Understanding Headaches

Learning more about this common health concern can lead to more-effective prevention and treatment.

 

By Mia James

Everyone has had a headache of one kind or another—tension headaches, sinus headaches, and fatigue-related headaches are just a few of the most common types. Many people are also afflicted with migraine headaches, which can be debilitating and are often more difficult to treat effectively.

Whether you suffer regularly from headaches or get them only on occasion, understanding more about what may trigger headache pain and how to treat it effectively can be useful information to have. Read on to learn more about this common health issue; and, as with all health concerns, speak with your doctor if you have questions or concerns about headaches you experience.  u

Overview

Headaches—discomfort that may be described as pain, pressure, or tension affecting the head and the face—are grouped into three types: vascular, muscle contraction (tension), traction and inflammatory.

Vascular headaches include migraines (the most common type of vascular headache), toxic headaches produced by fever, “cluster” headaches (repeated episodes of intense pain), and headaches related to high blood pressure.

Muscle contraction headaches are characterized by tight or tense facial and neck muscles.

Traction and inflammatory headaches are symptoms of other medical conditions, such as stroke or sinus infection. These types of headaches may be signs of a more serious disorder, so—as with any unusual changes to your health—it is important that you consult a doctor.

 

Symptoms and Diagnosis

The symptoms of headaches generally include different levels and types of pain affecting various regions of the head. Diagnosis—based on the nature of your discomfort—of the specific type of headache may be an important step in getting effective treatment. Diagnosis is also important if your headache may be an indication of a more serious health concern (such as is possible with traction and inflammatory headaches).

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 for medical attention. Consult your doctor if you experience any of the following:

Headaches that get worse—meaning they cause more pain and last longer—over a period of days or weeks

If you’ve never had headaches and suddenly begin to experience them (a particular concern in people age 50 and older)

A feeling of weakness or numbness or changes in vision or hearing

Persistent pain—even after taking over-the-counter analgesics (pain killers)

Changes to your memory, personality, and cognitive abilities

A stiff neck, rash, nausea, vomiting, fever, breathing problems, or head injury

Your primary care physician may be able to 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, you may want to start keeping a diary that includes headache frequency, characteristics of the pain, and circumstances or substances—known as triggers (certain foods, for example)—that seem to bring on a headache.

 

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, zigzag lines, or temporary loss of vision), before the headache begins.

 

Symptoms and Diagnosis of Migraines

Symptoms that can help differentiate a migraine from other types of headaches include the following:

Pain concentrated on one side of the head (typically around the eye or temple and sometimes in the face, sinus, jaw, or neck)

Pulsating or throbbing pain

A level of pain that affects normal activities

Nausea or vomiting

Increased sensitivity to light and sound

Attacks that last for 72 hours or more

Visual disturbances (an aura, wavy lines, dots, flashing lights, or blind spots) that begin about 20 minutes to an hour before the headache

Tingling in an arm or the face

Difficulty speaking

To determine whether your headaches are migraines, your doctor will consider the history and the 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 a computed tomography (CT) scan and a magnetic resonance imaging (MRI) scan can be used to rule out other medical causes of the headache.

 

Triggers and Prevention Measures

Understanding what triggers headaches goes hand-in-hand with taking measures to prevent them. As you identify the situations and the behaviors that set off a headache, you can make efforts to avoid these triggers while also making other lifestyle changes to control headaches or prevent them from recurring.

Triggers can differ from person to person and by type of headache. Here are some examples of triggers that may bring on a headache or migraine:

Stress and anxiety

Irregular sleep patterns

Certain foods (cured meats and foods high in sugar,
for example)

Missing meals (low blood sugar)

Dehydration

Excessive caffeine intake

Excessive alcohol intake

Drug use

A number of people who suffer from migraines find that environmental and physical factors, such as changes in climate or weather, can be triggers. These factors include high winds and changes in humidity, temperature, or barometric pressure. Travel and changes in routine may also trigger a migraine, as can a change in altitude. Some people report that flickering light (such as that produced by fluorescent lights, 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 the following:

Get regular sleep. Aim for six to eight hours per night, and go to bed and wake up at regular times each day—even on the weekends.

Stay physically active. Control stress and improve well-being by staying active. Moderate exercise on a regular basis (three to five days per week) can be beneficial.

Stay hydrated. Sip water throughout the day, as dehydration may trigger a headache.

Reduce stress. Find a stress-management technique that’s effective and that you enjoy. Consider yoga, meditation, massage, or simply a warm bath.

 

Nutrition

You may find that certain foods trigger headaches or migraines. Pay attention to the types of foods that could be triggers. 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 headache prevention.

Nutrition and headache prevention may be about more than avoiding suspected triggers; observing a balanced eating plan may also help prevent headaches. Aim to eat regular meals, as the low blood sugar levels that can result from missed meals can be a trigger. Meals should be balanced, providing protein, carbohydrates, and vitamins and minerals. You can further keep blood sugar levels stable by avoiding excess sugar and by consuming caffeine and alcohol only in moderation (if at all), as excess amounts of either substance may trigger a headache.

 

Medication

There are several different options for preventing and treating headaches and migraines with medication. Ask your doctor about drugs—both prescription and over-the-counter—that may be appropriate for you. When choosing medication options, your doctor will consider such factors as the nature of your symptoms, your overall health, any other medications you are taking, and the type of headaches you experience.

Some people find that over-the-counter pain relievers such as aspirin, ibuprofen, and Tylenol® (acetaminophen) help control headache pain. The US Food and Drug Administration has also approved some over-the-counter medications formulated specifically to treat migraines; these include Excedrin® Migraine (acetaminophen, aspirin, and caffeine) and Advil® Migraine (ibuprofen).

Migraine headaches may also be treated with prescription medications; one of the most common such drugs is Imitrex® (sumatripan succinate), which targets migraine symptoms. Other prescription medications used to treat migraines include drugs to counteract blood vessel constriction (used for prevention) and drugs intended to reduce the frequency and the 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.

 

Living with Migraines

With a combination of lifestyle measures and medication to prevent migraines and treat their symptoms, it’s possible to control the frequency and the severity of attacks. Some people affected by migraines find that alternative therapies like acupuncture, acupressure, and yoga help control the 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). 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.  _