May 18, 2012
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May 18, 2012
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Headaches—discomfort that may be described as pain, pressure, or tension affecting the head and face—are grouped into four types: vascular, muscle contraction (tension), traction, and inflammatory.
Migraines
Migraine headaches are the most common type of vascular headache. They involve intense pulsing or throbbing pain on one or both sides of the head and may be accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Women experience more migraines than men, and onset may be associated with hormonal changes during the menstrual cycle. Some people who experience migraines report having an aura, or visual disturbance (flashing lights, zig-zag lines, or temporary loss of vision) before the headache begins.
The symptoms of headaches generally include different levels and types of pain affecting various regions of the head. Diagnosis—based on the nature you discomfort—of the specific type of headache may be an important step in getting effective treatment. As well, diagnosis is also important if your headache may be an indication of a more serious health concern (such as is possible with a traction or tension headache).
Although headaches are a common complaint and many people don’t seek medical treatment for them, there are certain headache characteristics that do indicate the need to medical attention. Consult your doctor if your experience any of the following:
Your primary care physician may be to help treat your headache or diagnose another medical condition that is causing it. Some people affected by headaches also consult headache specialists or visit headache clinics for diagnosis and treatment. You may want to discuss this option with your healthcare team.
To help you and your doctor diagnose and treat your headache, it may be helpful to keep a headache diary. This diary will include headache frequency, characteristics of the pain, and circumstance of substances (certain foods, for example) that seem to bring on a headache (known as triggers).
Symptoms and Diagnosis of Migraines
Symptoms that can help differentiate a migraine from other types of headaches include:
To determine whether your headaches are migraines, your doctor will consider the history and nature of your symptoms as well as family history of similar headaches. Although there is no medical test to confirm a migraine, tests such as CT scan and MRI can be used to rule out other medical causes of the headache.
Understanding what triggers your headaches goes hand-in-hand with taking measures to prevent them. As you identify the situations and behaviors that set off a headache, you can make efforts to avoid these things while also making other lifestyle changes to control or prevent headaches.
Triggers can differ from person to person and by type of headache. Examples of circumstances and exposures that may bring on a headache or migraine include:
A number of people who suffer from migraines find that environmental and physical factors, such as changes in climate or weather, can trigger their headaches. These factors include changes in humidity, temperature, or barometric pressure, or high winds. Travel and changes in routine may also trigger a migraine, and so may a change in altitude. Some people report flickering light (such as that produced fluorescent light, television, and movies); glare; intense light reflection; extremes in heat or sound; and fumes and vapors (such as in poorly ventilated spaces) can set off a migraine. People affected by migraines can be particularly sensitive to light.
Hormones and Migraines
More women than men suffer from migraines, a fact that may be attributable to changes in hormones during a woman’s menstrual cycle. Pregnancy may also affect migraine incidence—increasing attacks for some and decreasing them for others.
Prevention Measures
Once you recognize the circumstance or factors that may trigger a headache or migraine, you can take steps to prevent them, often by making adjustments to your everyday life. Examples of measures you can take include:
You may find that certain foods trigger your headaches or migraines. Pay attention to the types of foods that seem to trigger a headache. If, for example, you often get a headache when you eat chocolate, it’s likely that chocolate is a trigger for you. Other foods that are thought to set off a headache or migraine include aged cheeses, cured meats, and citrus fruits. Naturally, avoiding food triggers is an important step in prevention.
Nutrition and headache prevention may be about more than avoiding suspected triggers—a balanced eating plan may also help to prevent headaches. Aim to eat regular meals, as the low blood sugar levels that can result from missed meals can set off a headache. Meals should be balanced, providing protein, carbohydrates, and vitamins and minerals. Further keep blood sugar levels stable by avoiding excess sugar. As well, consume caffeine or alcohol in moderation amounts (if at all), as excess amounts of either substance may trigger a headache.
There are several different options for preventing and treating headaches and migraines with medication. Ask your doctor about options—both prescription and over-the-counter—that may be appropriate for you. Your doctor will consider factors including the nature of your symptoms, your overall health, any other medications you are taking, as well as the type of headaches you experience when choosing medication options.
Some people find that over-the-counter pain relievers such as aspirin, ibuprofen, and acetaminophen (Tylenol®) help control headache pain. There are also FDA-approved over-the-counter medications formulated specifically to treat migraines; these include Excedrin® Migraine and Advil® Migraine.
Migraine headaches may also be treated with prescription medications; one of the most common such drugs is sumatripan, which targets migraine symptoms. Other prescription medications used to treat migraines include drugs to counteract blood vessel constriction (used for prevention) and others intended to reduce the frequency and severity of migraines. Antidepressants and anticonvulsants may also be used.
For women whose migraine attacks appear to be related to their menstrual cycle (changing hormone levels), hormone therapy or birth control pills may offer some relief.
With a combination of lifestyle measures and medication to prevent migraines and treat their symptoms, it’s possible to control the frequency and severity of attacks. As well, some people affected by migraines find that alternative therapies like acupuncture, acupressure, and yoga help to control frequency of attacks and symptoms and contribute to an improved quality of life. Biofeedback is also used to help people manage migraine attacks; this self-help treatment involves the monitoring of breathing, pulse, heart rate, temperature, muscle tension, and brain activity—all involuntary physical responses to stimuli like stress (a potential migraine trigger). The goal is that by learning how to identify and control these responses, individuals can learn to control their body’s response to stress and thus prevent some migraines.
National Institute of Neurologic Disorders and Stroke
NINDS Headache Information Page. National Institute of Neurologic Disorders and Stroke Web site. Available at: http://www.ninds.nih.gov/disorders/headache/headache.htm. Accessed July 2010.
NINDS Migraine Information Page. National Institute of Neurologic Disorders and Stroke Web site. Available at: http://www.ninds.nih.gov/disorders/migraine/migraine.htm. Accessed July 2010.
Tools for Sufferers. National Headache Foundation Web site. Available at: http://www.headaches.org/education/Tools_for_Sufferers. Accessed July 2010.
Trigger Avoidance Information. American Headache Society Web site. Available at: http://www.achenet.org/tools/TriggerAvoidanceInformation.asp. Accessed July 2010.
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