A headache is pain or discomfort that comes from the head or the upper neck region. Headaches can vary in location, frequency and intensity. They can range from a dull ache to sharp, throbbing pain. Pain from a headache does not actually originate from the brain tissue, as the brain itself has no nerves for sensation. Instead, headache pain comes from the surrounding structures of the brain.
Wellness & Prevention
There are two kinds of headaches: primary and secondary headaches. A secondary headache is a symptom of an illness or an injury. In this case, the best form of prevention is to treat the underlying condition to alleviate the headache.
A primary headache is not a symptom of another condition. Severe or persistent primary headaches can negatively impact a person’s quality of life, interfering with productivity, causing insomnia or creating general feelings of illness or irritability.
Maintaining good health habits, like getting enough sleep and eating right, can limit the chances of developing primary headaches. However, not all primary headaches can be prevented.
People with chronic or recurrent headaches may undergo a number of tests. A physical examination, neurological exams and imaging tests can all be used for diagnosis. CT scans or MRIs may be run to rule out other medical issues such as brain tumors. A CT scan is a series of X-rays taken at different angles. A computer-generated cross-sectional image is made from the X-rays. An MRI uses a magnetic field and radio waves to make pictures of structures inside the body.
People are encouraged to keep a diary that tracks relevant health information to aid in diagnosis and treatment. The diary can include:
- When headache occurs
- How long the headache lasts
- Intensity of pain on a scale of one to 10
- Whether medications were helpful, and which medications were taken
- Possible triggers, such as foods, physical activities, noise, stress, smoke, bright lights or weather changes
A doctor will use results from tests and individual information to make a diagnosis. There are three types of primary headaches: tension headaches, cluster headaches and migraines.
Tension headaches are the most common form of headache. They make up about 90 percent of headaches. A tension headache typically causes mild to moderate pain, along with feeling tightness or pressure around the head. Muscles in the back of the neck and upper shoulders may also feel tight, sore or tense with a tension headache.
Cluster headaches typically occur in cycles, but an attack can last for weeks or months. A bout of several headaches is usually followed by a period of remission, when the headaches are completely absent. Cluster headaches are one of the most painful kinds of headaches, and also one of the rarest.
A migraine headache is a severe, extremely painful headache. It causes intense throbbing or a pulsing sensation that’s usually just in one area of the head. A migraine is commonly accompanied by sensory warnings, also known as an aura, and can include increased sensitivity to light and sound along with nausea or vomiting. Migraines can last for hours or even days. Physical activity can make migraine pain worse.
Headache treatments vary according to type. People with known triggers are recommended to avoid the things that can cause headaches to occur. Often, a combination of treatments is used.
Pain Relief Medication
Both over the counter (OTC) and prescription medication can be used to treat tension headaches. They may not cure the headaches but they can help to reduce the pain. Pain relief medication includes:
- Pain Relievers: OTC pain relievers are usually the first method for treating headaches. Common drugs include aspirin, ibuprofen and naproxen. Prescription pain relievers may also be prescribed.
- Combination Medication: Aspirin or acetaminophen can be combined with caffeine or a sedative in a single medication to treat headaches. They are sometimes more effective than single-ingredient pain relievers. Many combination medications are available over the counter.
- Triptan: A type of medication specifically used to relieve the pain caused by migraines and episodic tension headaches.
Frequent, chronic or severe headaches that don’t respond well to pain relief medication may be treated proactively. These medications can take several weeks to build up in the system before they are effective. Commonly prescribed preventive medications for headaches include:
- Tricyclic antidepressants
- Venlafaxine (Effexor XR) and Mirtazapine (Remeron)
- Anticonvulsants and muscle relaxants
Stress can cause tension headaches. People who can manage and reduce their stress may experience a reduction in headaches.
A number of alternative therapies may also be used to treat headache pain. Acupuncture, massage, and biofeedback can help to relieve tension and pain.
Rest, ice packs, a hot bath or shower, and relaxation can all help to treat tension headaches.
A series of follow-up visits are generally expected to evaluate how well treatments are alleviating the migraines and headaches.
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