Headaches, a real pain above the neck
Headaches. Most of us have had them at one time or another. A few of us, however, suffer from one of the most severe and often disabling types: migraines.
As many as 45 million Americans suffer from recurring headaches; 28 million of these sufferers have migraines. Looking at our children, it is estimated that as many as 20 percent of them have significant headaches of some type. That’s a lot of headaches!
The word “migraine” comes originally from the Latin term “hemicrania,” which was used to describe a blinding pain occurring at regular intervals, usually in one half of the head. The word was changed into the low Latin word “hemigranea,” which later became migraine. While over 150 types of headaches have been described in the medical literature, migraines sit in the number two position in terms of frequency. If we look at recurring headaches, migraines jump to number one.
In our top five countdown, which have you had?
1) Tension headaches: These are caused by muscular contractions in the scalp and neck. They tend to come on slowly and progressively, and go away the same. They rarely have other associated symptoms, although nausea and photophobia (a worsening of the headache by bright light) may be present.
2) Migraine headaches: Originally thought to be strictly due to vascular contraction and dilatation, we now know there are a variety of brain chemicals involved. These headaches are moderate to severe and last from hours to two-three days. They often are preceded by an aura or abnormal sensory experience. This might include flashes of light or other visual changes, abnormal smells or even muscular weakness. While 60 percent of migraines are unilateral (one sided), the rest may affect the entire head. Nausea, vomiting and photophobia are common. These headaches may impair the ability to do routine things.
3) Sinus headaches: These are associated with sinus infection or congestion, although the headache may be more severe than the perceived sinus symptoms. They frequently occur in the front of the face above or below the eyes. The upper teeth may ache, even causing a trip to the dentist. Rapid head movement, especially bending over, usually intensifies the symptoms.
4) Hormonal headaches: Occurring only in women (or I’d be writing for one of the tabloids!), these are caused by fluctuations in estrogen and other female hormones. They are usually associated with menstruation and may go away with menopause.
5) Mixed headaches: Yes, it is not uncommon to have some combination of the above symptoms and may even include all of the above.
So what to do?!
n If your headaches are persistent, recurrent, don’t improve with over-the-counter medications or are associated with other symptoms, see your doctor. Rarely an underlying problem may be found, or you might require prescription medications.
n Avoid excessive alcohol or caffeine. If you’re not sure if you’re consuming too much, you probably are! At the same time, don’t discontinue caffeine abruptly or you may get caffeine withdrawal headaches!
n Relax! Much easier said than done! Stress and anxiety are frequent headache triggers. Learning relaxation techniques, exercise and personal time are all important to our health.
n Keep a diary. Track activities, food, associated symptoms and the overall timing of your headaches. Knowing these things as well as what makes them worse and better may help you and your doctor find the cause.
n Try over-the-counter medications in recommended doses. If you need more, you’re at risk for side effects or ignoring a more serious problem. If you need medication more than two out of seven days, it is also a sign you should see your physician. Too much medication can cause rebound headaches, which are among the most difficult to treat.
n There are a variety of new and experimental drugs being used for headaches, especially migraines. Even botox has been used experimentally with success! Don’t give up if “nothing ever works.” There may be something new for you.
Remember, your health is your responsibility. Health is our greatest asset and it doesn’t happen by accident. If something doesn’t seem right, or questions are left unanswered don’t wait, call your doctor.
Dr. Drew Werner writes a weekly column for the Daily. Write him c/o Editor, Vail Daily, by e-mail to firstname.lastname@example.org or P.O. Box 81, Vail, 81658.