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Home Disease Index Headache

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Overview

Causes
Symptoms
Risk Factor

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Overview

 

Headaches involve mild to severe pain in one or more parts of the head as well as the back of the neck. There are many different types of headache patterns and a variety of causes. While painful and annoying, the majority of headaches do not indicate a serious disorder and, in non-chronic cases, may be relieved by medicines and/or changes in lifestyle.




Causes

 

There is no single cause of headaches. A number of causes have been identified which fall into two general categories.

Tension headache

This type of headache results from contraction of head and neck muscles. It is the most common form of headache and accounts for 70 per cent of headaches. It can occur in people of either sex and at any age but it is most common in adults and adolescents. Tension headache usually occurs in isolated incidents but can become chronic for some people. Possible causes of muscle contraction associated with tension headaches include:

  • stress.
  • fatigue.
  • poor posture.
  • eye strain.
  • tobacco and alcohol use.
  • in women, hormonal changes occurring before and after a menstrual period.

Migraine headache

Migraine is the cause of 20 per cent of all headaches. This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels. Migraine is usually experienced as a throbbing pain on one side of the head with an associated feeling of sickness and sensitivity to light and sound. Migraines are known to affect more women than men and are often chronic. Below are some of the factors that have been identified as being associated with migraines:

  • family history of migraine.
  • prolonged muscle tension and stress.
  • alcohol use.
  • smoking or exposure to tobacco smoke.
  • lack of sleep.
  • for women, menstrual periods and the use of oral contraceptives.
  • certain foods such as chocolate, nuts and fermented or pickled condiments, as well as foods containing the amino acid tyramine (aged cheese, red wine, smoked fish) and foods containing preservatives and artificial sweeteners.

 



Symptoms

 

Tension headache

  • Pain is often felt in the generalised area of the head and neck as opposed to on one side.
  • Pain may also be situated in the back of the head and neck and feel like a 'tight band'.
  • Sometimes accompanied by muscle tightness in back of neck.
  • Of relatively short duration if treated in time.

Migraine headache

  • Throbbing, pulsating feeling usually worse on one side of the head.
  • Pain may be dull or severe and often begins in the morning, gradually worsening in an hour or so.
  • Pain may be accompanied by other symptoms such as nausea, vomiting, vertigo-like feeling and visual disturbances.
  • Sensitivity to loud noises and light.
  • Commonly lasts from a few hours to one or two days in some cases.


Home Care

 

Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches. When a headache occurs, write down the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern.

A headache may be relieved by resting with your eyes closed and head supported. Relaxation techniques can help. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches.

Try acetaminophen, aspirin, or ibuprofen for tension headaches. DO NOT give aspirin to children because of the risk of Reye's syndrome.

Migraine headaches may respond to aspirin, naproxen, or combination migraine medications.

If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications.

Prescription medications used for migraine headaches include ergotamine, dihydroergotamine, ergotamine with caffeine (Cafergot), isometheptene (Midrin), and triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), andzolmitriptan (Zomig). Sometimes medications to relieve nausea and vomiting are helpful for other migraine symptoms.

If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. Examples of these includes:

  • Antidepressants, like nortriptyline (Pamelor), amitryptyline (Elavil), fluoxetine (Prozac, Sarafem), sertraline (Zoloft), or paroxetine (Paxil), for tension or migraine headache
  • Beta-blockers, like propranolol (Inderal) for frequent migraine headaches
  • Calcium channel blockers, like verapamil for frequent migraine headaches .

If you are using pain medications more than 2 days a week, you may be suffering from rebound headaches. Rebound headaches are caused by a cycle of using pain medications for short-term relief, followed by the headache pain returning for increasingly longer periods of time despite taking more pain medications.

All types of pain pills (including over-the-counter drugs), muscle relaxants, some decongestants, and caffeine can cause this pattern. If you think this may be a problem for you, talk to your health care provider.

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