For headache prevention, identifying triggers is key
- your medications
- sleep patterns
- alcohol intake
- menstrual cycle, for women
- stress levels
- physical problems
- Headaches that first develop after age 50
- A major change in the pattern of your headaches
- An unusually severe "worst headache ever"
- Pain that increases with coughing or movement
- Headaches that get steadily worse
- Changes in personality or mental function
- Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
- Headaches that are accompanied by a painful red eye
- Headaches that are accompanied by pain and tenderness near the temples
- Headaches after a blow to the head
- Headaches that prevent normal daily activities
- Headaches that come on abruptly, especially if they wake you up
- Headaches in patients with cancer or impaired immune systems
Many people suffer from headaches, but it’s important to know what brings them on as well as the symptoms of more severe headaches that may require medical attention
By Lauren Glendenning
Brought to you by Kaiser Permanente
Headaches are one of the most common medical problems, but how do you know when a headache is serious enough to seek medical attention?
“Not everyone experiences headaches, and for some they have several a week,” said Dr. Patricia Dietzgen, Family Medicine Physician at Kaiser Permanente’s Frisco Medical Offices. “For most people, they’re not a serious cause for concern.”
The most common types of headaches are sinus, tension, and migraine headaches. Sinus headaches usually occur when there is infection or pressure in the sinuses, according to Harvard Medical School. Tension headaches strike when the muscles in the head and neck tighten. Migraines come on when super-sensitive nerve endings in the brain create pain.
The causes of headaches aren’t fully understood — there are more than 300 types of headaches but only 10 percent have a known cause, according to Harvard Medical School — but there are common triggers such as alcohol, food additives, hunger, thirst, lack of sleep, or stress, among others.
“Learning lifestyle modifications and how to manage will help alleviate frequency and symptoms,” Dietzgen said.
Symptoms and severity
Tension, or stress, headaches are an everyday-type headache for some people, Dietzgen said. People tense their neck, shoulders, and scalp, and some people also clench their jaw or grind their teeth when stressed.
These types of headaches can feel like a band squeezing and can also be associated with neck pain, neck and upper back spasms, she said. These headaches can be sporadic, but for some people, they occur daily.
Migraine headaches are often accompanied by many other symptoms. Dietzgen said they’re often preceded by what’s called an aura, which can be everything from bright flashing light to decrease in vision.
“Migraines can last up to several days, which is why it is so important to become familiar with your particular migraine pattern, to learn when it will occur so that you can take medication as soon as possible,” she said. “This helps minimize the actual migraine as well as decreases the length of time you have it. Keeping a headache diary will often alert you to migraine and headache triggers.”
Then there are headaches that can result from infection — sinus headaches — which feel like there’s a steady sensation of pressure that’s worse while bending over. They also come with coughing and nasal discharge.
Cluster headaches deliver intense pain that’s usually one-sided around an eye. These headaches can come on suddenly and can happen in “clusters,” such as weeks or months, before resolving, Dietzgen said. One in 1,000 people get cluster headaches, and they’re more common in men than women.
How to treat or manage headaches
Changes in the pattern of headaches, an unusually severe headache, and headaches that come on abruptly are causes for concern.
“Waking up with a headache, or having headache during the night can be worrisome symptoms, and you should see your doctor,” Dietzgen said.
People who take daily medication or too much medication might suffer from what’s called rebound medication headaches and should also see a doctor.
Tracking headache triggers is important for anyone who experiences frequent headaches. Dietzgen advises keeping a headache diary to identify headache triggers and how to avoid them.
“Staying well hydrated with non-caffeinated drinks will also minimize headaches,” she said. “Getting adequate sleep and correct posture are also important.”
Headache warning signs that need immediate medical attention include sudden severe headaches, “thunderclap headaches,” persistent headaches, and headaches accompanied with facial paralysis or limb paralysis.
“These are emergent and should be evaluated at the emergency room,” Dietzgen said.
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