Monday, August 27, 2007

"Brain-Freeze" and "Ice Cream...BACKache"?

Ever get a "brain-freeze"..that intensely painful (but mercifully brief) "ice cream headache"* that some 30% of us experience when we eat or drink something cold too quickly?


*For the record, "ice cream headache" , "brain-freeze" or sphenopalatine ganglioneuralgia is defined as a "headache attributed to ingestion or inhalation of a cold stimulus", and medically it seems to be of zero interest, other than something about which to occasionally reassure worried patients, because even though it really, really hurts, ice cream headache is
1.self-limiting
2. not dangerous
3. nobody dies from it (directly)
4. avoidable in the first place
... therefore it's really of no importance, health-wise.

To read what the Mayo Clinic has to say about ice cream headache, click this link~
http://www.mayoclinic.com/health/ice-cream-headaches/DS00640.


Brain-freeze is usually less than a minute in duration (often much less), but while it's going on, it can feel like Hell's actually freezing over, inside your head, with piercingly intense pain felt mostly in the frontal areas of the head. (Ow! Ow! Ow! Ow!! OW!!!)

Unofficially I'd guess that (here in the U.S.A.), the main trigger for "brain freeze" seems to be sucking a blended drink made mostly of ice through a straw, such as a "Slurpee", "Slush", or frozen Margarita; ice cream and especially ices and sherbets probably come in a close second. (My Dad, an intelligent man given to strong (if sometimes overly broad) opinions, avoided eating sherbet because he'd always experienced the ice cream headache from sherbet, but rarely from ice cream. Something about consistency I guess..)

Here's how it works: Ingesting the icy substance (especially through a straw), rapidly cools the hard palate causing vasoconstriction of the descending palatine arteries. The trouble seems to start when the area begins to warm back up quickly during the acts of breathing and speaking, which reverses the vascular action causing immediate and extreme vasodilation , which is interpreted by the nerves in the area as pain. (Sounds like a brief, mislocated migraine to me.)

The thing is, some of us feel our version of the "brain-freeze" between the shoulder blades instead of the head. I don't know what else to call it but an "ice cream backache". I'm not implying it's of medical significance, I just think it's interesting.

From childhood I experienced the typical "brain-freeze", but about 20 years ago (in my 30's) it suddenly moved out of my head and relocated in the middle of my back, deep between the shoulder blades, which I liked even less.

With the "brain-freeze", at least I could apply strong counter pressure with my hands, which was some comfort. But when ice cream backache strikes, all one can do is press back hard against a chair or a wall, or just squirm. (
And I know from experience that that "squirming" reaction is not only undignified but can tend to alarm onlookers, who may think you're having a heart attack or stroke or something. No, it's nothing that you'll get any sympathy for, because by the time you've explained what's happening to you, it's over and the onlookers are rolling their eyes..).

Anyway, I'd never heard of that between-the-shoulder-blades variation on the "brain-freeze" before I experienced it myself, and my neurologist had never heard of it either, so I assumed I was alone in this unpleasant, unimportant weirdness... story of my life, really, but that's another blog...


Luckily, in 1997 I found a bona fide medical article on the subject of "Ice Cream Headache", published in the "British Medical Journal" by Dr. Joseph Hulihan, Professor in the Department of Neurology at Temple University Health Sciences Center. http://www.bmj.com/cgi/content/full/314/7091/1364

Dr. Hulihan seems to be the world's only "I.C.H." (Ice Cream Headache) expert, although that's not his focus since it's probably not enough to build a career around. But he's the authority. And fortunately, Dr. Hulihan's artcle on "Ice Cream Headache" was followed by a Q & A board on the subject, so I posted a question asking whether anyone else had experienced (or even heard of) what I described and called "ice cream BACKache".
Click here http://www.bmj.com/cgi/eletters/314/7091/1364 to read the board.

Well, it turns out I wasn't alone at all - several people wrote in that they'd experienced the same thing, "ice cream backache", and they all thought they were unique in this.


I wrote to Dr. H. about it, and he wrote back to say that he'd never heard of this variation on ice cream headache, and found it interesting. He surmised that it might have something to do with referred pain from esophageal spasm.

Since Dr. H. hadn't heard of it, I assume that ice cream backache is relatively rare, and as far as I've been able to tell, no one is studying (or has ever studied) it, so it's not well understood. But it does happen.

It's not an important issue, medically speaking, or even remotely dangerous, but personally I'm curious and would like to understand it. I'm hoping to eveventually collect some basic data about this.