Headaches are one of the most reported symptoms in all of medicine. Headaches are very non-specific, and can signify anything from a primary headache disorder, prodrome of a viral illness, sinus congestion related to weather changes, represent a sign of a serious life-threatening condition such as bleeding in the brain or a brain tumor, or be a symptom of a host of other medical, ophthalmologic, vascular, or neurologic disorders.
However, while headaches are a symptom of the above different medical conditions, they most frequently represent a medical condition in and of themselves. It is estimated that at some point in their lives, over half of the world’s population will be affected by an active headache disorder.
What Kinds of Headaches Exist
“I thought I had migraines, but later found out neck strain caused these headaches!”
Primary headache disorder is a term used to represent several different types of headache syndromes, including migraines, tension-type headaches, and trigeminal/autonomic “cephalgias”. Other types of headache disorders may be triggered by trauma or musculoskeletal conditions.
While the various types of headaches can present similarly, there is often a characteristic pattern of onset or stereotypical pain characteristic associated with specific syndromes. Even though some headache treatments may work for multiple headache types, distinguishing between different syndromes is important, as some triggers and treatments may be specific to headache type.
When Do I Need to Call 911?
It felt like someone just hit me with a hammer and the pain wouldn’t let up…”
While most headaches are benign, some severe headaches or ones accompanied by other symptoms, require immediate medical attention. You should immediately activate emergency medical services (EMS, or 911) if you or someone you know are having these headaches:
- New, severe, and sudden in onset, as if you were just struck by lightning and have the worst headache you have ever felt
- Headache with fever, stiff neck, or confusion
- Accompanied by seizure (in a patient who was not diagnosed with Epilepsy)
- New onset in a pregnant woman
- New onset and frequent in a child
- Headache accompanied by other symptoms, like:
- slurred speech
- difficulty coming up with words
- difficulty understanding others when they are speaking to you
- weakness of a limb or side of the body
- numbness of a limb or side of the body
- coordination changes
- loss of consciousness
What Triggers Headaches
“Every time I smell strong perfume its like my head starts throbbing…”
As alluded to, headaches can be triggered by numerous factors. One of the first things your headache specialist is likely to do is review your headache history and medications to determine if there are identifiable patterns associated with your headaches. Some of the questions that might be asked include:
- Do they occur when your sleep routine has been interrupted?
- Do they occur during a certain time of day?
- Are they more common after consuming a specific food or beverage?
- Do they occur after certain activities?
- Do you take pain medication for headaches regularly, only to have the headache return several hours later necessitating taking additional pain medication?
- In women of childbearing age, do headaches occur during a certain time of the menstrual cycle?
Sometimes managing headaches can be as simple as avoiding a specific trigger, modifying certain activities, or by making a dietary adjustment.
Treatment Options for Headaches
When dietary or lifestyle modification are not effective or are not an option, medications, both over the counter and prescription, are often used for headache management. Depending on how frequent and severe your headaches are, this may involve recommending or prescribing an “abortive” medication (a medication intended to treat a headache as it is occurring), a “prophylactic” medication, (a medication intended to reduce the frequency or severity of your headaches), or a combination of both. In some types of chronic migraine headaches, botox injections can be an effective means of treatment.
For certain types of headaches, or in headaches that have not responded to more traditional treatments, sometimes interventional approaches are required. Physical therapy or dental evaluation might be recommended if headaches are felt to be related to a musculoskeletal condition of the neck or jaw. In some instances, interventions such as relaxation training, cognitive-behavioral therapy, or massage therapy may be found to be effective additions to headache management strategies.
Why Come to LCMC Health Neuroscience Institute
With so many different types of headaches, and with the ever-increasing number of treatments for headaches, there is no “one size fits all” approach. Here at LCMC, our headache specialists will work with you to eliminate possible triggers, identify potential dietary and lifestyle modifications, and work to tailor a treatment plan to achieve the best headache control possible.