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Headache

What is a headache?

The pain from tension-type headaches have been described as "vise-like."

Headache is a broad term that encompasses many different things.Headaches are pains that occur in any region of the head; they can occur on both sides the head or be isolated to a certain location.

Headaches can radiate across the head from a central point or have a pincering vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly and last for multiple days or less than an hour.

There are multiple ways to define headaches. The International Headache Society (IHS) categorize headaches as primary headaches or secondary headaches, depending on what has caused them.

Causes of headaches

We will look at the causes of primary headaches and secondary headaches in turn.

1) Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive. This includes the blood vessels, muscles and nerves of the head and neck. They may also result from changes in chemical activity in the brain.

Primary headaches can occur when pain-sensitive structures in the head do not work properly.

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What is a headache?

The pain from tension-type headaches have been described as "vise-like."

Headache is a broad term that encompasses many different things.Headaches are pains that occur in any region of the head; they can occur on both sides the head or be isolated to a certain location.

Headaches can radiate across the head from a central point or have a pincering vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly and last for multiple days or less than an hour.

There are multiple ways to define headaches. The International Headache Society (IHS) categorize headaches as primary headaches or secondary headaches, depending on what has caused them.

Causes of headaches

We will look at the causes of primary headaches and secondary headaches in turn.

1) Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive. This includes the blood vessels, muscles and nerves of the head and neck. They may also result from changes in chemical activity in the brain.

Primary headaches can occur when pain-sensitive structures in the head do not work properly.

Common primary headaches include migraines, cluster headaches and tension headaches.

Some types of headache can be both primary and secondary as they may be an isolated issue or a result of another condition or illness. Such headaches can involve:

2) Secondary headaches

Secondary headaches are headaches that are symptoms of another condition that stimulates the pain-sensitive nerves of the head. There are a vast number of different conditions that can cause secondary headaches, ranging in severity from an alcohol-induced hangover to a brain tumor.

Secondary headaches can be the result of serious conditions such as stroke, but can equally be a consequence of eating cold food too quickly.

In addition to those two examples, the following list should serve to illustrate the variety of different conditions that can cause secondary headaches:

As headaches can be a symptom of a serious condition, it is important to seek medical advice if headaches become more severe, regular or persistent.

For example, if the headache is more painful and disruptive than previous headaches, worsens or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes and stiffness, a health care provider should be contacted.

Types of headaches

People experience many different types of headache, affecting a number of areas of the head in myriad ways, with differing intensities and for variable amounts of time. Here are the characteristic symptoms associated with some of the more prominent forms of headache:

Tension-type headaches

Tension-type headaches are the most common form of primary headache. They are described as a feeling of having a tight band around the head, with a constant, dull ache felt on both sides. The pain may spread to or from the neck. Such headaches normally begin slowly and gradually in the middle of the day.

Tension-type headaches can be either episodic or chronic. Episodic attacks are normally a few hours in duration, but can last for several days. In contrast, attacks are considered to be chronic if they occur for 15 or more days a month for a period of at least 3 months.

Migraines

Migraine can be accompanied by blurred vision, lightheadedness, nausea and sensory disturbances.

Migraine is the second most common form of primary headache and has been ranked as the seventh-highest specific cause of disability worldwide.5 A migraine can last for any amount of time between a few hours and 2-3 days.

A migraine headache may cause a pulsating, throbbing pain on one or both sides of the head. The aching may be accompanied by blurred vision, lightheadedness, nausea and sensory disturbances.

Medical News Today has a Knowledge Center article dedicated to migraines, which can be viewed for further information.

Rebound headaches

Rebound, or medication-overuse headaches are the most common secondary headache, caused by the excessive use of medication to treat headache symptoms. They usually begin early in the day and persist throughout, improving with pain medicine but worsening when its effects wear off.

Rebound headaches can cause a number of symptoms, and the pain can be different each day. Along with the headache itself, rebound headaches can cause neck pain, restlessness, a feeling of nasal congestion and reduced sleep quality.

Cluster headaches

Cluster headaches are a relatively uncommon form of primary headache that affect less than one in every 1,000 adults. They strike quickly, once or more daily at the same time each day and often without warning. They usually last between 45-90 minutes and persist for the duration of a cluster period, normally 4-8 weeks.

The pain caused by cluster headaches is severe, often described as sharp or burning, and is normally located in or around one eye. The affected area may become red and swollen, the eyelid may droop and the nasal passage on the affected side may become stuffy and runny.

Medical News Today has a Knowledge Center article dedicated to cluster headaches, which can be viewed for further information.

Diagnosis of headaches

The health care provider will usually be able to diagnose a particular type of headache through a description of the condition, the type of pain and the timing and pattern of attacks. It can be helpful for those experiencing headaches to keep a diary detailing their symptoms and any possible triggers; this can help both the patient and the health care provider in establishing the precise nature and possible cause(s) of the headaches.

If the nature of the headache is particularly complex, a health care provider may request tests to eliminate other possible causes. Further testing could include blood tests, X-rays and brain scans, such as computerized tomography (CT) and magnetic resonance imaging (MRI).

Treatments for headaches

The most common methods recommended for treating headaches are rest and pain relief medication. Generic pain relief medication can be bought over the counter, or health care providers can prescribe preventative medication, such as tricyclicantidepressants, anti-epileptic drugs and beta blockers.

It is important to follow the advice of health care providers as overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reduction or cessation of pain relief medication. In extreme cases, a short hospital stay may be required in order to manage withdrawal safely and effectively.

Self-care

There are a number of steps that can be taken to adjust daily routines so as to reduce the risk of headaches and to ease the pain of headaches that do arise:

Applying a heat pack or ice pack to your head or neck can help ease the pain of headaches.

Alternative therapies

In addition to the treatment methods mentioned above, several alternative forms of treatment for headaches are also available.

It is best to consult a health care provider prior to beginning any alternative forms of treatment. Such treatments include:

In some cases, headaches may arise as a result of a deficiency of a particular nutrient or nutrients, especially magnesium and certain B vitamins. Nutrient deficiencies can be caused by an overall poor quality diet, underlying malabsorption issues or other medical conditions.

As such, it is important for anyone with a suspected nutrient deficiency to work with a qualified health professional to correct the deficiency in a sustainable and holistic way where possible, rather than simply relying on an isolated supplement.

The WHO report that 50% of people with headaches are self-treating. This means that many people that develop headache disorders do not receive optimal care. The WHO is currently involved with the Global Campaign against Headache; an initiative that aims to raise awareness of headache disorders and improve access and standards of care worldwide.

Detailed treatment and prevention information for both migraines and cluster headaches can be found on their respective Knowledge Center pages.