Headaches

Jan 1, 2011
2011 / January 2011

Headaches are the most common reason for sick days from work or school and the most frequent complaint at doctor visits. Approximately 90 percent of headaches result from one of three syndromes: migraine headaches, tension-type headaches (TTH) and cluster headaches. In 2007, the International Headache Society created a classification system for headaches which enables healthcare providers to diagnose specific types of headache and administer effective treatment.

Migraine headaches cause moderate to severe pain that is worsened by light, noise and motion. Some people also experience nausea and vomiting. Migraines typically last for a few hours but may last for as long as three days. The pain, described as throbbing, pounding or pulsating, tends to begin on one side of the head but may spread to the other side. A migraine with aura includes visual disturbances that occur before or during the pain.

Symptoms of TTH include pressure or tightness around both sides of the head or neck, with mild to moderate pain that is steady and does not throb. The pain is not worsened by activity and can increase or decrease in severity. The muscles of the head, neck or shoulders may be tender. People with TTH often feel stress or tension before onset. Unlike migraines, tension headaches occur without other symptoms; however, some people experience tension and migraine headaches at the same time.

TTH are usually related to stress, depression or anxiety. Overworking, not getting enough sleep, missing meals and using alcohol or street drugs can make you more susceptible. Headaches can be triggered by chocolate, cheese and monosodium glutamate. People who drink caffeinated beverages can have headaches when they don’t get their usual daily amount. Other common causes include overexertion, holding your head in one position for a long time when using a computer, poor sleep position or clenching or grinding your teeth when sleeping.

Cluster headaches are severe, debilitating headaches that occur repeatedly for weeks to months at a time, followed by periods with no headache. Cluster headaches affect less than 1 percent of the population, with the peak age of onset between 25 and 50. People with cluster headaches are more likely to have family members who also experience cluster headaches, and men are affected more commonly than women. Drinking alcohol can bring on a cluster headache. Symptoms begin quickly without any warning and reach a peak within a few minutes. The headache is usually deep, excruciating, continuous and explosive, although occasionally it may be throbbing. The attack may occur up to eight times per day but is usually short in duration, between 15 minutes and three hours.

The pain of a cluster headache typically begins in or around the eye or temple but it can start in the face, neck or ear. It is always on one side and is often accompanied by eye redness, tear production or light sensitivity on that side, as well as a stuffy or runny nose, sweating and pale skin. Most sufferers are restless and may pace or rock back and forth during an attack.

A patient’s description of the pain helps healthcare providers identify the type of headache. Keeping a headache diary can also help; by tracking the frequency, day, time and duration of headaches and what you were doing prior to onset, you may discover what triggers them. Most people do not need X-rays or imaging tests to diagnose their headaches. A CT scan or MRI may be indicated if there are unusual symptoms, if abnormalities are seen during the examination, if headaches steadily worsen despite treatment, or if a sudden change in the pattern of headaches or symptoms suggests another medical condition. Seek medical care if you experience a headache that is out of the ordinary for you or if you have been diagnosed with migraine and your usual treatment does not produce relief.

Most headaches can be treated with self-care, whether you are at home or on the road. Take an over-the-counter pain medication such as acetaminophen or ibuprofen at the first symptoms. For chronic migraines, follow the treatment your physician has prescribed. If you experience tension headaches, remove yourself from the stressor. Lie down with a cool, wet towel over your forehead or behind your neck.

While most headaches are not serious, they can signal a more severe problem requiring emergency medical care. A sudden, violent headache could be a cerebral hemorrhage. A headache with loss of vision or weakness in your arms or legs could indicate a stroke. A headache with a fever and stiff neck could be meningitis. If more than one family member gets a headache at the same time, the problem could be carbon monoxide poisoning; get everyone outside and call 911. For more information, visit www.mayoclinic.com.


No Strain, No Pain

Lessen your stress to reduce the occurrence of headaches.

  • Get adequate sleep
  • Eat a healthy diet
  • Exercise regularly
  • Stretch your neck and upper body and take breaks at the computer
  • Sit and stand with good posture
  • Quit smoking
  • Decrease alcohol consumption
  • Use relaxation techniques: meditation, yoga, massage, acupuncture
  • Wear correctly prescribed eye glasses

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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