Headaches: most everyone gets them, but when they come frequently or are severe, consult your IMA physician

August 21, 2012

Headaches come in many varieties, from merely bothersome to debilitating. Common causes are stress, lack of sleep, fatigue, hormonal changes, certain foods, alcohol or even changes in the weather.

Over-the-counter medicines effectively treat many everyday-type headaches, but others can be signs of an underlying health problem or be severe enough to require medical attention. It’s important to know which headache types and symptoms should be evaluated and treated by your primary care physician.  

When headaches occur frequently or persist longer than a few days, you should consult your doctor. Headaches that follow head injuries or come on suddenly and severely also require immediate attention. Any headache associated with fever, stiff neck, seizures, numbness, double vision, dizziness, severe nausea, shortness of breath, or confusion should also be evaluated immediately.

The National Headache Foundation classifies headaches into several categories: tension, migraine, cluster, hormone, rebound and sinus.

  • Tension headaches are the most common form of headache, and one that nearly every person has experienced. For most people, the pain is constant not throbbing, and centers on the temples, back of the head or neck. Some common causes are stress, fatigue, lack of sleep, eye strain, poor posture when working or emotional issues.
    People bothered by tension headaches have a variety of treatment options ranging from over-the-counter pain relief medications to relaxation techniques. Caffeine can help relieve some headaches and many headache medicines include caffeine. A hot or cold compress on the pain site may also provide relief.
  • Migraine headaches are more severe and affect nearly 30 million Americans. They may last from a few hours to a few days. Migraines are characterized by severe and intense throbbing pain on one side of the head, sensitivity to light and sound, and often nausea/vomiting. Of all the headache types, migraine causes more employees to call in sick than any other because of the debilitating symptoms. Four of five migraine sufferers report a family history. The term migraine is derived from the Greek word meaning “half of the head,” and for 70 percent of people, the pain is limited to one side of the head, face or neck. Hereditary abnormalities in the brain likely caused migraines, but the severe headaches are usually preceded by triggers such as stress, fatigue, oversleeping or lack of sleep, fasting or skipping a meal, caffeine, chocolate, alcohol, menstruation, hormonal changes or barometric pressure changes.
    Most people with migraine have two to four headaches each month, but some have one every few days and others only one or two a year.

One third of migraine sufferers will experience an “aura” five to 30 minutes before onset. The aura may be dots or flashing lights, tunnel vision, blind spots or wavy jagged lines.

When diagnosing migraine, your physician may ask you to keep a calendar of your activities, foods, beverages, stress levels, physical activity, etc., to help determine what triggers your migraines. There are a variety of prescription medications that can both treat and prevent persistent migraines.  

  • Cluster headaches: This type of headache, considered the most intense and severe, is so named because the attacks come in groups. The pain usually lasts 30-45 minutes, comes on with little or no warning, and affects one side of the head. Most people have one to four headaches in the cluster period. Cluster headaches affect only 1 percent of the population, with men being five times more likely than women to experience them. There are several prescription medications that can ease symptoms.
  • Hormone headaches: are caused by changes in hormones, and for that reason, affect more women than men. Two types are menstrual migraine and PMS headache. These differ in severity, but are both caused by fluctuating hormones. If you are a woman who is bothered by headaches that seem to be related to your period, talk to your doctor about treatment options.
  • Rebound headaches: this type of headache is actually caused by overuse of over-the-counter pain relievers. Taking pain relievers too frequently or in higher than recommended dosages can cause a rebound headache. If you are experiencing frequent headaches, talk to your physician about prevention and other treatment options.
  • Sinus headaches: These headaches are distinguished by pain in the forehead, cheeks and behind the eyes. They are caused by inflammation or blockage of the sinus cavities. Treating the underlying infection, allergy or blockage will also relieve the accompanying headache.