Headaches

Tension Headaches:

The most common headache, causing a dull ache in the forehead, above the ears; or in the back of the neck.  Usually described as tight band around head, or head in " a vise".  Often neck muscles are tight. These headaches can last several hours, or come and go over several days. Most often they respond to acetaminophen or ibuprofen. Persons can report added stress or illness associated with the headache. If headaches persist and you are taking pain relievers frequently, you may be suffering from "rebound" headaches which are caused by withdrawal of medication after long term use. These headaches are usually worse than the initial headache. 

Migraine Headaches:

Migraine headaches are severe headaches that usually  have a sudden onset. They can last several hours or several days.  Sometimes they are associated with an "aura"; most often a visual change.  The headache is one sided, often described as pounding, and may be associated with nausea, vomiting, sensitivity to light or sounds.  Foods that may trigger a migraine are chocolate, caffeine, processed meats or salty foods containing MSG, and alcohol. Oral contraception pills may increase the frequency of migraines. However, when migraines are related to a drop in estrogen levels, continuous birth control may be prescribed to help avoid migraines. Ibuprofen is the drug preferred for pain management.  Often additional medications are needed to help control the pain.  Prophylactic therapy is also available. 

Cluster Headaches: 

These headaches are rare and are more common in men than women. They get their name because the headaches occur for weeks or even months at a time and then disappear for months.  They generally start around the eye and progress to one side of the head.  They are thought to be caused by swelling of  blood vessels in the head.  Some prescription medications may help with pain.  Avoidance of alcohol, bright lights, and stressful situations are recommended. 

Sinus Headaches:

Sinuses are hollow passages located behind your cheeks, eyes and  nose. When the sinuses fill up with secretions,  pressure is felt  in the face or even teeth. Sinus headaches are caused by colds, allergens, or breathing polluted air.  Some people may experience a sinus headache when flying or swimming under water. Sinus headaches are not a definitive sign of an infection.  Treatment may include increasing fluids, nasal saline spray, antihistamines and/or decongestants.  When blowing your nose, do so gently to avoid "blowing" more secretions into sinuses. 

Headache  Relief Techniques:

• gentle massage to back of head or neck

• cold or hot compresses to back of neck

• breathe deeply  and slowly

• close your eyes and allow yourself to rest

• take a nap

• take a walk

• yoga or mediation

• aspirin or ibuprofen products

• increase fluids

HEADACHE LOG: keeping a headache log will help differentiate what type of headache you are suffering with. 

RECORD: 

• time of day/day of week

• length of time headache lasts

• how much does it hurt ( pain scale 0=no pain and 10= worse pain of life)

• where does it hurt; one sided; forehead, back of head, any associated neck pain

• any medication to relieve pain

• any stress relief techniques effective as discussed above

• any associated symptoms, i.e., nausea, vomiting, aura

• any known triggers;  stressful events; foods, alcohol consumption, menses, smoke, bright lights, etc....

When to contact a clinician:

• severe headache following a head injury

• headache accompanied by seizure, confusion, or loss of consciousness

• headache with eye pain and blurred or double vision

• headache with nausea and vomiting as new and unexplained symptoms

• headache with neck stiffness

• recurring headache that is not relieved with over the counter medications such as Tylenol or Ibuprofen

• any change in headache pattern