Headache

The symptoms of headache are not just restricted to dull or sharp pain in the forehead region but differ depending on the type of headache. Some of the common symptoms associated with different headaches include:

• Dull pain around the forehead, neck, and back region. These symptoms are more common in tension-type headaches.
• Severe and throbbing pain usually on one or both sides of the head, along with pain in the eye, temple, or back of the head. Sensitivity to light, sound, and aura is common in migraine types of headaches.
• Constant pain that occurs in the sinus regions such as the bridge of the nose or the cheeks, along with the feeling of fullness in the sinus, is common in sinus headaches.

Headache usually occurs when the muscles of the head and neck region tighten. This may occur in different types of headaches such as tension headaches and migraines. There are various causes and triggers of different types of headaches:

1. Tension Headache

A tension headache can be caused by:

• Overuse of alcohol
• Caffeine or caffeine withdrawal
• Fluctuating hormones in women
• Straining of the eyes
• Injury to the head or neck
• Poor posture

2. Cluster Headache

The exact cause of cluster headaches is unknown. However, genetic and environmental factors can contribute. Triggers may include:

• Overuse of alcohol
• Smoking
• High altitude
• Overexertion

3. Migraine Headache

Migraine refers to a neurological condition where headaches may be associated with other symptoms such as aura. The exact cause is not known, but some studies suggest it involves serotonin and pathways that cause narrowing of blood vessels followed by widening of these arteries. Triggers may include:

• Cold weather
• Processed foods
• Bright light
• Sound

4. Sinus Headache

Sinus headaches are caused by sinusitis, which is the infection or inflammation of the sinus cavities. This can be triggered by changes in weather or allergies.

5. Other Causes

In addition to the above-mentioned causes, some other causes of headache can be serious and potentially life-threatening, such as:

• Head or brain injury
• Hypoglycemia (low blood sugar)
• Intracranial bleeding (bleeding inside the skull)
• Brain aneurysm
• Brain tumor
• Concussion
• Meningitis
• Stroke
• Temporal arteritis
• Trigeminal neuralgia

• Are under a lot of stress
• Have uncorrected nearsightedness or farsightedness (also known as visual aberrations or disorders)
• Have uncontrolled hypertension
• Experience irregular sleep patterns or lack proper sleep
• Are fatigued
• Experience hormonal changes (such as estrogen level fluctuations in women)
• Take certain prescription medications, including nitroglycerin and estrogen
• Have suddenly stopped consuming caffeinated beverages

Headache is not a disease in itself but is a condition arising due to various underlying pathologies. Evaluation of a headache usually begins with taking your medical history and performing some basic tests such as:

• Complete Blood Count (CBC): CBC test is carried out to look for an infection that could be causing your headaches.
• Erythrocyte Sedimentation Ratio (ESR): ESR test is done if giant cell arteritis (GCA), an inflammatory disease of large blood vessels, as well as other systemic disorders, are suspected.
• Computed Tomography (CT) Scan: CT scan may be chosen in some cases of headaches. However, due to radiation exposure, MRI is the preferred option.
• Magnetic Resonance Imaging (MRI): MRI is often used to identify any structural abnormalities in the brain.
• Cerebrospinal Fluid Study: Lumbar puncture (LP) and cerebrospinal fluid test may be advised in patients who have headaches along with fever, meningeal signs, focal neurological deficits, or suspicion of intracranial hypertension.

To prevent the occurrence of headaches, one must identify the triggers and try to avoid them.

