Headaches

Headaches with an underlying medical condition are classified as secondary headaches because they are related to the condition. An example of this would be a headache due to neck injury or sinus infection.

When the headache itself is the main medical problem, it is classified as a primary headache. Primary headaches may have non-medical causes, such as muscle tension, foods, medications, dehydration, or changing levels of hormones. Factors that influence headaches are sometimes called headache triggers.

The headache specialists at Semmes Murphey Clinic will be able to help you with a specific diagnosis and treatment.

Types of primary headaches include:

Migraines are usually accompanied by symptoms other than pain, such as nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and others.

While migraine experiences may be different for each individual, they usually report these distinct phases:

• Premonition phase: A change in mood or behavior that may occur hours or days before the migraine headache begins
• Aura phase: A group of visual, sensory, or motor symptoms (such as hallucinations, numbness, changes in speech, and muscle weakness) that immediately precede the headache
• Headache phase: A period of the actual headache which may include throbbing pain on one or both sides of the head, sensitivity to light and motion, as well as depression, fatigue, and anxiety
• Headache resolution phase: Pain lessens, but may be replaced with fatigue, irritability, and difficulty concentrating for some, while others may feel refreshed after an attack

Tension headaches

The most common type of headaches is caused by stress and muscle tension. These headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).

While symptoms may differ from person to person, common symptoms of a tension-type headache are:

• Slow onset of the headache,
• Head usually hurts on both sides,
• Pain is dull or feels like a tight band or vice around the head,
• Pain may involve the back part of the head or neck, and
• Pain is mild to moderate, but not severe.

Cluster headaches

Headaches that usually occur in a series lasting weeks or months are called cluster headaches. The headache series often returns every year or two.

While individuals experience symptoms differently, the following are the most common symptoms of a cluster headache:

• Severe pain on one side of the head, usually behind one eye,
• The eye that is affected may have a droopy lid, small pupil, or redness and swelling of the eyelid,
• Runny nose or congestion, and
• Swelling of the forehead.

Diagnosis

A simple historical interview is usually the first step in diagnosing migraines or tension-type headaches. Doctors may follow up with a neurological exam which if normal, no further diagnostic testing may be necessary.

However, if it is not, other tests may be needed to determine the cause, such as:

• Blood tests - various blood chemistry and other laboratory tests may be run to check for underlying conditions
• Sinus x-rays - a diagnostic imaging procedure to check for congestion, infections, or other problems
• Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body
• Computed tomography scan (Also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body

More detailed than general x-rays, a CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.

On the journey toward the ultimate goal to stop headaches from occurring, the first step is the accurate identification of the type of headache. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

Some severe headaches may require immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery.

Many patients have experienced relief through proven headache management treatments. While new medications and treatments are in study phases, today’s headache management options include:

• Avoiding known triggers—certain foods or beverages, lack of sleep, fasting, etc.
• Acute medications - prescribed by your physician and taken after the headache has begun that act on specific receptors in nerves and blood vessels in the head to stop a headache in progress
• Rescue medications - purchased over-the-counter, such as analgesics (pain relievers), to stop the headache
• Preventive medications - prescribed by your physician and taken daily to reduce the onset of severe migraine headaches

• Changing eating habits
• Changing or adding exercise
• Resting in a quiet, dark environment
• Stress management
• Medications, as recommended by your physician

This information was provided by the specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatment.