Your Aching Head
Headaches come in several kinds and have many causes. But knowing your own patterns can help you minimize hazardous “triggers” and spend more time pain-free.
Do you ever wonder wake up in the morning with a mysterious headache—and wonder why? Even after a restful eight hours of sleep, the annoying pain thwarts the start of the day. But you look out the window, and now it makes sense: It’s cloudy and rainy; the weather must be to blame.
Weather and fluctuating barometric pressure are indeed associated with some headaches. Other headache “triggers” include stress and anxiety, certain foods and beverages, sleep deprivation and dehydration—and genetics and hormones can contribute to making them more likely. Headache is one of the most common medical complaints, but it can be complicated to manage. In some instances, a headache may indicate something more serious that needs attention.
“Headache pain comes from the release of certain neurochemicals by nerve endings near blood vessels in the protective layers around the brain,” says Farzana Nanavati, M.D., a neurologist with the Englewood Health Network.
“At the same time, nerve receptors in the head become more sensitive, making the pain worse. As for why this happens, that’s still not completely understood.”
For that reason, Dr. Nanavati says, it’s important that we understand the different types of headaches, causes and treatment to help manage them effectively.
WHAT’S AILING YOU?
Headaches divide into two main categories: primary and secondary. “Primary headaches happen on their own rather than being triggered by another condition,” our expert says. Common types include tension and cluster headaches and migraines. The most frequent type, a tension headache causes dull, constant pain, typically across the forehead or the back of the head and neck. A cluster headache is a severe pain that occurs in groups (sometimes multiple headaches a day over some time). These are often accompanied by watery eyes or nasal congestion.
“Migraines can be caused by genetics, hormones, certain foods, weather changes, stress or lack of sleep,” Dr. Nanavati says. “Some start with warning signs like flashing lights or blurry vision before the headache begins. The pain usually affects one side of the head, lasts for hours and can come with nausea, dizziness and extreme sensitivity to light, sound or smells. Even after the headache is gone, many people feel exhausted and have trouble focusing.”
Secondary headaches, on the other hand, are caused by another medical issue such as respiratory infections like the flu, sinus congestion, meningitis, arthritis in the neck or even dental problems such as impacted molars or jaw clenching.
“Most serious causes,” Dr. Nanavati adds, “include brain tumors, aneurysms or intracranial bleeding. Sleep problems like insomnia or sleep apnea can also contribute to headaches. Even frequent use of painkillers for migraines can lead to what’s known as a medication-overuse headache.”
DIAGNOSIS AND TREATMENT
If headaches are frequent, severe or an unusual departure from your norm, “it’s always a good idea to talk to your doctor to determine the cause and best treatment plan,” Dr. Nanavati. says. “If migraines change in pattern, become persistent or come with new or worsening symptoms, it’s time to see a doctor.” Headache sufferers should 43 not to take symptoms lightly, as doctors have seen patients try to work through intense pain, or work through nausea, light sensitivity and aura. These can be signs of migraine that require treatment and attention.
Treatment can vary depending on the type and severity of the headache. For mild headaches, over-the-counter pain relievers such as ibuprofen or acetaminophen can be effective. For more severe cases, like migraines, beta-blockers, calcitonin gene-related peptide (CGRP) antagonist medications, calcium channel blockers, Botox, antidepressants or anticonvulsants may be prescribed.
Dr. Nanavati suggests using painkillers sparingly, however, as their overuse can make headaches worse over time. Other treatments may include acupuncture or physical therapy.
If left untreated, frequent headaches can lead to anxiety, depression, irritability and even subtle brain changes that affect thinking and processing speed, the doctor says. “The good news is that there are now highly effective treatments with minimal side effects,” she adds. “If headaches are interfering with your life, talk to your doctor about your options.”
PREVENTIVE MEASURES
Avoiding headaches altogether is unlikely— everyone gets them—but you can reduce the likelihood of developing one. “Avoiding known triggers is key, especially for migraines,” says Dr. Nanavati. Regular sleep, hydration, stress management techniques (yoga or meditation, for example), reduction of screen time and a balanced diet can help manage headache frequency and severity. In some cases, imaging tests such as an MRI (magnetic resonance imaging study) or CT (computed tomography) scan may be ordered to rule out structural problems or tumors.
Also consider keeping a headache diary to track triggers and patterns. Persistent headaches that you can’t relieve with conventional remedies should be evaluated. If steps like rest, hydration and taking over-the-counter pain medications such as ibuprofen or acetaminophen don’t help after a week, or your headaches keep getting worse, don’t hesitate to discuss the problem with your doctor.