• Steer clear of stress: Stress can cause muscle tightening in the neck and shoulder region, leading to tension headaches. Such a headache feels like a tight band, usually beginning in the neck and back and working its way up to the head. Stress is also known to trigger migraine headaches. Therefore, it is advised to stay away from stress to prevent headaches.
• Stay away from foods that trigger headaches: Eating certain foods often triggers migraine headaches. Common triggers include bananas, cheese, chocolate, citrus fruits, and dairy products. Knowing which foods trigger your headaches and avoiding them is the best way to keep headaches at bay.
• Limit your alcohol intake: Alcohol is a common cause of headaches, including migraine and cluster headaches. Limiting your alcohol intake can help prevent headaches.
• Environment: Headaches, such as cluster headaches and migraines, can be triggered by factors such as smoke, humidity, bright light, intense scents, or cold weather. It is advised to protect yourself from environmental triggers that could aggravate your headaches.
• Be aware of caffeine withdrawal: If you normally consume caffeine in coffee or tea, stopping this intake abruptly can trigger a migraine. This occurs due to the constriction of blood vessels without caffeine, which is the main reason for the pain associated with migraines. Therefore, do not abruptly cut down on your caffeine intake if you are prone to headaches.
• Do not cut down on your sleep: A lack of sleep is associated with migraines and tension headaches.

There are various treatment approaches to headache such as:

• Oral analgesics: Analgesics such as ibuprofen and paracetamol are generally the first-line treatment for headaches. Non-steroidal anti-inflammatory drugs (NSAIDs) are typically prescribed for cluster headaches and tension headaches.
• Antiemetics: Antiemetics such as domperidone may be prescribed for migraines where headaches are accompanied by nausea and vomiting.
• Combination analgesics: In some cases of severe headache, analgesics are given adjuvantly with caffeine, barbiturates, and opiates. This therapy is usually short-term and should only be taken under medical supervision.
• Triptans: Triptans such as sumatriptan provide long-term relief from migraine headaches. These medications not only treat migraines but are also used as preventive therapy.
• Ditans: Lasmiditan is a newer drug used in patients with chronic migraine. Its action is similar to triptans but is more specific to the central nervous system (CNS).
• Single pulse transcranial magnetic stimulation (STMS) & vagal nerve stimulation (VNS): These procedures are recommended for patients who do not respond to conventional therapy. These newer treatment modalities, approved by the FDA, are used with varying success in treating migraine attacks in adults. Electromagnetic probes are placed externally over the head to help regulate the neural pathways in the brain and relieve headaches.
• Behavioral therapy: Behavioral therapy, including cognitive behavioral therapy and relaxation techniques such as meditation, helps reduce muscle tension, which is common in tension headaches.
• Physical therapy: Physical therapy for headaches includes improving posture, using hot and cold packs, exercise programs, and electrical stimulation.

Note: If your headache is due to migraine, then medications to prevent migraine are recommended. These include beta-blockers like propranolol, antidepressants like amitriptyline, antiepileptics like topiramate, calcium channel blockers like flunarizine, and CGRP antagonists.

Here’s more about migraine and its treatment.

Headaches can be annoying and disrupt your daily functioning. Here are some self-care tips that can help you find relief from headaches.

Don’t Forget the Basics

• If you are prone to headaches, be extra careful about taking your meals on time.
• Ensure you get proper sleep.
• Stay away from foods that may aggravate your headaches.

Relaxation Techniques to Your Rescue

Relaxation techniques such as deep breathing, yoga, and meditation can greatly assist in relieving and preventing headaches. Tension headaches can be alleviated easily with hot or cold packs applied to the shoulders and neck. Stretching exercises can also provide relief from headaches.

Try Acupressure

Acupressure is an ancient practice that can help relieve headaches, particularly tension headaches. Pressing specific acupressure points can release tension and promote proper blood circulation.

Go Natural

Certain herbs, such as butterbur and peppermint oil, have been found to help relieve headaches. Additionally, minerals and vitamins like magnesium, coenzyme Q10, and Vitamin B12 can aid in alleviating your headaches.

Here are more quick fixes for migraines and ways to get rid of pain!

