Headaches

Headache Relief May be Close By

It can strike anywhere at any time. In the car. At the gym. Sitting at work. Playing with the kids.

The pain can be a dull aching all over the head or it can be sharp and pinpointed. Regardless of the symptoms or causes, headaches are never fun.

There are three basic types of headaches: tension, migraine and cluster.

These headaches are not dangerous to your health, but they are uncomfortable and annoying. Tension headaches can be caused or “triggered” by a number of different things. Physical triggers can include tight, contracted muscles in the shoulders, neck, scalp and jaw. Tension headaches also can be triggered by external conditions such as stress, depression or anxiety. However, tension headache triggers are not limited to the previous list. Other triggers can include the following.

• overworking
• lack of sleep
• stress
• depression
• anxiety
• using alcohol or street drugs
• holding your head in one position for a long time (ex: working at your computer)
• poor sleep position
• sleeping in a cold room
• sickness (ex: cold, flu, sinus infection)
• excessive caffeine use
• excessive smoking
• fatigue
• eye strain
• overexertion
• clenching or grinding your teeth

So, how do you tell a tension headache apart from a migraine headache? Typically, tension headaches start at the back of the head and spread forward. A tension headache usually occurs on both sides of the head and is accompanied by a dull, squeezing pain. Also, your shoulders, neck, jaw and even scalp muscles may feel tight and sore. Tension headaches can be made worse by stress, fatigue, noise and glare.

The best treatment for tension headaches is prevention. Here are some recommended solutions.

• practice stress management techniques
• use a different pillow
• change sleeping positions
• use good posture when reading or working
• exercise the neck and shoulders frequently when working on the computer or other close work
• keep a headache diary to help you pinpoint what triggers the tension headaches

A headache diary is simple to set up. After you have a headache, write down everything that happened in the previous 24 hours before the headache set in. Remember to include things such as

• what you ate
• how much sleep you got
• what kind of sleep you had (i.e. restless, deep, etc.)
• any unusual circumstances or stress
• what you experienced immediately before the headache
• how long the headache lasted and
• what made it stop.

No matter how much prevention you try sometimes these headaches cannot be stopped. While these headaches are not dangerous to your health they are uncomfortable. The next time a tension headache hits, it may be helpful to try one of these suggestions.

• massage the sore muscles
• take over-the-counter pain medicine such as aspirin, ibuprofen or acetaminophen
• take a hot or cold shower

If the headaches become chronic, then it may be time to see your doctor in order to get some help. According to the National Headache Foundation, chronic tension headaches occur more than 15 days a month. Of the many treatment options available, your doctor might prescribe an antidepressant or nonsedating muscle relaxant.

A migraine is a neurological disorder that involves repeated headaches. While the exact chain of events is unknown, doctors do know that a migraine hits when something triggers abnormal brain activity. This process seems to involve changes in various nerve pathways and chemicals in the brain that affect the blood flow in the brain and surrounding membranes. The National Headache Foundation reports that about 29.5 million Americans suffer from migraines. Migraines are more common in women than in men and in people between the ages of 10 to 46.

There is no known singular cause of migraines, but there are some triggers.

• allergic reactions
• bright lights
• loud noises
• physical or mental stress
• changes in sleep patterns
• smoking or exposure to tobacco smoke
• missed meals
• alcohol
• hormones
• foods
  - chocolates
  - nuts and peanut butter
  - fruits (avocado, banana, citrus)
  - onions
  - those containing the amino acid tyramine (ex: red wine, aged cheese, smoked fish, chicken livers, figs and certain beans)
  - dairy products
  - baked goods
  - meats containing nitrates (ex: bacon, hot dogs, salami, cured meats)
  - those containing MSG
  - any foods that have been processed, fermented, pickled or marinated

A few migraine sufferers do get a physical warning called an aura before a migraine strikes. These auras can occur anywhere from a few minutes to 24 hours before the migraine strikes. Auras can occur in any combination of

• seeing zigzag lines or flashing lights
• visual hallucinations
• temporary blind spots
• sensitivity to bright light
• blurred vision and
• eye pain.

There are many symptoms associated with migraine headaches.

• loss of appetite
• dizziness
• feeling that the room is moving (vertigo)
• nausea
• vomiting
• chills
• increased urination
• increased sweating
• swelling of the face
• irritability
• fatigue

 Unlike tension headaches, migraines headaches involve a dull ache that starts on one side of the head and progressively gets worse as time wears on. Some people also experience pain behind the eye or in the back of the head and neck. For some people the pain can become so intense that it leaves them incapacitated.

It is beneficial to keep a headache diary, because it can help to define potential triggers; thus making it a little bit easier to predict and/or avoid potential attacks. If a migraine does strike, then you should rest in a dark, quite room and drink plenty of liquids to prevent dehydration. Some over-the-counter medications can help to reduce pain if they are taken early enough; however, if these don’t work, then there are many different types of prescription medications used to prevent, treat or stop migraine attacks. Your healthcare provider can help find the right medication for your symptoms.

These are severe, chronic, recurrent headaches that come on suddenly and affect only one side of the head. Men are more often affected by this kind of headache and, while it can occur at any age, it is more common between adolescent to middle age. Unfortunately, the exact cause of cluster headaches is unknown. However, it is more common to occur during REM sleep. Cluster headaches can be episodic or chronic. Episodic cluster headaches occur daily for months with periods of time without headaches. Chronic cluster headaches can persist for a year or more without stopping.

The following are symptoms of cluster headaches.

• begins suddenly
• commonly begins 2 to 3 hours after falling asleep
• steady, sharp pain
• burning or boring pain
• usually occurs on one side of the head
• can occur in and around one eye
• may involve one side of the face from the neck to the temples
• pain quickly gets worse, peaking within 5 to 10 minutes
• peak pain may last 30 minutes to 2 hours
• swelling under or around the eyes (usually one eye, on the same side as the head pain)
• excessive tears (on the affected side)
• red eye (on the affected side)
• runny nose or nasal congestion
• red, flushed face

If you think you are suffering from cluster headaches, then it is a good idea to go and see your healthcare provider. Your healthcare provider can perform tests to determine the exact cause of your symptoms.

While there is no treatment to cure cluster headaches, some treatments can help relieve symptoms or prevent headaches. There have been very few triggers identified for cluster headaches. However, avoiding things such as smoking, alcohol use, glare and stress are helpful. Like other headaches, keeping a headache diary can help to identify things that trigger the onset of these headaches.

Most headaches are not dangerous to your health. However, there are certain headache symptoms that are more serious, and you should discuss them with your healthcare provider.

• sudden and severe pain
• fever
• stiff neck
• uncontrollable vomiting
• confusion or loss of consciousness
• numbness
• weakness
• vision loss

It also is time to talk to your healthcare provider if these headaches occur after 50 years of age, if the headaches interfere with your ability to live a normal life or if they require medication more than two days a week.

Visit the Brain and Spine Institute to learn more about headache causes and headache treatment.


Resources
National Headache Foundation.