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Headache

Overview

Headaches are a widespread complaint that almost everyone would have at some point in their lives. A headache is discomfort or distress in the head or face. It can be a pulsating, continuous, intense, or dull sensation. Your symptoms might assist your doctor in evaluating its source and the suitable treatment. Most of the time, your headache would not be a problem and go away after a while. Treatment depends on the underlying reason; however, pain killers are frequently used.

Types

Headaches can be categorized into these types:

Primary headache: Primary headaches can be due to some chemical activity in the brain, blood vessels surrounding your head, or your head and neck muscles. It might run in the family. There is no underlying disease in the case of primary headache. Primary headaches commonly begin in adults between the ages of 20 and 40.

The following are the most important primary headaches:

  • Migraine
  • Tension headache
  • Cluster headaches and paroxysmal hemicranias

Even though the following headaches are all classified as primary, each one could be an indication of an underlying disorder;

  • Chronic tension-type headache
  • Headaches caused by coughing
  • Headaches caused by physical activity
  • Headaches due to sex

Secondary headache: A secondary headache is a type of headache which occurs due to any underlying disorder.  It can be caused by various conditions with varying degrees of severity, including:

  • Nasal and sinus infection
  • Nasal and sinus infection a tumor in the brain
  • Carbon monoxide poisoning
  • Chiari malformation
  • Carotid or vertebral dissections (tear in arteries)
  • A blood clot in the brain.
  • Aneurysm of the brain
  • Arteriovenous malformation
  • Concussion
  • Coronavirus
  • Severe Dehydration
  • Dental issues

Causes

Headaches can be due to a variety of elements, including:

  • Illness: Infections, colds, and fevers are examples of this. Sinusitis (inflammation of the sinuses), a throat infection, or an ear infection is all typical causes of headaches. Headaches can be the consequence of a blow to the head or, more rarely, an indication of a more serious health condition.
  • Factors other than illness: Stress, Alcohol abuse, missing meals, sleeping irregularly, and taking medicine too often are all examples of stress-related headaches. Neck or back discomfort from bad posture is another factor.
  • Environmental factors: Second hand cigarette smoke, intense odors from various chemicals or fragrances, allergies, and specific foods are all factors in your surroundings. Other probable factors include stress, pollutants, traffic, illumination, and weather changes.
  • Genetics: Migraine headaches, in particular, seem to run in families. Most adolescents and teenagers (90 percent) who suffer from migraines have other relatives who suffer from it. When both parents have a background of migraines, there is an increased chance of developing migraines.

Epidemiology

Only about 1–5% of those who need urgent medical treatment for headaches have a significant underlying condition. Primary headaches account for more than 90percent of all headaches.

Tension headaches account for the majority of such primary headaches.  Most individuals who suffer from tension headaches experience "episodic" tension headaches that come and go; only 3.3 percent of persons suffering from chronic tension headaches that last longer than two weeks.

Migraine headache affects between 12 and 18 percent of the world's population.

Migraines affect more women than men. Male suffer from migraines 5–9% of the time, while females suffer from migraines 12–25% of the time.

Risk Factors

Some environmental variables play a role in primary headaches, such as:

  • Red wine 
  • Processed meats 
  • Bad posture
  • Intermittent fasting
  • Depression

Signs And Symptoms

Headache is usually accompanied by other signs and symptoms such as:

  • Red Eyes
  • A congested nose
  • Sagging Eyelids
  • Blurring of vision
  • Facial pain/eye pain
  • Pain on bending forward

Red Flags: Headaches can indicate major brain diseases like infections, inflammation, or bleeding within or around the brain. You must inform your doctor as early as possible

  • If  your headache starts on abruptly and becomes severe very quickly
  • If accompanied by a fever and neck stiffness.
  • If it occurs with a seizure or causes any personality change
  • If it occurs immediately after intense workouts or a slight accident.
  • If it’s a new symptom that manifests as fatigue, tingling, or vision difficulties. 

Diagnosis

The approach is to discuss your headaches with your physician. They'll examine you and inquire about all your symptoms, and how frequently they occur. It's critical to be as thorough as possible while writing these explanations. Make a list of what causes the headaches, what makes them harder, and what makes you feel better, and give it to your doctor. To assist your doctor in diagnosing your condition, keep a headache record.

The majority of people do not require any special tests. However, your doctor may recommend a CT scan or perhaps an MRI to check for issues within your head causing your headaches. X-rays of the skull will not assist more in diagnosing the cause of the headache. Unless you've fainted from a headache, an EEG is likewise unneeded.

Inform your GP to send you to a headache consultant whenever your headache symptoms persist or occur more frequently despite medication.

Treatment

Identifying your stressors is one of the most important aspects of managing headaches. You can do it by keeping a headache record.

Your GP can customize treatment to you once you've recognized your triggers.  Psychotherapy and stress management approaches can assist you in dealing with this situation more effectively. Not all headaches necessitate the use of drugs. Therapies are offered in a variety of forms. Treatment options vary depending on the type, intensity, and source of your headache.

Managing stress: Stress management is a skill that teaches you how to handle things. To ease stress, you may benefit from deep breathing, Relaxation techniques, your favorite instruments/music, and muscle relaxation.

Biofeedback therapy: It trains you how to notice when your body is tense. You'll discover how the body reacts to high-stress situations as well as how to calm down. Sensors are attached to your body throughout biofeedback. They keep track of your automatic physical reactions to headaches, such as a rise in:

  • Pulse
  • breathing
  • body temperature
  • brain functions

Medications

Over-the-counter pain medications generally work effectively for transient tension headaches. Yet, excessive use of such drugs can result in a chronic daily headache. For the treatment of headaches, a pain killer may be advised first. NSAIDs such as ibuprofen or naproxen are examples of such medications; others are Acetaminophen or Aspirin.

Mild pain medicines can also be used with caffeine to boost their effectiveness; an instance is paracetamol, aspirin, and caffeine.  If a pain treatment by itself does not cure the headache, this combo may be suggested.

Headache treatments may be recommended if you have regular or severe headaches. A migraine episode can be stopped using triptans and other medications. Migraine prevention is occasionally possible with hypertension, epilepsy, and depression medications. To lessen headache recurrence, your doctor may advise you to take one of these drugs.

Prognosis

Migraine, regular tension headache, and chronic tension headaches have a good prognosis. The prognosis of secondary headaches depends on underlying causative factors.

Lifestyle Modifications

A headache log might keep track of any trends or variations in your mood. Be aware that determining the appropriate treatment regimen for you may take some time, so be calm. Be transparent and upfront with a doctor about what works and what doesn't.

You must avoid foods and odors that you recognize cause headaches. It's also critical to maintain healthy behaviors that will keep you feeling good, such as physical activity, adequate sleep, and a nutritious meal. Also, keep your planned follow-up visits so your physician can assess your progress and make adjustments as needed to your medication regimen.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 20, 2023. 

References

Headache Pain: When to Worry, What to Do - Harvard Health Publishing - Harvard Health

https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do

Diagnosis and Management of Headache: A Review | Headache | JAMA | JAMA Network

https://jamanetwork.com/journals/jama/article-abstract/2779823

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