What is Headache?
Headache is one of the most common causes of human discomfort. Most of the times a headache are more of a nagging nuisance than an indicator of a serious problem. But, in some cases the headache does warrant more serious attention as it can be the indicator of some significant problem. Like other problems, it can have many causes.
What are the different types of headache?
There are four types of headache: vascular, muscle contraction (tension), traction, and inflammatory. The most common type of vascular headache is migraine. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and, at times, disturbed vision. Women are more likely than men to have migraine headaches. After migraine, the most common type of vascular headache is the toxic headache produced by fever. Other kinds of vascular headaches include “cluster” headaches, which cause repeated episodes of intense pain, and headaches resulting from high blood pressure. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Like other types of pain, headaches can serve as warning signals of more serious disorders. This is particularly true for headaches caused by inflammation, including those related to meningitis as well as those resulting from diseases of the sinuses, spine, neck, ears, and teeth.
Headache is also classified as Primary and Secondary Headache. Primary headache is one without an underlying cause while Secondary headache is caused by an underlying disease. Tension Type Headache is the commonest type of primary headache diagnosed in outpatient department.
What are the treatment options?
Early diagnosis and management along with reassurance is part of successful management for most patients with headache. There are two ways to approach the treatment of headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. The medications available include pain killers like Non-steroidal anti-inflammatory drugs (NSAIDs) like paracetamol, aspirin, ibuprofen or naproxen etc., Opioid pain killers like tramadol, pethidine, codeine which can be used to control pain.
When headaches occur three or more times a month, preventive prophylactic treatment is usually recommended. Drug therapy, biofeedback training, yoga therapy, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Regular exercise, such as swimming or vigorous walking, can also reduce the frequency and severity of migraine headaches. Drug therapy for migraine is often combined with biofeedback and relaxation training. One of the most commonly used drugs for the relief of migraine symptoms is sumatriptan. Drugs used to prevent migraine also include methysergide maleate, which counteracts blood vessel constriction; propranolol hydrochloride, which also reduces the frequency and severity of migraine headaches; ergotamine tartrate, a vasoconstrictor that helps counteract the painful dilation stage of the headache; amitriptyline, an antidepressant; valproic acid, an anticonvulsant; and verapamil, a calcium channel blocker.
When to consult doctor?
Not all headaches require medical attention. But some types of headache are signals of more serious disorders and call for prompt medical care. These include: sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions, or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person who was previously headache free; and recurring headache in children. Migraine headaches may last a day or more and can strike as often as several times a week or as rarely as once every few years.
Can you prevent Headache?
Early diagnosis and Treatment help preventing further episodes.
- The patients must pay proper attention to their symptom(s) —
- What are the characteristics your headache like location, duration, severity (worst ever headache?), and character (dull, sharp, throbbing, etc.).
- What are the aggravating factors for headache for example, certain foods, stress, bright light, and fasting or sleep disturbances?
- You should seek early medical help when:-
- It is the “worst headache of your life”.
- Different than your usual
- Starts suddenly or is aggravated by exertion, coughing, bending over, or sexual activity.
- Associated with persistent nausea and vomiting.
- Associated with fever or stiff neck.
- Associated with seizures.
- Associated with recent head trauma or a fall.
- Associated with changes in vision, speech, or behaviour.
- Associated with weakness or change in sensation.
- Not responding to treatment and is getting worse.
- Requires more than the recommended dose of over-the-counter medications for pain.
- Disabling and interfering with work and quality of life.
- If it persists for over 2 weeks.
- If the pain is too severe as to be unbearable.
- Associated with high blood pressure.
- Consult your doctor and get the necessary Investigations done to help diagnosing type of headache.
- MRI/CT Scan of the Brain and sometimes CSF (Cerebro-spinal Fluid) examination in secondary headache.
- Routine blood investigation.
- Proper management of the headache can prevent the associated disability.
Living with headache; what can you do?
- Consult your doctor at earliest
- Get the necessary investigations done
- Take the medicines as prescribed by the doctor
- Understand and learn to identify specific headache triggers and avoid them.
- Regulated lifestyle, healthful diet, regular exercise, regular sleep pattern, avoidance of excess caffeine and alcohol.
- Avoid acute change in stress level by yoga, meditation.