Headaches are common and may occur occasionally. However, ignoring headaches can sometimes do more harm than good, as they may indicate an underlying pathology. Headaches should not be overlooked for long, as they can affect normal functioning, hinder productivity, and potentially lead to complications such as severe neurologic disability. Therefore, it is important to identify secondary causes of headaches and manage the underlying pathology. Here are some conditions where headaches should not be ignored:

• Headaches that are unusually severe in intensity
• Headaches that develop after the age of 50
• A drastic change in the headache pattern
• Headaches that increase with movement, coughing, or sneezing
• Headaches that worsen over time
• Headaches accompanied by changes in personality or functioning
• Headaches followed by fever, confusion, stiffness in joints, decreased alertness, or memory issues
• Headaches associated with neurological symptoms such as visual disturbances, slurred speech, weakness, or seizures
• Headaches accompanied by a painful red eye
• Headaches with pain and tenderness near the temple region
• Headaches that start occurring after a head injury
• Headaches that affect daily functioning
• Headaches in patients with impaired immune systems, such as cancer patients

Though there are various treatment options available for headaches, they may not be effective for certain patients or may pose side effects. Thus, many patients seek complementary and alternative medicine for headaches, such as:

• Chiropractic Treatment: Chiropractic treatment is considered useful for migraines. Spinal manipulation and interventions such as massage are recommended for managing patients suffering from episodic or chronic migraines. Low-load craniocervical mobilization may be beneficial for patients with episodic or chronic tension-type headaches in the long run. For cervicogenic headaches, spinal manipulation is the preferred chiropractic treatment.
• Homeopathy: Some homeopathic remedies may have beneficial effects in patients suffering from chronic tension-type headaches.
• Home Remedies: While it might be easier to take a pill every time you have a headache, trying a few effective remedies can relieve headaches without the side effects of medications. Here are some simple and effective natural remedies to alleviate headaches instantly:
  • Ginger tea
  • Warm lemon water or tea
  • Black pepper soup or rasam
  • Cinnamon paste
  • Steam inhalation with essential oils
• Acupressure: Acupressure is an ancient practice that may help relieve headaches, especially tension headaches. By pressing acupressure points, tension can be released, promoting proper blood circulation.
• Psychological Treatment: Behavioral therapy, such as cognitive behavioral therapy (CBT), along with relaxation techniques like meditation, can help reduce muscle tension, which is common in tension headaches.

Headache caused by stress or tension often improves with lifestyle remedies and medication. However, if you suffer from migraine headaches, it is crucial to monitor triggers and seek medical help to prevent them. To prevent headaches, understanding the cause and addressing it is essential. Here are a few tips for individuals who experience headaches regularly:

• Keep a headache calendar to track what you ate or did that might have triggered a headache.
• Stick to a regular sleep schedule; maintaining sleep hygiene and a consistent circadian rhythm can significantly alleviate headaches. Go to bed early and wake up at the same time every day, including weekends. Avoid daytime napping and stimulants like tea, coffee, or alcohol close to bedtime. Turn off all electronic devices at least an hour before bed. Keep the room cool and consider including vitamins like melatonin and magnesium (after consulting your doctor) for better sleep.
• Try herbal drinks such as ginger tea or lemon tea, which are rich in antioxidants and can reduce inflammation, providing headache relief.
• Avoid common headache triggers such as alcohol, caffeine, skipping meals, cheese, or inadequate food intake.
• Practice relaxation techniques such as meditation, acupressure, and yoga, which can help manage stress and relieve stress-induced headaches.
• Avoid taking painkillers indiscriminately; the appropriate medication for headaches depends on the type, frequency, and severity of the headaches.
• Consult a doctor if you experience additional signs and symptoms along with a headache, such as fever, stiff neck, seizures, confusion, blackouts, vision difficulties, weakness, or numbness.

Headaches can result from stress or may indicate an underlying condition, such as a brain tumor. It is not always possible to determine the type of headache based on symptoms alone. In such cases, your doctor may recommend investigations like a CT scan or imaging techniques to identify the root cause and provide appropriate treatment. Therefore, consult your doctor if you experience frequent headaches and avoid self-medicating.