Headaches

Headaches are prevalent, affecting most people severally in their lifetime. They are characterized by discomfort and pain in the face or head, varying intensity, and location. Headaches can be throbbing, dull, constant, or sharp and can be managed and treated with stress management techniques and medication. There are various types of headaches. The common types include:

Sinus headaches: These are caused by swelling of the sinus passages from infection, with the pain worsening in the morning or when bending forward.

Tension headaches: These are the most common type, with pain spreading across both sides of the head. The pain starts from the back, creeps to the front, and is worsened by activities such as bending. Tension headaches are frequently caused by stress, hunger, or eyestrain.

Cluster headaches: These are the most severe and occur in clusters, usually at the same time in spring or fall. They can last two weeks to three months resulting from blood vessel dilation from serotonin and histamine release. The pain is usually throbbing or constant, intense with a burning or stabbing sensation, and located behind one eye.

Migraine

A migraine is a severe throbbing headache accompanied by other symptoms like nausea and sensitivity to light and sound. They usually occur two or more times a month, while for some people, they may occur once or twice a year.

They have a warning symptom known as the aura that occurs before or after the migraine headache starts. An aura is a group of motor, speech, and sensory symptoms that act as warning signals that a migraine is about to begin.

The frequency level varies. Some are episodic (now and then), high-frequency episodes (8-14 headaches per month), or chronic migraines (more than 15 headaches a month, of which 8 have migraine features). Episodic and chronic migraines can disable a person, so seeking medical advice and treatment is essential.

The symptoms start gradually from the nervous system and continue picking 5- 20 minutes as a dull ache, then turn to throbbing pain.

Types of Migraines

They are several types of migraines divided into primary and secondary categories. The most common types are migraine with aura (classic migraine) and migraine without aura (common migraine).

Migraine with aura: An aura typically occurs in 15 -20% of people with migraines, while a migraine without aura strikes without warning with symptoms like numbness, vision loss, bright flashing lights, ringing ears, wavy lines, or a change of smell.

Other types include and are not limited to:
Silent/acephalgic migraine: This comes with aura symptoms but without the headache.

Vestibular migraine: This presents problems like vomiting, nausea, vertigo, and balance loss.

Ophthalmologic migraine (ocular or retinal migraine): This occurs with pain in the eye due to pressure in the nerves behind the eyes or aneurysm, double vision, droopy eyelid, or vision changes.

Menstrual migraine: This occurs due to hormonal changes, primarily in women during their periods because of estrogen changes.

Hemiplegic migraine: This comes with short periods of paralysis or weakness on one side, numbness, vision changes, and dizziness.

Abdominal migraine: It causes nausea, vomiting, and stomach pain.

Status migraine: It can last 72 hours with severe, intense pain and nausea.

Symptoms

The symptoms usually differ for everyone and may happen in stages, although not everyone goes through the stages. The stages include:

Prodrome: This lasts for a few hours or days. It is also known as pre headache or premonitory phase. Hours or days before the headache, you may notice symptoms such as mood swings, sensitivity to light, food cravings, severe thirst, bloating, constipation or fatigue.

Aura: This stems from the nervous system, and symptoms often involve vision. The symptoms gradually begin slows, and this can last for 60 minutes. You may experience vision loss, tingling or numbing on one side of the body, inability to speak clearly, or ringing in the ears.

Attack: The headache can last for 72 hours with pain at one side of the head, throbbing or pulsing pain, nausea, and vomiting.

Postdrome: After a migraine, you may feel drained, confused, unusually refreshed, happy, weak, or wiped out. It goes on for a day or two and is called a ‘hangover’.

Causes

The real cause is unknown. They are thought to result from abnormal brain activity affecting the brain’s nerve signals, chemicals, or blood vessels. This might cause imbalances in the brain chemicals such as serotonin, which helps regulate the nervous system. The neurotransmitters cause inflammation and pain. Calcitonin gene-related peptide (CGRP) might also play a role, causing the blood vessels in your brain to swell.

Migraine Risk Factors

Anyone can get migraines or headaches. You may be more likely to get a migraine due to the following factors:

• Medical conditions like epilepsy, anxiety, depression, or bipolar disorders.
• Family history
• Age (from age 10 to 40)
• Sex (women are prone to migraines more than men)
• Obsessive-compulsive disorder (OCD)
• Fibromyalgia
• Overactive bladder
• Bipolar
• Irritable bowel syndrome (IBS)

Headache and Migraine Triggers

There are various headache or migraine triggers which commonly include:

• Stress and depression
• Hormonal changes
• Alcohol and tobacco use
• Certain medications such as vasodilators
• Physical activity
• Diet changes
• Changes in sleep patterns
• Too much or too little caffeine
• Senses like loud noise, strong smells, bright lights, flickering screens, or a stuffy atmosphere
• Changes in weather patterns
• Foods like aged cheeses, chocolates, or some types of food additives
• Jet lag
• Dehydration
• Poor posture
• Fatigue

When to See a Doctor

Some symptoms require a doctor immediately, like a stiff neck, fever, vomiting, trouble speaking, seizures, double vision, mental confusion, or balance issues. Other symptoms include:

• Headaches that refuse to go away
• Sudden severe headache
• A chronic headache that becomes worse after exertion, cough, or strain
• Headaches that start after you are 50 years old
• A headache that starts after an injury
• Number of headaches keep increasing or changing their pattern
• When medications no longer relieve the pain or have brought side effects

Diagnosis

The doctor will require a medical history and ask about symptoms experienced, how long they lasted, and family history. You will also be asked about any medications or supplements you are taking.

It is good to have a migraine journal that helps diagnose headaches. Use the diary to note the headache’s date, time, how long it lasted, pain location, symptoms experienced, if you took any medicines, and the different stages you might have gone through. Give specifics about your sleeping pattern, stress levels, water, and food intake.

To ensure no other underlying cause of your headache, your doctor might order blood tests, imaging tests such as CT scans, MRI, and an electroencephalogram (EEG) to rule out seizures.

Treatment

Finding out your triggers is an essential step in getting treatment. Once your doctor identifies your triggers; they can customize your treatment plan.

Treatment options may include:
Over-the-Counter Medicines: For occasional tension headaches, such as ibuprofen, acetaminophen, and aspirin. You may also be given preventative medicine for high blood pressure, depression, and seizures to reduce headache frequency. If you get nausea, you might be medications to control it.
Stress management: This helps you cope with stressful situations by using relaxation techniques such as breathing exercises, yoga, and meditation.

Biofeedback: This teaches you to note when tension is building up in your body by learning how your body reacts to stressful situations to stop the attack before it becomes full-blown. During a biofeedback session, your physical response to headaches, such as heart rate, temperature, and pulse rate, will be monitored.

Lifestyle changes: These can help prevent and manage some migraines and headaches. You can improve your sleeping habits, take more water, make dietary changes, improve your posture, avoid bright light, and exercise regularly.

At Axon Health Associates, we customize treatment plans for headaches or migraines, tailor-made for your unique needs. Contact us today for more information about migraines/headaches. You can also schedule an appointment online.