A headache is a painful sensation in any part of the head. It affects everyone regardless of age, sex or social status. A number of conditions can cause headache. It may be associated with other symptoms also. Headache is the most common condition for which people seek treatment. A minor headache is not bothersome. But sometimes headache can be a symptom of increased blood pressure or stroke or infection. Come, let’s see what all causes headache and how to deal with one when you get.
What are the types of headaches?
The International Headache Society classifies headache into three types based on the causes.
PRIMARY HEADACHES
Primary headaches are due to problems in pain sensitive parts of head. Not all parts of our head is sensitive to pain. For instance, our brain, which is the most important one, is insensitive. Whereas the blood vessels, muscles and tissues over the skull are sensitive. Migraines, tension headaches and cluster headaches form the main bulk of primary headaches.
SECONDARY HEADACHES
Secondary headaches occur due to the triggering of pain centers in head by causes anywhere in the body. There is a vast list of headaches under this category. Some of the common ones are, hangover after alcohol or drugs, dehydration, brain tumor, elevated blood pressure, concussion, influenza and stroke. Moreover, secondary headache could be an indication of some underlying disease. So you will have to check up with a specialist.
cranial neuralgia and facial pains
Twelve nerves supply the head and neck region. Pain may be referred to the head through any of these nerves. The most important is the trigeminal nerve which supplies your face. Neuralgia literally means nerve pain. Patients of trigeminal neuralgia suffer intense pains when certain sensitive regions are stimulated.
how do the individual headaches differ from each other?
migraine headache
These headaches produce a severe throbbing and pulsatile pain on one side. They have triggers about which we will discuss shortly. Migraines are associated with nausea, vomiting, irritability, light-headedness and altered vision. Besides, they are very common in women and severe during menstruation. They last for a few hours to even 2-3 days.
tension headache
Tension headaches are the most common type of headache. The cause is unknown. They start with a tightness or dull pain from the back of neck and spread to other areas. Patients often feel a tight band compressing their head. Additionally, they complain of a constant pain on both sides. Tension headaches can be chronic too.
cluster headaches
These occur in groups separated by pain free interval period. Headaches may occur repeatedly over many weeks or months followed by months or years of pain free period. The pain is usually severe, single sided and may wake up the patient from sleep. It is inherited from parents. Next, the patients usually describe the pain around one eye which may be swollen or red. Last, the pain comes in the same time of the day every time.
rebound and medication headaches
Some people suffer a unique type of headache which resolves with pain medicines but recurs once the effect weans off. It is particularly gruesome and leads to a vicious cycle. Additionally, this gets complicated as headache is a side effect of some pain medicines! These patients lead very difficult lives sometimes scared to take pain relieving medicines for fear of worsening their headache. Do you have such a headache? Talk to one of our experts.
SINUS HEADACHES
Sinus headaches are dull aching and can be single sided or both. They occur along with nose block or nasal discharge. You feel the pain near the brow region or the cheeks. It increases when you bend down or press the eye brows. Sinuses are air-filled spaces inside our head. They reduce the weight of head and produce mucus to keep the airway tract moist. The sinuses are ventilated when we breathe in and out. Some individuals have nasal pathology causing decreased air entry into sinuses. As a result, they get infected and secrete pus. Consequently, we feel pain, nose block and congestion. Sinusitis, if left untreated, can cause vision loss. We shall discuss sinusitis in detail in a different post.
thunderclap headache
This, as the name sounds, develops abruptly within seconds. Patients often describe this as the worst headache of their life. It starts abruptly and is excruciating. Thunderclap headache may be a symptom of some serious underlying problem like stroke or intracranial bleed. You will need immediate attention if you develop this kind of headache.
some other headaches
Some of my patients often associate headache with sexual activity. Many males complain of headache after sex. Taking a pain relieving pill an hour before sex prevents this. Next, elevated blood pressure can cause light headedness and headache. I always advice my hypertensive patients to check their blood pressure whenever they get headache. Some kids complain of headache when they are in front of books. Most of them want to avoid reading and hence complain, but a few may have focusing problems in the eye. An eye check-up and appropriate glasses will solve the problem. Last, sudden exercise can trigger headache in a few. You must avoid exercising suddenly after a long break. Rather you should work up gradually from warm-ups to tougher exercises.
i have a headache. should i worry?
