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Headaches

“Honey, I have a Headache!” Has this pesky condition affected you yet again? Some of us are fortunate enough to only suffer from headaches occasionally or almost never, while others get them more frequently, and sometimes without any obvious explanation.

Headache is a general term used to describe pain in the head. This pain may be localised, for example on one side of the head or face, or may be over the whole head. Presentation of the headache also varies, some may be sharp or throbbing, while others may present as a squeezing pain in the head. Different kinds of headache have different characteristic presentations, so being able to describe them, helps shed a light into the kind of headache we may be dealing with.

It is important for us to understand whether the headaches are chronic or episodic headaches as the pattern will possibly give a clue to potential causes involved. We then need to establish whether the headache is:

  • A primary headache - without evident causes, or;

  • A secondary headache - associated to an activity or cause, such as, a side effect to medication or even the result of the extra glass of wine from the night before, to give one of the more obvious examples.

We have compiled this list of some of the more common types of headaches, to help you unravel some of the possible causes of headaches and how to manage them when they occur.

Tension Headaches – A common primary headache that is often mild to moderate pressure or pain on both sides of the head. It is often triggered by stress, poor sleep or posture. These causes lead to the muscles in the neck to tighten and joints stiffen, thus leading to a headache. It can be addressed by physiotherapy, heat and/or stretches. They sometimes respond well to over the counter (OTC) medications too.

Migraine headaches – These are moderate to severe headaches. These are described as pounding, throbbing or an intense pulsing deep inside the head, usually one sided but not exclusively. While experiencing a migraine, people are often sensitive to light and sound, while nausea and vomiting can also occur. Symptoms can appear similar to a stroke in some cases, therefore, if someone experiences these symptoms and is not a chronic sufferer of migraines, it is recommended for to see a doctor to rule out any other possible causes of the headache.

Migraines generally have an aura associated with them. These auras can present in three possible ways:

  • Visual disturbances - such as flashing lights, blind spots, stars;

  • Sensory disturbances - such as numbness, tingling - particularly one sided, and/or;

  • Motor disturbances - such as difficulty with speech.

Women, as well as people suffering from PTSD (Post Traumatic Stress Disorder) are more prone to having migraines. Environmental triggers such as sensitivity to certain foods and chemicals can definitely play a role for many migraine sufferers – as well as other factors such as, sleep deprivation, skipped meals, hormonal (60% of female sufferers) and dehydration. Unfortunately, migraines don’t usually respond to OTC medications and generally require medication prescribed by a doctor.

Cluster headaches – A burning/piercing pain is felt behind the eye in these headaches. These are severe primary headaches that present on one side and may be accompanied by swelling and redness of the affected eye. These headaches are rare but generally occur during a change of seasons, where nasal congestion and eye tearing due to allergies can occur concurrently. People prone to this kind of headache normally anticipate this response during this period. The headaches generally occur in series, lasting 15mins to 3 hours. If they last longer then they are more than likely a sinus headache that will be discussed below. There is no cure for this kind of headache, but medication as well as other medical interventions may help ease the symptoms and decrease their frequency.

Exertion headaches – Headaches that occur during or after physical exertion or exercise. The pain is experienced bilaterally (on both sides) and is often short lived. These headaches may be:

  • Primary – when the specific cause is unknown. The process is believed to be linked to an increase in blood flow to skull that occurs during physical exertion.

  • Secondary – due to an underlying condition or disease, such as a flu, hypertension or even a tumor.

In cases where the pain persists, It is advisable to see a doctor to rule out any other possible causes, particularly if currently undergoing treatment for hypertension, as this may become an emergency.

Hormonal headaches – Also known as Menstrual headaches, are a secondary type of headache caused by fluctuating levels of hormones in the body. They are predominantly linked to changes in the levels oestrogen in the body, whether it is an increase or decrease in levels of this hormone, depending on each person’s sensitivity. It can occur before, during or after menses as well as during ovulation. These types of headaches are also common in pregnancy, as well as women on birth control or in hormone replacement therapy. Fortunately it generally responds well to OTC medications.

Sinus Headaches – Secondary headaches due to mucus build up in sinuses, causing inflammation in the sinuses, that occurs due to an allergic reaction or an infection. These headaches are chronic, and seasonal in people whose sinusitis is due to allergic reactions. In most cases , the pain is experienced as a throbbing, pressure type of ache in the sinus areas (around the eyes, on the forehead, bridge of the nose and cheekbones), and may at times be felt on the jaws and teeth. Other symptoms may be: nasal congestion, fever or nausea. These headaches are treated by decreasing the pressure from the mucus build up in the sinuses using decongestants or antihistamines. If an infection is present then antibiotics may also be prescribed in the acute less chronic situation.

Rebound Headache – These are secondary headaches associated with overuse of medication in people with pre-existing headache disorders. It commonly occurs in people with primary headaches that have been undergoing treatment with ineffective or non-specific medication, thus resulting in medication overuse. The presentation can vary from a dull ache to an intense throb. It is more common with medications that contain caffeine as well as prolonged use of OTC medications (beyond 15 days of use). The treatment consists of weaning off of overused medication, as well as a combination of pharmacological interventions and other modalities such as, physiotherapy and behaviour therapy. In some cases pharmacological interventions may not be recommended and this may lead to worsening of the headaches initially, before it then improves.

We hope you find this article helpful in guiding you to recognizing some of the most prevalent types of headaches, as well as how they can be managed to prevent them from impacting on your quality of life. It is not a comprehensive list by any means, and is not a replacement for an examination by a health care provider, who would be better equipped to diagnose headaches and identify other variables may come in to play. We would also like to highlight the importance of getting a headache evaluated, if it deviates from the norm for you.

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