Headaches

Headaches

For some, headaches are an infrequent inconvenience, but for many, they are a common occurrence that can range from mildly irritating to completely debilitating. Those who are suffering from the excruciating pain of migraines or cluster headaches often miss work, school and social gatherings due to the extent of the pain, and the side effects that can accompany that pain.

Sinus and tension headaches can leave you feeling fatigued and frustrated, and sinus headaches in particular can be difficult to treat or prevent. Often, those suffering from these headaches may attempt to self-medicate, and doing so unsuccessfully can lead to rebound headaches.

There are several different kinds of headaches. Some of the most common include

• Migraine
• Cluster
• Tension
• Rebound
• Sinus

General symptoms of these types of headaches may include

• Tightness
• Throbbing or pulsing pain on either side of the head
• Nausea
• Dizziness
• Sharp pain behind one or both eyes or in the temples
• Painful pressure in the face associated with sinus headaches is often accompanied by fever
• Severe pain that lasts from 30 minutes to several days

Overview

Migraine Headaches

Symptoms

Migraine headaches are commonly described as a throbbing or pulsing pain, often on one side of the head.

This pain can be so severe as to create a sensitivity to light and sound and may even result in vomiting. Some sufferers experience ‘auras’ prior to the headache in the form of flashing lights, tingling, numbness and other bodily sensations that indicate the onset of a migraine. The duration of a migraine can last just a few hours. However, some migraines may stretch out over several days.

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Causes

Migraines can be triggered by even the slightest environmental irritations such as strong odors or loud noises, or other triggers such as a skipped meal, lack of sleep or even stress.

Certain products like yogurt, bananas, red wine, beer, aged cheese, and buttermilk can also trigger migraines.

Women who suffer from this condition frequently report experiencing migraines before or during their monthly cycle due to the shifting of hormones. These types of migraines often surface at puberty, or during or after a pregnancy.

Risks

According the February 2010 issue of the journal Neurology, migraine sufferers are more likely to report a history of heart attack, stroke or peripheral artery disease.

Previously, it was thought that only those migraine sufferers who experience “auras” were the only group at risk. Now studies are showing that all migraine sufferers may be at risk.

Other risks include impaired judgment and vision that are often associated with migraines and cluster headaches. Those suffering from these side effects should avoid driving or operating heavy machinery, especially if they are taking prescribed medications that may cause drowsiness.

Diagnoses

Your doctor may request a CT scan, blood work and urinalysis to rule out any other factors that may be causing your migraines. Your doctor may also ask that you keep a headache diary to document how often they occur and how severe your headaches are, as well as any foods you may have consumed prior to getting the headache. This can help define factors that may be triggering the headaches.

Prevention

Because migraines can be triggered by a variety of stimuli, they can be effectively prevented by avoiding certain situations, foods like cheese and alcohol, and activities that may trigger or worsen a headache. While caffeine is often an ingredient in headache remedies, too much caffeine can also trigger a headache. Patients who notice frequent headaches that seem to accompany the consumption of caffeine should eliminate it from their diet.

Cluster Headaches

Symptoms

Cluster headaches are considered to be the most painful type of headache and get their name due to the nature of their occurrence, typically coming in clusters of 30 to 90 minutes and sometimes re-occurring several times throughout the same day. Pain is often very severe enough for patients to require a trip to the emergency room.

Causes and Prevention

It is not completely clear why cluster headaches occur, but alcohol consumption and cigarette smoking appear to be significant factors in patients who suffer from these headaches.

Treatment for Cluster Headaches and Migraines

Cluster headaches and migraines are often treated with oxygen breathed in through a mask, paired with a Prophylactic like Prednisone, an Ergotamine like Wigraine or Dihydroergotamine, an injection that patients can administer themselves. Triptans like Imitrex or Zomig are widely used and effective drugs that have few side effects.

Calcium Channel Blocks like Calan and Verelan or even Lithium can be prescribed to prevent migraines and cluster headaches. Occasionally, when these medications do not work, doctors sometimes prescribe anti-seizure medications like Topamax or Depacon.

Tension Headaches

Symptoms

Tension headaches are commonly described as a band of tightness or pain that can radiate up from the neck, throughout the jaw and is often accompanied by fatigue. Tension headaches can also mimic some of the symptoms of migraines.

Causes

Tension headaches are often caused by emotional of physical stress, poor posture, squinting due to poor lighting, jaw or teeth alignment issues, arthritis and even environmental factors like noise. If you have been in a car accident or have suffered any sort of physical trauma, you may experience tension headaches. Tension headaches can also occur as a result of anxiety or depression.

Treatment

While doctors may prescribe a muscle relaxer for chronic problems, over-the-counter pain medications are often enough to relieve the pain of tension headaches. A massage can also sooth and loosen tight muscles that are contributing to the pain, and if severe enough or perhaps the result of a physical trauma, may require physical therapy.

Prevention

Tension headaches can be prevented through exercise, stress reduction, proper diet and by getting adequate sleep.

Practices like yoga and meditation can help to loosen tight muscles and focus the mind, reducing physical and emotional stress. Even activities like gardening, reading, painting, knitting or anything that provides a level of relaxation can reduce stress and ward off tension headaches.

Rebound Headaches

Symptoms

Rebound headaches are often re-occurring migraines and tension headaches and will exhibit the same symptoms as these conditions.

Causes

Rebound headaches are a common result of over-medicating. When a patient has been taking a pain reliever, often an over-the-counter type remedy that never quite does the trick, they have a tendency to take more than is prescribed.

The body becomes accustomed to the medication which in turn becomes less effective.

