FMS Community Index Page
Headaches and Trigger Points
Headache Pain Treatment Publications
| Symptom | Yes | No | 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 |
| Daily |
| 2 - 3 Times Weekly |
| 4-6 Times Weekly |
| Before my Menstrual Cycle |
| During my Menstrual Cycle |
| After my Menstrual Cycle |
| Headaches occur when: |
| I exert myself |
| When I am at rest |
| Both |
| Headaches Cause Sensitivity 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 the Headache Occured |
| Wheat products. (bread, rolls, pizza, pitas, cereal, cookies) |
| Sugar (Donuts, cookies, hard candy, soda) |
| Dairy (milk, ice cream, cottage cheese, cheese) |
| Chocolate |
| Wine |
| Beer |
| Other alchohol |
| Coffee/Tea |
| Soda |
| Diet Soda |
| I have been checked for a sleep disorder |
| I have recently had my blood pressure checked |
| I have been tested for TMJ (Temporomandibular Joint Disorder) |
| I am currently taking medication for my headaches |
| I am currently taking medications for another condition |
| I sleep |
| Eight hours a night |
| Five hours a night |
| I twilight sleep all night |
| I wake up every few hours |
| I fall asleep immediately but wake up easily and toss and turn. |
| I have no trouble sleeping |
| I sleep all night unless I am experiencing my menstrual cycle. |