Health Guide: Headache
Overview
Headaches are symptoms that we feel severe pain in some parts of the head or even the back of the neck. Medical researches show that headaches can be divided into different types and caused by different reasons. While painful and annoying, the majorities of headaches do not indicate a serious disorder and, in non-chronic cases, may be relieved by medicines and/or changes in lifestyle.
Types of headache and related causes
The most common headaches are probably caused by tight, contracted muscles in your shoulders, neck, scalp, and jaw. These are called tension headaches. They are often related to stress, depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to them. Headaches can be triggered by chocolate, cheese, and monosodium glutamate (MSG). People who drink caffeine can have headaches when they don't get their usual daily amount.
More causes include:
•   Holding your head in one position for a long time, like at a computer, microscope, or typewriter
•   Poor sleep position
•   Overexerting yourself
•   Clenching or grinding your teeth
Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight and sore. The pain is usually persistent, but does not get worse with activity.
Migraine headaches are severe headaches that usually occur with other symptoms such as visual disturbances or nausea. The pain may be described as throbbing, pounding, or pulsating. It tends to begin on one side of your head, although it may spread to both sides. You may have an "aura" (a group of warning symptoms that start before your headache). The pain usually gets worse as you try to move around. For more information on this type of headache, see: migraine.
Cluster headaches are sharp, extremely painful headaches that tend to occur several times per day for months and then go away for a similar period. They are far less common.
Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches.
Headaches may occur if you have a cold, the flu, fever, or premenstrual syndrome.
If you are over age 50 and are experiencing headaches for the first time, a condition called temporal arteritis may prove to be the cause. Symptoms of this condition include impaired vision and pain aggravated by chewing. There is a risk of becoming blind with this condition. Therefore, it must be treated by your doctor right away.
The best treatment found
A 'headache' diary is very useful to help your doctor figure out what kind of treatment is most appropriate for your diagnosis.
The easiest way to do this is to write the dates of headaches on a calendar.
Make a note of when the pain started and how long it lasts. Note down any additional factors that seem important such as what has been drunk and eaten, the intake of medicines, daily activities, details about periods if you are a woman, and weather conditions.
It is a good idea to keep up the diary for between one and two months so that any patterns can be identified. By establishing what triggers the headaches, it is possible to learn to avoid factors that cause them.
If you are unable to find a connection it might be a good idea to show the diary to a doctor, who may be able to ask pertinent questions that will help identify a pattern.
While each person will require their own form of treatment, generally over-the-counter pain relievers such as paracetamol (eg Panadol), aspirin (eg Aspro clear) and ibuprofen (eg Nurofen) are quite helpful in relieving the symptoms of tension-like headaches. Prescription medicines may be helpful for other types of headache pain such as chronic migraines.
In migraine, the most effective treatment is an explanation of the problem and identifying and avoiding trigger factors. There are various treatments available for relieving acute attacks, starting with over-the-counter painkillers such as paracetamol or ibuprofen. These are most effective if taken as early as possible into the attack, preferably in a soluble form.
Some OTC medicines designed specifically for migraine also contain an antisickness medicine such as buclizine. If OTC painkillers are ineffective your doctor may prescribe alternative treatments containing different antisickness medicines, stronger painkillers, or one of a group of antimigraine medicines called triptans, eg sumatriptan (Imigran) or zolmitriptan (Zomig).
Your doctor may prescribe a preventive treatment if migraine attacks are especially frequent. The strongest evidence for preventive treatment of migraine is available for sodium valproate (eg Epilim) (unlicensed use) and beta-blockers such as propranolol (eg Inderal LA).
For people experiencing burning sensations in the stomach or for those already diagnosed with a stomach ulcer, NSAIDs such as ibuprofen and medicines containing acetylsalicylic acid such as aspirin should be avoided. Aspirin should not be given to children under 16 years of age, unless on the advice of a doctor.
NOTE: The above mentioned medicines should not be given to children unless you are advised to do so by your GP.
Help by yourself to treat headache
If the doctor has examined you without finding any serious cause for the headaches, these tips should prove helpful:
•   avoid excessive use of alcohol and tobacco.
•   engage in correct posture while sitting and working. The type of chair you use is important. It should be one that maximises comfort and good posture and may need to be adjusted to suit your needs.
•   perform relaxation techniques on a consistent basis.
•   get plenty of fresh air and exercise.
•   some people find that taking the natural herbal treatment Feverfew is very effective at reducing or preventing their headaches occurring. This needs to be taken daily – even if no headache is present – to have an effect. Consult your GP before starting this.
For migraine headaches, symptoms may be reduced by:
•   resting in a quiet room with the lights turned off.
•   avoiding food or drink in your diet that have been identified as having possible factors associated with migraine headaches.
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