Headaches are very common conditions that most people experience in their lives. Headaches are one of the most common pain conditions. Up to 75% of adults experience headaches in one year. There are many different kinds of headaches (more than 150 types) and some can be more complicated than they seem.
How are headaches treated?
Despite the many different types of headaches, they fall into two main categories: primary and secondary headaches.
Primary headaches are headaches that are not caused by a secondary medical condition
- Cluster headaches
- Tension headaches
Secondary headaches are caused by a medical condition such as:
- Head injury
- High blood pressure (hypertension)
- Medication overuse
- Sinus congestion
- Neck arthritis (cervicogenic headaches)
What causes headaches?
Headaches, especially migraines, have a tendency to run in families. Headaches can also be triggered by environmental factors, such as certain foods (caffeine, alcohol, etc.). During a headache, a certain mechanism will activate specific nerves that affect muscles and blood vessels in the brain, triggering an episode.
Signs and symptoms of headaches?
Headache symptoms vary, depending on the type of headache you have.
Tension headaches are the most common type of headache.
- Come and go over time
- Aching, not throbbing
- Bilateral (affect both sides)
- Mild to moderate in intensity
- Responsive to over-the-counter treatment
- Worse during routine activities
Migraines are the second most common type of primary headaches. Symptoms include:
- Moderate to severe pain
- Associated with nausea and/or vomiting
- Pounding or throbbing pain
- Can last from hours to days
- Sensitivity to light (photophobia), noise (phonophobia) or odors
Cluster headaches are the most severe type of primary headache. Cluster headaches are episodic and occur in clusters. They occur one to eight times per day during a cluster period. Symptoms include:
- Intense pain with a burning or stabbing sensation
- Located behind one of the eyes
- Can cause tearing or redness in the eye
- Throbbing or constant.
When to seek immediate medical attention?
- A sudden, new, severe headache
- A headache that is associated with neurological deficits such as weakness, numbness, tingling, difficulty speaking, paralysis, confusion
- If there is a fever, rash or stiff neck
- Headaches with severe nausea or vomiting
How are headaches treated?
Treatment of headaches can be simple with over-the-counter medications or it may require more complex medical procedures. One of the most crucial aspect of treating headaches is determining the triggers (for example stress) and avoiding them.
A range of treatments is available. Depending on your headache type, frequency and cause, treatment options include:
- Stress management
- Over-the-counter medications
- Prescription drugs
- Interventional procedures
Depending on the type of headaches, you may be a candidate for specific interventional procedures. For example, patients with migraines who fail to respond to prescription drugs may be a candidate for Botox injections. Alternatively, patients with headaches related to occipital neuralgia or trigeminal neuralgia may be a candidate for nerve blocks. Headaches that are caused by arthritis of the neck joints can be treated radiofrequency ablation of the cervical medial branches. Patients who fail to have sustained relief from nerve blocks may be a candidate for a peripheral nerve stimulator to treat their headaches.