation. Tension headache can imitate dental pain, too, but here there are trigger points on the neck, face or scalp – touching these exacerbates the pain. However, because of the way in which pain is referred from teeth, it can often cause reflex spasm in muscles at some distance from the actual site of the pain, so local tenderness in the muscles of the head or neck does not necessarily rule out a dental cause.

Treatment

Obviously denial work is required; to scrape out the inside of the infected tooth, maybe root-fill it, or perhaps perform an apiceclomy, if there is an apical abscess.

Self-help

Simple, minor tooth decay doesn’t cause pain. The problems occur when nothing has been done and the decay has been allowed to advance. So, simply have regular dental check-ups and brush your teeth regularly with a fluoride toothpaste.

Brushing your teeth property is important. It’s not just the teeth that you need to clean, but also the gums. It’s worth remembering that as many teeth are lost by gum disease as they are to tooth decay. Unfortunately, it is all too easy for scraps of food to collect between the tooth and the gums, where they begin to fester and set up an infection called gingivitis. Gingivitis can be almost as painful as toothache: typically it’s much worse with hot and cold foods, and can be eased substantially by careful attention to brushing the teeth.

Complementary treatment

Obviously severe toothache caused by decay should be treated by your dentist, but there are a number of treatments for pain and inflammation that will provide some relief during attacks. Cloves have an analgesic oil contained in them and they can either he bitten whole, next to the offending tooth, or their oil can be applied neat to the painful area.

An infusion of marshmallow and sage can be used as a mouth rinse, and then swallowed. Mint also has antiseptic and analgesic properties and can be chewed or sucked at the site of the pain. Gum disease can be treated by chewing tarragon, sage and thyme, or by rubbing oil of thyme into the gums. Vitamin C is essential to gum health, so ensure you are getting enough.

Rinse your mouth daily with hypericum and calendula, mixed with cooled, boiled water, to prevent infection, A hot compress of camomile over the cheek, will ease the pain and draw the infection to the surface, if an abscess is present.

There are many different homoeopathic remedies available – and they will deal specifically with the kind of pain you are suffering, whether you have abscesses, or gingivitis, etc. Some suggestions are arnica, kali phos, silica and camomile. There are even homoeopathic remedies to deal with the fear of dental treatment, and discomfort following treatment.

Reflexology can sometimes ease toothache, Acupressure and acupuncture can deal with local pain, and also fear, tension and headaches.

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The characteristic features of Paget’s disease are that the thickened skull bones increase the size of the head; this thickening can be seen clearly on X-ray. There are also special blood tests which can diagnose Paget’s disease.

Paget’s disease is rare and can lie helped by giving injections of the hormone calcitonin, which encourages the bones to absorb more calcium. Analgesics may be prescribed to deal with the pain.

Complementary Treatment

Constitutional homoeopathy might help, and extra Vitamin D), which has a similar action to calcitonin, is often recommended.

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