Headaches

Headaches Overview

Everyone gets a headache from time to time. While most are a minor nuisance not associated with another disease, some headaches can be debilitating and signal a more significant problem. More than $4 billion is spent annually on over-the-counter pain relief for headaches. The National Headache Foundation says most of these treatments do not work.

There are three main types of headache:

Tension-type is the most common (about 80% of all headaches) and is characterized by generalized, mild-to-moderate pain all over the head. Some tension headaches are episodic. Others occur approximately daily and are associated with depression, sleep disturbance and emotional problems. Tension headaches are often caused by clenching muscles, stress or lack of sleep.
Migraine headaches (vascular) are characterized by moderate to severe pounding and throbbing pain on one or both sides of the head. Migraines also cause upset stomach and in some cases disturbed vision. Migraine headaches can be hereditary.
Cluster headache is a rare and extremely painful condition that occurs repeatedly at the same time of day for weeks or longer.

Secondary headaches are related to other underlying causes such as tumor, infection or diseases of the brain, eye or nose. They can also be associated with fever, injury, stroke or tumor.

Headaches in children are usually due to migraine or to emotional problems. If a headache occurs in the very young or the very old, it is important to consult a doctor to rule out organic disease.

Most headaches will disappear on their own without medical attention. However, if you are concerned, or if the headache occurs three or more times per month, consider making an appointment with your Wellstar neurologist. The doctor can help you understand the symptoms you are experiencing and, as necessary, conduct tests to determine if there is an underlying cause.

Symptoms

Headache-related discomfort can range from quite mild to excruciatingly painful. The type, location and duration of pain vary according to the type of headache.

Seek medical attention immediately if you or a loved one have the following symptoms:

Sudden, severe headache or a sudden headache associated with a stiff neck
Headache accompanied by fever, confusion, confusion, vision problems or loss of consciousness
Multiple headaches in a single week
Headache with seizure or shortness of breath
Headache following a blow to the head or associated with eye or ear pain
Persistent headache in someone who does not usually get headaches
Recurring headache in a child

Risk Factors

For tension headaches:

Sex. Women are more likely to have tension headaches than men.
Age. Tension headaches peek in the 40s although people of all age can get them.

For migraines:

Family history..
Age. By age 40 most people have had their first attack..
Sex. Women are three times more likely to have them than men..
Hormonal changes. Migraines can begin before or soon after onset of menstruation. Generally migraines improve after menopause..

For cluster headaches:

Sex. Men are more likely to have cluster headaches than women.
Age. Most people with cluster headaches develop the disorder between age 20 and age 50.
Smoking
Alcohol use
Family history

Headaches Prevention

Although it is difficult to prevent the onset of a headache, there are things you can do to minimize discomfort if a doctor has told you the type of headache you have.

At the first sign of a migraine:

Drink water to avoid dehydration, especially if you have vomited
Rest in a quiet, dark room
Place a cool cloth on your head
Use relaxation techniques

When a tension headache begins try over-the-counter pain relievers like acetaminophen, aspirin, or ibuprofen. Do not take these if you might be bleeding from your head and do not give aspirin to children.

Reduce Stress

In general, stress makes headaches worse. Consider stress-reduction tips including these:
Keep it simple. Don’t say yes to everything.
Get help. You might want to talk things over with family, friends or a therapist.
Manage your time. Tackle one task at a time and delegate when you can.
Get organized. Plan out your day, but realize that changes in your schedule are likely.
Try to reduce your worrying.
Work on having a more positive attitude.
Take a break. If you feel stressed or overwhelmed, take a few minutes to breathe, stretch or take a short walk.
Get regular exercise.
Consider learning and using mediation, yoga or deep breathing techniques.

Headaches Diagnosis

One way to help your Wellstar physician diagnose the type and reasons for your headache is by keeping a headache journal. Make notes about when headaches begin, what you ate for the 24 hours prior, how much sleep you got before the headache started, how long the headache lasted and what you did to make it stop.

You should continue to keep the journal even after beginning treatment to determine what lifestyle changes, medications, etc. are working.

Your neurologist will start with a medical history and will examine your head, eyes, ears, nose, throat and nervous system. The doctor will ask you a variety of questions about your health, habits and lifestyle.

Tools and Tests

Your Wellstar physician may use certain tests to determine what’s causing the headaches and if there is an underlying disease that requires treatment.

Blood tests or lumbar puncture (spinal tap) to identify a possible infection
CT scan, MRI or MR angiography to produce images of the brain
X-ray of the sinuses
EEG (brain wave test) if your neurologist believes a seizure may be causing the headaches
An overnight sleep study to determine if obstructive sleep apnea may be a cause of early morning headaches

Headaches Treatment

For mild headaches at-home treatments like rest, relaxation and neck massage can provide relief. Over-the-counter medications can help but they should not be used on a daily basis.

Your physician will assess the situation and discuss possible treatment options, especially if headaches occur three or more times a month. Treatments can include prescription pain medication, biofeedback training, stress reduction and dietary modifications.

The doctor may also discuss lifestyle changes including getting regular exercise to reduce the number and severity of migraines. Headache education can help patients learn what triggers your headache and how to avoid those triggers. Examples of triggers are lack of sleep, irregular eating times, caffeine and stress.

Ongoing Care for Headaches

For mild headaches at-home treatments like rest, relaxation and neck massage can provide relief. Over-the-counter medications can help but they should not be used on a daily basis.

Treatments can include prescription pain medication, biofeedback training, stress reduction and dietary modifications. Work with your doctor to define the best care that works for your headaches.

Lifestyle changes including getting regular exercise to reduce the number and severity of migraines as well as healthy eating and sleeping habits can help. Headache education can help patients learn what triggers your headache and how to avoid those triggers.

Regular visits to your Neurologist or primary care physician can help keep headaches under control.