111 N. Wabash Ave Suite 2011 • Chicago, IL 60602
By. Alan R. Hirsch, M.D.
What do Thomas Jefferson, Sigmund Freud, Karl
Marx, Julius Caesar, Edgar Allen Poe, Lewis Carroll, Charles
Darwin, George Bernard Shaw, and thirty million Americans
have in common? They all suffer or suffered from recurrent,
debilitating headaches. Headaches are ubiquitous in society.
Historically, the treatment of headaches is
quite interesting, if not bizarre. Early therapy from old
Irish manuscripts instructed the headache sufferer to pray
to the eye of Isaiah, the tongue of Solomon, the mind of Benjamin,
the heart of St. Paul, and the faith of Abraham. One early
therapy involved placing the skins of reptiles over the face
and head. Another suggestion was that leeches should be attached
to the body to induce bleeding and blister formation on the
skin. Still another treatment included the use of seeds from
the elder tree, cow's brain and goat dung, all dissolved in
vinegar. And yet another early therapy even involved the use
of beaver testes bottled in spirits.
There are numerous types of headaches. Some
recur and are very painful, yet pose no significant threat
to the patient, while others indicate a serious disease. Fortunately,
the great majority of headaches fall into the first, or benign,
category. Among the more common types of this kind of headache
are migraine, cluster, sinus, allergy, chemical sensitivity,
and muscle contraction or "tension" headaches. It
is to sufferers of these muscle contraction type headaches
(constituting a large portion of the benign category) that
Dr. Goldman addresses this book.
Generally, headache pain has more than one
cause in a given patient at a given time. Because of the similarities
of the types of pain that these different causes can create,
the diagnostic challenge is great. Temporomandibular joint
dysfunction syndrome must be included as a possible cause
(or one of the combination of possible causes) for all headaches.
In TMJ Syndrome, Dr. Goldman has eloquently
described temporomandibular joint dysfunction. Throughout
medical school, this syndrome is barely touched on-perhaps
covered in only a single lecture. Yet clearly millions of
people suffer from this disease.
Throughout the many years I have seen patients
suffering from headache and temporomandibular joint dysfunction,
the number who have undergone ineffective treatment and invasive
surgical management for their pain has been enormous. I have
seen patients who have had all of their teeth removed; people
who have had multiple operations on their jaws to alleviate
TMJ syndrome. Usually, these approaches have been unsuccessful
and have required further treatment.
Dr. Goldman's well thought of and conservative
approach to temporomandibular joint dysfunction makes medical
sense and has been successful for thousands of patients. His
thoughtful and innovative style has assured the diagnosis
and successful treatment of temporomandibular joint problems
and has also led to the diagnosis of diseases that mimic temporomandibular
joint dysfunction. Clearly, Dr. Goldman is to be commended
as an example for all of us in the medical community who deal
with headache and temporomandibular joint pain.
Alan R. Hirsch, M.D. Neurologist, Director
Hirsch Headache Center Chicago, Illinois