HEADACHES, LIKE BACK pain, are a universal human phenomenon that just about
every adult has experienced at some point in time and can relate to. From
the dull twinges to the nausea-inducing pounders, headaches can run the
gamut. The Headache Society has cataloged and classified more than 150
primary and secondary
headache disorder types. So how do you figure out what brings a headache on so that you can stop
it in its tracks? More importantly, how do you know when the headache(s)
you're experiencing warrant further medical attention?
First, let's cover the distinction between a primary headache and a
secondary headache. A primary headache is one that occurs independent
of any other medical issue – meaning it isn't caused by another
medical condition. However, a secondary headache is a symptom brought
on by another health issue or neurological concern. Especially for people
who encounter headaches with some frequency or regularity, distinguishing
between primary and secondary headaches is essential. If another condition
is causing the headache, it needs to be evaluated and addressed by a neurological
expert so that the headache symptoms it's causing can hopefully be
eliminated.
Where primary headaches are concerned, the most common types include tension
headaches and
migraines. Tension headaches are characterized by a dull pain, pressure or tightness
that uniformly surrounds the forehead or back of the head and neck and
tend to "build" over time. Though pain from a tension headache
can range in severity from mild to severe, many people believe its primary
difference from a migraine is in the intensity of the pain. This isn't
necessarily true because the mechanism of migraine is thought to be different.
Furthermore, the differences in clinical characteristics involve more
than just severity. Migraine headache can come on quite suddenly and severely,
seemingly out of nowhere (although many people have an "aura"
that can serve as a warning that the headache is coming.) Migraine headaches
can also affect one side of the head more than the other, and people who
get these types of a headache can also experience nausea or vomiting in
severe cases and may also develop an acute sensitivity to light or noise
during a migraine episode. Migraine is felt to be "underdiagnosed"
– meaning that many individuals suffering from migraine don't
know it. They believe they have sinus headaches or tension headaches and
may miss opportunities to more successfully treat them because of the
misdiagnosis.
Though the symptoms may present similarly to those experienced by people
suffering from a primary headache, secondary headaches are brought on
by another cause that usually involves the head or the neck. The origins
of a secondary headache can vary significantly. For some people, it's
a headache brought on by dental pain from an infected tooth. For others,
it can be the symptom of a concussion. In rare but serious cases requiring
immediate medical attention, a secondary headache can be caused by bleeding
from the brain.
Most headaches are episodic, meaning they are infrequent and don't
require medical attention. Others are considered chronic – meaning
they occur more than a few times a month. So how can you tell whether
a headache is severe enough to warrant medical attention? If a headache
follows a blow to the head, is accompanied by sudden, excruciating pain,
a stiff neck, fever, convulsions, confusion, loss of consciousness or
associated with severe pain in the eye or ear – immediate medical
evaluation is crucial. In less severe cases, where a headache occurs more
than three times in a month, a visit to the doctor is where to find out
what may be causing the headaches and to help minimize their frequency
and severity.
Of course, the best headache is the one you never get. Especially when
it comes to primary headaches that have no other underlying cause,
figuring out your headache "triggers" and avoiding them is the best defense. In today's digital age, too
much screen time can be a headache trigger for many people. Take frequent
breaks from your computer and smartphone screens to give your eyes a rest.
And, how's your diet? Sensitivity to certain foods can bring on headaches
for some people. Sleepless? Stressed out? Lack of sleep, disordered sleep
(as with obstructive sleep apnea) and life-stress are also common headache
triggers. Consistently getting enough shut eye, certain forms of biofeedback
and mindfulness meditation have been shown to help lessen the headache
occurrences and severity for many sufferers. Are you experiencing headaches
often enough for there to be a pattern to them, but you aren't exactly
sure what the cause is? Try keeping a journal. When a headache comes on,
write down what you did that day or the day before that might have triggered
it. After a few entries, you may begin to see a pattern emerge that will
help you stop a headache in its tracks next time. It's worth the effort.
We are learning more and more about premonitory phases (with symptoms
other than pain that may begin hours or days prior to certain headache
types) and postdromal phases (symptoms such as fatigue, or GI symptoms
that may continue for some time after migraine headache pain has resolved).