| Definition: | A headache is pain or discomfort in the head, scalp, or neck. Most headaches are due to tension, migraine, or a combination of the two. Serious underlying causes of headaches, like a tumor or a stroke, are extremely rare, despite the fact that many people worry about these possibilities. Most people with headaches can feel much, much better by making lifestyle changes, including learning ways to relax, and occasionally by taking medications. See also tension headache, cluster headache, classic migraine headache, and common migraine headache.
|
| Alternative Names: | Pain - head
|
| Common Causes: | Tension headaches are due to contraction (tightness) of the muscles in your shoulders, neck, scalp, and jaw. They are often related to stress, depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to headaches. Foods that can trigger a headache include chocolate, cheese, and monosodium glutamate (MSG), a flavor enhancer. People who drink caffeine can have headaches when they don't get their usual daily amount. Other common reasons you may develop a tension headache include: - Performing an activity that causes you to hold your head in one position for a long time, like using a computer, microscope, or typewriter
- Sleeping in a cold room or an abnormal position
- Overexerting yourself
- Clenching your jaw or grinding your teeth
Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, even like a tight band or vice around your head. The muscle tension often begins in your shoulders, neck, or jaw before spreading to your head. Therefore, these areas may feel tight and sore as well. Migraine headaches are severe, recurrent headaches that are generally accompanied by other symptoms like visual disturbances or nausea. They tend to begin on one side of your head, although the pain may spread to both sides. You may have an "aura" (warning symptoms that start before your headache) and usually feel a throbbing, pounding, or pulsating pain. Other types of headaches include: - Cluster headaches are sharp, extremely painful headaches that tend to occur several times per day for months and then go away for a similar period of time. They are far less common than migraine or tension headaches.
- Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches.
Headaches may occur if you have a cold, the flu, fever, or premenstrual syndrome. If you are over age 50 and are experiencing headaches for the first time, a condition called temporal arteritis may prove to be the cause. Symptoms of this condition include impaired vision and pain aggravated by chewing. There is a risk of becoming blind with this condition. Therefore, it must be treated by your doctor right away. Rare causes of headache include:
|
| Home Care: | Keep a headache diary, particularly when you first have headaches, to help identify the source or trigger of your symptoms. From that information, you can figure out how to modify your environment or habits to avoid recurrent headaches. When a headache occurs, write down the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern and be able to identify triggers to avoid. A headache may be relieved by resting with your eyes closed and head supported or by using relaxation techniques. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches. Over-the-counter pain medications are often effective headache relievers. Try acetaminophen (Tylenol), aspirin, or ibuprofen (Advil or Motrin) for tension headaches. ASPIRIN SHOULD NOT BE USED IN CHILDREN because of the risk of Reye's syndrome. Migraine headaches may respond to aspirin, naproxen (Aleve), or combination medications such as Excedrin Migraine. If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications. Prescription medications used for migraine headaches include ergotamine, dihydroergotamine, ergotamine with caffeine (Cafergot), isometheptene (Midrin), and triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), andzolmitriptan (Zomig). Sometimes medications to relieve nausea and vomiting are helpful for other migraine symptoms. If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. Examples of these include: - Antidepressants, like nortriptyline (Pamelor), amitryptyline (Elavil), fluoxetine (Prozac, Sarafem), sertraline (Zoloft), or paroxetine (Paxil), for tension or migraine headache
- Beta-blockers, like propranolol (Inderal) for frequent migraine headaches
- Calcium channel blockers, like verapamil for frequent migraine headaches
If you are using pain medications more than 2 days a week, you may be suffering from rebound headaches. Rebound headaches are caused by a cycle of using pain medications for short-term relief, followed by the headache pain returning for increasingly longer periods of time despite taking more pain medications. All types of pain pills (including over-the-counter drugs), muscle relaxants, some decongestants, and caffeine can cause this pattern. If you think this may be a problem for you, talk to your health care provider.
|
| Call your health care provider if: | Take the following symptoms very seriously. If you cannot see your health care provider immediately, go to the emergency room or call your local emergency number (usually 911): - Your headache comes on suddenly and is explosive or violent.
- You would describe your headache as "your worst ever", even if you are prone to headaches.
- Your headache is associated with slurred speech, change in vision, problems moving any of your arms or legs, loss of balance, confusion, or memory loss.
- Your headache gets progressively worse over a 24-hour time period.
- Your headache is accompanied by fever, stiff neck, nausea, and vomiting.
- Your headache occurs with a head injury.
- Your headache is severe and localized to one eye with redness in that eye.
- You are over age 50 and your headaches just began.
For the following, see your health care provider soon: - Your headache has lasted more than a few days.
- Your headaches are worse in the morning.
- You have a history of headaches but they have changed in pattern or intensity.
- You have headaches frequently, and there is no known cause.
|
| What to expect at your health care provider's office: | Your health care provider will obtain your medical history and will perform an examination of your head, eyes, ears, nose, throat, neck, and nervous system. The diagnosis is usually based on your history of symptoms. A "headache diary" may be helpful for recording information about headaches over a period of time. Your doctor may ask questions such as the following: - Is the headache located in the forehead, around the eyes, in the back of the head, near the temples, behind the eyeball, or all over?
- Is the headache on one side only?
- Is this a new type of headache for you?
- Would you describe the headache as throbbing?
- Is there a pressure or band-like sensation?
- When does the headache occur? How long have you had headaches? How long does each headache last?
- Does the headache awaken you from sleep? Are the headaches worse during the day and better at night?
- Did other symptoms begin shortly after the headaches began? Do headaches occur repeatedly?
- Does the headache reach maximum intensity over 1 to 2 hours?
- Are the headaches worse when you are lying down? Standing up?
- Are the headaches worse when you cough or strain?
- Do they occur at a specific time related to your menstrual period?
- What home treatment have you tried? How effective was it?
Diagnostic tests that may be performed include the following:
If a migraine is diagnosed, medications that contain ergot may be prescribed. Temporal arteritis must be treated with steroids to help prevent blindness. Other disorders are treated as is appropriate.
|
| Prevention: | Good health habits can help lessen stress and reduce your likelihood of getting headaches. These include: - Adequate sleep
- Eating a healthy diet
- Exercising regularly
- Stretching your neck and upper body, especially if your work involves typing or using a computer.
- Learning proper posture
- Quitting smoking
- Learning to relax using meditation, deep breathing, yoga or other valuable techniques
|
|