FMS Community Index Page
Headaches and Trigger Points
Headache Pain Treatment Publications
Symptom | Y | N | Sometimes | Comments/Notes |
The Pain occurs in: |
Right Eye |
Left Eye |
Both Eyes |
Forehead |
Right Temple |
Left Temple |
Both Temples |
Temple and Jaw |
Back of Head and Neck |
Front of Head and Teeth |
Other |
Vision: |
My Vision Blurs in Left Eye |
My Vision Blurs in Right Eye |
My Vision Blurs in Both Eyes |
I Lose Vision in One/Both Eyes |
My Headaches Occur |
1- 3 Times Weekly |
4-6 Times Weekly |
Before my Menstrual Cycle |
During my Menstrual Cycle |
I Become Sensitive to: |
Light |
Sound |
Odors |
All of the above |
I Experience: |
Nausea |
Vomiting |
Sinus Congestion |
Sinus Draining |
Tooth Pain |
Dizziness |
Diarrhea |
Constipation |
Confusion |
Depression |
Anxiety |
Foods Consumed before Headache: |
Food Containing Wheat. |
Sweets/Beverages Containing Sugar. |
Dairy |
Chocolate |
Wine/Other Alcohol |
Beer |
Coffee/Tea |
Soda/Diet Soda |
I have a sleep disorder |
I have recently had my blood pressure checked |
I have been tested for TMJ |
I am currently taking medication for my headaches |
I am currently taking medications for another condition |
I Sleep (enter average # of hours you sleep) |