Dr. Diamond received his medical degree from the Chicago Medical School from which he received the Distinguished Alumni Award in 1977. He has been elected as a fellow of the Royal Society of Medicine, Neurology Section. Dr. Diamond has served as editor for 16 publications. Currently, he serves as editor-in-chief of the journal, Headache Quarterly, Current Treatment and Research. In addition, he has published more than 300 articles in professional literature and has authored or co-authored more than 30 books. In 1992, with Donald J. Dalessio, he co-edited the fifth edition of The Practicing Physician's Approach to Headache.

Dr. Diamond has lectured extensively throughout the United States, Europe and Asia. In addition to holding more than 30 professional association offices in the past, Dr. Diamond currently serves as the executive chairman of the National Headache Foundation. Dr. Diamond received the National Migraine Foundation Lectureship Award in 1982, and in 1988, he was honored as the first recipient of the Migraine Trust Lectureship.
Pain.com: How long have your been involved in the study and treatment of headaches?

Dr. Diamond: Thirty-five years. During the early 1960s, I was doing research into the use of the antidepressants in the treatment of chronic pain. My interest in headaches evolved from my investigating the use of the antidepressants in the treatment of chronic headaches.
Pain.com: What are the basic types of headaches and their cause?

Dr. Diamond: We divide headaches into 3 basic classes - organic, tension-type, and vascular. Organic headaches are also known as traction and inflammatory, and are caused by expansion and pulling of the blood vessels within the brain. Organic causes include aneurysm, subdural hematomas, and brain tumors. Tension-type headaches are also known as muscle contraction headaches, and can be triggered by stress, frustration, anxiety, and depression. Vascular headaches are due to a disturbance of the amines, including histamine and serotonin. Migraine and cluster headaches are considered vascular in nature, and are characterized by vasodilation of the cranial vessels.
Pain.com: : What is the difference between a "headache" and a "migraine"?

Dr. Diamond: A migraine is a type of headache as we have already discussed. Migraine is treated by 4 methods: general measures (diet, avoiding migraine precipitants, relaxation); abortive (treating an acute headache as soon as possible in the attack); pain relieving measures (symptomatic treatment of the pain if the headache has not responded to abortive agents); and finally, prophylactic agents to prevent the attacks from occurring.
Pain.com: Can recurring headaches be a symptom of something more serious?

Dr. Diamond: Yes. Organic headaches are due to a serious cause, often life threatening, such as a brain tumor or aneurysm. Often, urgent neurosurgical intervention is required.
Pain.com: Can headaches be avoided?

Dr. Diamond: Avoiding known triggers, such as certain foods, alcoholic beverages, stress, and getting adequate sleep, and eating at regular times can often prevent headaches
Pain.com: Some individuals don't like to take medications for their pain. Is it possible to build a tolerance to simple analgesics?

Dr. Diamond: I don't believe that with ordinary use a person will build up a tolerance for simple analgesics. The only exception is those drugs containing caffeine.
Pain.com: When should a patient seek the help of a physician for their recurring headaches? Who should they seek - a pain specialist, their family physician, who?

Dr. Diamond: In general, patients should seek the advice of a physician if they experience any of the following:

1. Sudden and severe headache
2. A headache which affects one side of the head
3. A headache which is associated with pain in the eye or ear
4. A headache which is accompanied by nausea, vomiting, hallucinations, or sensitivity to light and sound
5. A headache which recurs in a definite pattern - time of day, circumstances, and duration of pain are consistently similar
6. A headache which causes confusion or loss of consciousness, or weakness in the legs and arms
7. A headache which is persistent, when you were previously headache-free
8. A headache which interferes with your ability to function normally at work or in social situations
9. A headache which is similar to headaches suffered by other members of your family.

When should a patient stop using Over-the-Counter (OTC) medication and see a physician? If the headache is not responsive to the OTC agent, and fulfills the criteria listed above.

What is the best OTC medication for a headache? A combination agent with aspirin, acetaminophen, and caffeine. This drug should not be used on a daily basis.

Do certain activities cause headaches? Exertion can trigger or exacerbate a migraine attack. However, headache related to exertion could be related to an organic cause, and the patient should be thoroughly evaluated.

Do certain weather conditions cause headaches? Changes in barometric pressure and altitude have been recognized as headache triggers in certain individuals.

Do certain foods cause headaches? Foods containing vasoactive substances can trigger headaches, especially vascular headache. These substances include tyramine, which is contained in aged, and preserved foods, such as cheese, yogurt, pickled and marinated foods. Phenylethylamine, contained in chocolate, is a well-known headache trigger. Alcoholic beverages, particularly red wine, can trigger headaches. The nitrites contained in hot dogs and other luncheon meats can trigger headaches.

Do you recommend any non-traditional methods to treat headaches? Yes, we have used biofeedback at our Clinic since 1972 with very successful results.

How do you treat headaches? Treatment choice is based on the type of headache that the patient is experiencing. Also, if the headaches are infrequent, the headache is treated symptomatically. However, if the patient is experiencing 2 or more headaches per month, they should be placed on prophylactic medications
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