Most headaches do not mean anything sinister. You can take care of those yourself or by the medicines your doctor writes. However, some headaches can be a sign of a serious underlying problem. If you have any of the following problems then you better get prompt medical attention.
- Headache developing after 50 years of age.
- Change in your mental status.
- Change in headache pattern.
- Very severe headache.
- Worsening of neurological status.
- Confusion, decreased alertness.
- Altered vision.
- Headache with nose bleeds.
what can trigger a headache?
Migraine headaches are known to have triggers. Here is a list of common triggers which my patients complain of-
- Loud noises and flashes of light.
- Change in pattern of sleep.
- Stress and worries.
- Consumption of chocolate, alcohol, caffeine and sugars.
- Change in weather.
- Strong smells.
- Fasting.
How is the type diagnosed? What tests help in diagnosing?
Doctors diagnose headache predominantly based on history. Your physician will ask you all sorts of questions to find out the exact cause. The treatment and long term management of headaches depend on the cause. Additionally, the doctor may order some tests like routine blood work up, nasal endoscopy, CT scan or MRI. From an otolaryngologist point of view, we depend on nasal endoscopy and CT scan to rule out sinusitis apart from clinical examination. We also suggest cross consultations with eye specialist, neurologist, psychiatrist and internal medicine specialist many at times. The involvement of different specialties ensures that we do not miss any cause and you get the best treatment.
do you suffer from chronic or constant headaches?
Some people suffer from headaches on a routine basis. Headaches happen every few days affecting their work and quality of life. In addition to that, missing work repeatedly affects dynamics at the work place. Do you suffer from such a headache? First, get a proper diagnosis. Next, learn to identify the warning signs and avoid the triggering factors. Follow the precautionary measures elucidated below. Keep some pain killers with you ready after consulting your physician. Last, do not take medicines without proper guidance. Never give aspirin to kids.
How is headache treated? can i take some home remedies?
The treatment depends on the underlying cause. The treatment of migraine will be different from that of cluster headache. Therefore, it is important to sit down and discuss with your physician regarding what is the best strategy for you. Our experts are available round the clock to cater to your doubts. Treatment of a headache involves adequate rest and pain relieving medicines. Paracetamol (Tylenol), ibuprofen (Advil) and Aceclofenac (or diclofenac) are some of the commonly used medicines. Severe headache may need stronger medicines. However, do not take these medicines unless advised so by your physician. Sometimes, he might put you on anti-depressants or medicines acting on the central nervous system. Finally, there are some remedies for headache which you can try at home, like the below.
- Keep an ice pack or heat pack over your forehead.
- Steam inhalation relieves certain sinus headaches.
- Vicks vaporub offers some relief.
- Get adequate rest and don’t strain.
- Avoid smoke, TV and digital screens. Light can worsen headache.
- Avoid stress, develop some mind relaxation techniques.
- Have proper nutritious meals.
HOW TO PREVENT HEADACHES?
- Eat regularly, do not fast.
- Avoid coffee, tea, excessive sugars, chocolates and other known triggers.
- Get adequate sleep in the night (at least 7 to 8 hours for an adult).
- Exercise in the morning after waking up.
- Keep your blood pressure and sugars in control.
- If having sinus problems get adequate support.
- Drink enough water.
- Avoid smoking and drinking.
- Multivitamins rich on Co-Q, B-complex and Magnesium help.
- Stress management / Mind relaxation.
Although we have given you 10 measures to help prevent a headache, we emphasize on regular and balanced diet, daily exercises and avoiding triggers and stress. These alone will go a long way in keeping you headache free.
The author of this article, Dr. Shyam Kalyan N, is one of the directors of World ENT Care. If you wish to talk to him you can email to shyam.kalyan@worldentcare.com
