Headache

Introduction

As the name suggests, a headache refers to a pain in the head and neck region, and ranges from a mild inconvenience to a debilitating condition. According to the World Health Organization, about 47% of the adult population has experienced a headache at least once within the last year.

There are a few categories of headaches.

  • Tension headaches are the most common, typically stemming from stress, lack of sleep, poor posture and straining of eyes.
  • Cluster headaches are caused by an over activity in the brain. They are not so common, but are extremely painful.
  • Rebound headaches are also known as medication-overuse headaches. They are caused by overusing painkillers. If you have headaches almost every other day and are using painkillers regularly, please visit your doctor for an evaluation.
  • Lastly, migraines are pounding headaches, occurring more commonly on only one side of the head.

Signs & Symptoms

Tension headaches

  • Dull, diffused pain in head located on both sides of head
  • Feeling like there is tight band around the head or tight feeling in neck
  • Mild to moderate pain
  • Not made worse by physical activity

Cluster headaches

  • Severe pain, can be excruciating
  • Several attacks might come together in a “cluster”, and attacks can be cyclical at the same time every year
  • Typically one-sided, with one-sided eyelid dropping
  • Pain around the eye area
  • Flushing of the face
  • Watery eyes and nose

Rebound headaches

According to the ICHD-II criteria released by International Headache Society, a person has rebound headache if:

  • Headache occurs for more than 15 days a month
    • Developed or worsened during overuse of medication
    • Resolves within 2 months after discontinuation of pain killers
  • Painkillers have been overused for more than 3 months to treat headaches

If you suspect that you might be suffering from a rebound headache, please do not try to self-medicate. See your doctor for help.

Migraines

  • Throbbing, pounding pain, typically on one side of the head
  • Moderate or severe pain
  • Nausea and vomiting
  • Vision changes
  • Light and sound sensitivity

When to Seek Medical Attention

If you are having sudden, severe or frequent headaches, headaches after head trauma or if it is accompanied by other symptoms such as confusion and weakness, please check with your doctor as it could be the sign of an underlying condition.

Causes

  • Stress
  • Viral infections
  • Sinusitis
  • Hormonal changes (e.g. menstruation)
  • Certain foods such as cold drinks, aged cheese, red wine etc.
  • Alcohol
  • Lack of rest
  • Certain lights and smells
  • Smoking

Lifestyle modifications

Stay in a quiet, dark room to rest.

Warm or cold compresses can be soothing during an episode.

Drink more water to prevent dehydration.

If you are unsure of the triggers, keep a headache diary. This can help you and your doctor identify the reasons for your attacks.

Relaxation techniques can be useful, especially since stress is a trigger for migraine.

If poor posture is giving you a headache, try sitting straight and avoid staying in one position for too long. Ensure your arm rest (if any) and chair seat is of the correct height, and that your back, especially the curve of the spine, is supported.

If you are a believer in complementary medications, acupuncture might be an option for you. Do discuss with your doctor before commencing treatment.

Treatment options        

Paracetamol is the usual medication for mild to moderate headaches for adults and children. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) also work very well for headaches and migraines. If you are uncertain which is better for you, check with your pharmacist or your doctor.

If you have nausea and vomiting together with your migraine, an anti-vomiting medication such as Domperidone can help. This medication is available from your pharmacist or from your doctor, and be sure to mention any heart conditions that you might have.

Prescription-only medications for migraine include Ergotamines and Serotonin Receptor Agonists, better known as Triptans. For people with frequent debilitating migraines, a prevention therapy might be necessary. Do discuss these options with your doctor if you are not getting sufficient relief from lifestyle modifications and over-the-counter options.

 

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