Got a headache?

There are so many different kinds of headaches: cluster headaches, sinus headaches, tensions headaches, etc but what it comes down to is that you are uncomfortable and it can be difficult to get through your day due to a headache, and sometimes they can be completely debilitating!  Now, I am not talking about migraines, which I blogged about previously and have a different treatment and etiology. Headaches can be a dull pain, sharp pain, radiating across your head or located in just one area, they can be transient and last a short period of time, or last for hours or days. In short, headaches can just suck.  If you are having the worst headache of your life and your head feels like it is splitting open especially if you have dizziness a stiff neck, or changes in vision, it is a MEDICAL EMERGENCY, so call 911 or go to the closest Emergency Department! Headaches can be very deceiving and mean a lot of different things, or just mean that you are having a tough day!

What are the types of headaches?
Medically, there are primary headaches and secondary headaches.  Primary headaches are headaches caused by over activity of pain sensors in your head and is usually primary symptom of either increased or decreased blood flow (from caffeine, etc), muscle tightness in your head/neck, or chemical changes within your brain (could be electrolyte imbalances, from diet or medication).  Secondary headaches are the symptom of a disease that activates the pain sensors in your head.

What are types of Primary headaches?
Migraine
Tension (from stress)
Cluster
Chronic (daily)
Cough (from hard coughing can strain muscles in head and neck)
Exercise induced (dehydration and overexertion)
Sex (some people have headaches after an orgasm...not a big deal medically, but crappy luck!)

Causes?
Primary headaches can be triggered by alcohol, sleep deprivation, poor posture, skipping meals (hunger), dehydration, or sex.

What are types of Secondary headaches?
Brain Aneurysm
AVM (Arteriovenous malformation in the brain- changes blood flow paths and present at birth)
Brain tumor
Carbon Dioxide poisoning
Hangover
Meningitis (especially if stiff neck and pain present)
Flu
Stroke
Withdrawal (caffeine, alcohol, nicotine, pain medication, etc.)
Other growths/malformations in the blood vessels, tissue, skull of head.

Causes of Secondary headaches?
There is always a trigger, whether it is caused by something mechanical (the actual structure of your brain) or from something triggered elsewhere, for example, a headache from a hangover is caused from a hormonal imbalance and dehydration due to the insult of the alcohol ingested previously.

*All headaches that seem common or are relatively frequent should be worked up by an HCP and you should know the reason that you are getting them, so that you can prevent them or know if something more serious is going on.

When are headaches a serious problem requiring immediate medical attention?
Confusion
Slurred speech
Vision changes
Numbness or weakness
Trouble walking or moving
High fever 102F+ (39C+)
Nausea or vomiting
Stiff neck

What are some Treatment options?
For a Mild Headache:
Acetaminophen (no more than 2500mg per day)
NSAIDs- non steroidal anti inflammatory drugs (i.e. ibuprofen, naproxen)
Aspirin

For Moderate to Severe:
Treatment of underlying cause or prevention of triggers
Antidepressants can help (i.e. Pamelor, Prozac, Sarafem)
Beta Blockers, usually for treatment of high blood pressure and increased heart rate (i.e. metoprolol, propranolol)
Anti-seizure medications (i.e. Topamax or Neurontin)
NSAIDs
Botox injections to certain "trigger points" or nerves that aggravate headaches

Alternative therapies:
dark room (decreased light for eyes)
cool washcloth to back of neck/forehead
 fluids
caffeine (coffee/tea)
acupuncture
massage
biofeedback
Vitamin b-12 (riboflavin)- still being studied for effectiveness
Coenzyme Q10- still being studied for effectiveness

How do I Prevent headaches?
Make sure that you are eating well, drinking plenty of water, if you drink caffeine or ingest anything that will cause a headache if you don't take it, don't abruptly stop taking it.  If you have allergies, then take allergy medication and be aware of the pollen levels, try a neti pot to clear out your sinuses!  Talk to your HCP so that you can learn your triggers and try to prevent them, and know the cause and source of your headaches.

If you get headaches with frequency enough to cause you aggravation and interfere with your life, then go see your HCP and get a work up, it may be something more serious, or it could be something really simple that needs a quick fix.  Also, it is best to let your HCP know that you have these headaches, so you can get follow-up care and try different medications that might help to alleviate your pain.  You don't need to live with these headaches every day, and usually some Advil and a cup of coffee should fix your problem, but if it doesn't or you suspect something more serious, please go seek help!  And try alternative therapies to see if they will help with your pain!!

Yours in Good Health
B