Patients stop taking the medication, which causes the body to go into almost a withdrawal type response, causing a rebound headache.

Many of these medications contain caffeine which can also trigger a rebound headache, especially if you are consuming additional caffeine through food or beverages.

Treatment

Gradual discontinuation of the medication will often provide relief. If your rebound headaches are the result of taking narcotics or medications containing a sedative, you may need to go through a monitored detoxification process. This process can be unpleasant and may cause the headache to become more severe, or increase the frequency, before you find relief.

Prevention

Rebound headaches can be prevented by only taking over-the-counter medications as needed and by following the dosage instructions carefully. Unless your doctor advises otherwise, use of these medications should be limited to once or twice a week, and if you are taking a medication containing caffeine, you should avoid consuming additional caffeine through food and drink.

Sinus Headaches

Symptoms

Sinus headaches are described as pain or painful pressure in the face, usually the cheeks, forehead and between the eyes. Sinus headaches can also mimic and sometimes even trigger migraine headaches.

Causes

Sinus headaches are often the result of an infection or a general build-up of mucus in the Frontal and Maxillary cavities and the Ethmoid sinus cells. This build-up causes the pain that is associated with these types of headaches. Many believe that allergies can cause a sinus headache, which is a common misconception. While allergies can lead to clogged sinuses, causing headache pain, each condition must be addressed separately, as treating one will not cure the other.

Risks

Frequent sinus headaches can be a sign of a chronic problem called Sinusitis that, if severe enough, may need to be addressed with surgery. These chronic issues can lead to infection which should be treated with antibiotics.

Treatment

OTC medications can provide relief for the headache pain associated with sinus pressure. Doctors may also prescribe vasoconstrictors to alleviate congestion, corticosteroids to decrease inflammation, and decongestants to constrict blood vessels and relieve pain. If the problem is severe enough, surgery may be required to scrape out the clogged cavities.

Prevention

If you are suffering from frequent sinus headaches, you should consult a doctor to rule out an infection. Your doctor may talk to you about developing a routine to keep the sinuses clear which may include irrigation of the sinus cavities. Because allergies can cause headaches that are associated with sinus congestion, you may be prescribed a medication to help protect against any allergens.

General Headache Overview

Prevention

Prevention is key to combating headaches. Whether it is through medication or taking control of environmental, behavioral and lifestyle choices, headaches can be greatly reduced and even eliminated.

Medication

There are medications available on the market today that have been designed to prevent headaches. Patients take these pills either daily, or at certain times of the month that the headaches typically occur. These types of drugs are often prescribed for women suffering from the headaches that can occur as a result of hormonal changes.

Stress Reduction

Reduce stress and maintain a healthy weight with exercise, meditation or other relaxation methods, and be sure to get plenty of sleep. Even activities like reading, gardening, playing with your children or pets can provide stress relief and reduce tension headaches.

Diet

Keep healthy snacks at hand to reduce the risk of headaches that may be the result of a drop in blood sugar and avoid foods that trigger headaches.

Tests and Diagnosis

If you are experiencing frequent headaches or feel that they may be migraines or cluster headaches, consult a doctor to get a proper diagnosis.

At your first visit, your doctor will ask a series of questions relating to the frequency of the headaches, any factors that may be accompanying them such as stress or certain foods you ate, how you treated the headache and whether or not the treatment was effective.

Your doctor may request a CT scan, blood work, urinalysis, a lumbar puncture or spinal tap to rule out any other conditions. He may also ask you to keep a headache diary to document when your next headaches occur and what environmental, behavioral or life style factors may be contributing.

Treatment Options

Treatments that may help alleviate if not prevent severe headaches

• Over-the-counter pain relievers like Ibuprofen can often provide effective pain relief to most types of headaches, but may only work in a temporary or limited capacity for more severe headaches.
• You can also find a variety of migraine specific pain relievers on the market that may provide some relief. Be sure to take these medications on a limited basis and follow instructions carefully to avoid rebound headaches.
• Prescription medications as mentioned above can help.
• Over-the-counter medications containing caffeine can offer relief as it helps the body absorb medications that combat pain and can increase the effectiveness of regular medication by up to 40%.
• If your headaches are the result of a brain trauma such as an AVM (Arteriovenous Malformation) or an aneurism which are both detectable through CT Scans, surgery may also be required.
• Physical Therapy can be very beneficial to those suffering from almost any type of headache.
• Physical Therapy often deals with correcting muscle issues and can provide a lot of relief, especially to those dealing with tension headaches, clusters or migraines.
• Improved breathing can increase blood flow and reduce pain.
• Acupuncture has been used as a form of pain relief for over 5,000 years.

Home Remedies

• An ice pack applied to the area of the head affected can often provide some relief. Some even find comfort using a hot compress. Try adding a few drops of lavender essential oil to a warm, damp cloth and apply to the head.

Note: essential oils can irritate the skin, so you may want to put the cloth in a plastic bag before applying to the head.

• The frequency and severity of cluster and migraine headaches may be reduced with the help of herbal remedies like Feverfew, Melatonin, Magnesium and Vitamin B2.
• Aromatherapy can be useful in treating the symptoms of headaches. Scents like peppermint, lavender and chamomile have been shown to reduce pain. Sprinkle a few drops of these essential oils in a bath, on a pillow or bedpost and breathe deeply to reap the calming and pain reducing benefits.
• Cinnamon is thought to help with sinus headaches. Sprinkle some cinnamon in a pot of boiling water. Pour into a cup and breathe in the vapors.
• Exercise can also provide relief for some types of headaches, especially tension headaches. However, physical activity can make migraines or cluster headaches worse.