Does your head hurt? It happens – everyone gets a headache from time to time.
Headaches can vary in duration and intensity and have many different causes. For most people, a headache is a minor inconvenience that passes relatively quickly. But for some, headaches can be frequent and debilitating, lasting for hours or even days.
Headache is a broad term that describes pain felt in any part of the head. “Headaches can be triggered by the chemical balance in the brain, the blood vessels and nerves that extend into the skull or the muscles of the head and neck,” explains Dr. Jiangping Liu, a neurologist. “Headaches vary quite a bit: pain may be confined to one part of the head, or it may be felt on both sides. A headache may produce dull pain or a sharp, intense pain. Some headaches last for an hour or less, while others may last for days.”
Types of Headaches
Headaches are generally classified by their root cause. There are two types of headaches: primary and secondary. A primary headache is triggered when there is overactivity or another problem in specific pain-sensitive areas of the head.
Primary headaches include migraines and tension headaches, the most common type of headache. A tension headache is characterized by dull, aching pain and a sense of tightness or pressure on the sides of the head and forehead.
In addition, primary headaches can be caused by various lifestyle factors, including strenuous exercise, alcohol, certain foods, stress and poor sleep habits.
A secondary headache is a symptom of another condition or disease that triggers pain-sensitive nerves in the head. A headache caused by a sinus infection is an example of a secondary headache.
People who suffer from migraine headaches may experience intense pain that lasts for days at a time and interferes with their daily activity. Migraines are characterized by:
- Intense throbbing, generally on one side of the head
- High sensitivity to light and sound
Migraines often begin in childhood or adolescence and persist into adulthood. They are believed to be caused by both environmental and genetic factors. Doctors and scientists continue to research the exact causes of migraines, but it is thought that changes to the brainstem, in addition to chemical imbalances in the brain, may be involved. Specifically, researchers are looking at the role of serotonin, a key chemical that helps to regulate pain in our bodies.
Stages of a Migraine
Migraine headaches can have four distinct stages, although not everyone who gets migraines will experience all of them:
- Prodrome: This stage precedes the actual migraine, signaling one may be coming on. Symptoms include constipation, mood changes, food cravings, extreme thirst and frequent yawning.
- Aura: An aura can occur before or during the migraine. These symptoms generally last for an hour or less: vision loss, pins and needles sensation in the limbs, difficulty speaking, weakness or numbness in one side of the body and uncontrollable movements.
- Attack: The attack brings the extreme head pain, often accompanied by nausea and vomiting. The migraine attack may last from four to 72 hours.
- Post-drome: Following a migraine attack, a person may feel exhausted and confused or alternately, have feelings of euphoria. Suden head movements may trigger a temporary return of the head pain.
Migraine Risk Factors & Triggers
There are several known risk factors for migraines:
- Genetics: People with a family history of migraines are at greater risk of developing them.
- Gender: Women are three times more likely to suffer from migraines than men.
- Age: Migraines may occur at any age; however, they tend to begin in adolescence and peak in the 30s.
- Hormonal changes: For women, the hormonal variations brought on by pregnancy and menopause can affect migraines. Additionally, medications such as contraception and hormone replacement therapy can affect migraines. For some, these medicines can exacerbate migraines, while others have noted positive changes.
For people who get migraines, there are several possible triggers. Not everyone will be affected by all known migraine triggers, but some of the more common ones include:
- Strong smells
- Bright lights
- Too much sleep
- Too little sleep
- Jet leg
- Physical exertion
- Certain foods, such as those with high salt content
- Food additives and preservatives, such as monosodium glutamate (MSG)
- Certain medications
- Changes in weather, such as a drop in the barometric pressure
Diagnosis and Treatment
If you experience migraines or any type of frequent, intense headaches, you should see your health care provider for a diagnosis. A doctor can generally diagnosis migraines based upon the patient’s description of symptoms and a review of any relevant family history. An imaging test, such as an MRI or CT scan, may also be conducted.
When it comes to treating migraines, there are two categories of medicine: relief and preventative. Relief medications, taken once a migraine attack is underway, include:
- Pain relievers, such as aspirin or ibuprofen
- Triptans, a type of prescription drug that help block pain pathways in the brain
- Anti-nausea drugs
- Other drugs that treat pain and sensitivity to sound and light
Opioid drugs are generally only prescribed as a last resort for relief, given their highly addictive nature.
There are also a number of preventative medications that your doctor may prescribe in an effort to reduce the frequency of migraines, as well as their duration when they do occur:
- Blood pressure-lowering medications
- Anti-seizure medications
- Botulinum injections
- Monoclonal antibody injections
Prevention & Management
In addition to seeing your doctor and taking any medicine prescribed in order to prevent or lessen the impact of migraines, there are several proactive things you can do on a daily basis to reduce the frequency of migraines:
- Practice relaxation techniques in order to mitigate stress.
- Sleep well: Having a set sleep schedule, in which you neither sleep too much or too little, is helpful.
- Eat well: Eat your meals regularly, at approximately the same time each day.
- Stay hydrated: drink plenty of water (at least 64 ounces a day) and avoid drinking too much alcohol or caffeine.
- Get regular exercise: exercise helps reduce tension, a key factor in migraines. Walking, running, biking or swimming can all help.
When you do get a migraine, try keeping a log or diary of what happens. Noting when the attack occurs and what preceded it can help to establish triggers that may help you learn how best to reduce attacks in the future.
Living with Migraines
As painful and disruptive as migraines are, they can be managed with treatment so they occur less frequently and are not as severe when they do happen. Identifying, understanding and avoiding migraine triggers also helps.
Everyone gets headaches occasionally, but if you get them frequently or they are especially intense, go see your doctor about it. If you suffer from migraines, a proper diagnosis, the right medication and lifestyle adjustments may help make your migraines be less frequent and less severe.
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