Your Treatment Depends On Your Headache

Oh no, there is that headache pain again!  To combat the pain, you will need to discover what headache you have.  Headaches may be a symptom of a major disease or condition and your doctor will want to rule out those possibilities before discussing methods of treatments.

Your treatment will be decided on which headache you are experiencing.  The most common type of headache is caused by stress or tension.  They may feel like you have a tight rubber band around your skull.  Eyestrain or a quirky movement of your neck may also cause tension headaches.  Tension headaches can last up to three hours but last about 15 minutes.  Women experience tension headaches more than men and they can be treated with aspirin, acetaminophen, or ibuprofen.

If your headache is severe, your head is throbbing and is nausea and vomiting it probably is a migraine.  Migraines can be affect one side of your head and can last up to 72 hours.  Usually a migraine will affect only one side of the head.  Migraines are experienced more often in women.  If your headache is diagnosed as a migraine, you may need a prescription medicine to treat it.

Lying down in a dark room and putting hot or cold compresses where the pain is found can ease migraine pain.   You may also try a gentle massage and a small amount of caffeine.  A migraine may intensify with normal routine activity.

Another form of headaches is called cluster headaches.  These headaches occur off and on for several weeks at a time.  Typically the pain starts abruptly and without warning.  It normally reaches the maximum pain level within a few minutes.  These will affect one side of your head and often you will have a runny nose and a red, watery eye with it.

Cluster headaches happen repeatedly for several months and many patients report having one or more headaches every day.  This headache usually will only last for about 15 minutes but can last up to 3 hours.  Patients with cluster headaches usually do not feel relief by lying in a dark, quiet room.  They pace or rock their body to help ease the pain.  Cluster headaches only affect about one percent of the population and cannot easily be treated with over-the-counter drugs.  Prevention is the best treatment for cluster headaches.

If you have a headache nearly every day, daily chronic headaches might be your diagnosis.  Chronic headaches affect a small portion of the population and you should contact your doctor.  They may be a sign of a more serious problem.  If no other serious problem is found, you should concentrate on preventive means of stopping these headaches.

If you are taking pain medications for headaches more than three days a week they could be caused by medication you are taking.  A dull and throbbing pain often is a signal that you have taken too much medication for another pain.  You might find that this headache will be more severe in the morning and fade away as the medication wears off.

Your First Visit to the Doctor’s for a Migraine

As you prepare for your first doctor’s visit to be diagnosed with migraines or to seek treatment it will be helpful if you have been keeping a migraine journal. A migraine journal details each migraine and the events or circumstances that preceded them.

Things you should write down in your migraine journal:

The date of each headache

The time of day/night that the headache started

If a female were you experiencing a menstrual cycle when the headache hit?

Describe the type of pain and the intensity of the pain. Was it aching, dull, piercing, excruciating, throbbing, or squeezing in nature?

Record any other symptoms you experienced at the time of the headache such as nausea, vomiting, dizziness, head or neck muscles that were tense or that were tender, and were your hearing, eyesight or touch affected in any way?

Describe the location of the pain. Was it one sided, on both sides of your head, in the back of your head or in the front of your head? Was it over one or both eyes? Did you feel it behind one or both eyes?

How long did the headache last? Did it last for one hour, a few hours, or a couple of days?

Were you taking any medications at the time of your headache?

Have you taken any headache medications, either over-the-counter or prescription?

Have you taken any natural remedies for the headaches?

Have any drugs or remedies worked?

Where were you when the headaches started? Were you at home, at work, school, outside?

Do you get headaches during sexual activity?

Were you experiencing stress or an emotional situation before or during the headache?

What was the weather like when the headache started? Was it stormy, dry, hot, cold?

Do you recall if you were exposed to odors like strong cooking odors, perfume, chemicals, or smoke?

Did you skip a meal or had you just eaten? If you have eaten, what did you eat?

Had you been exercising or straining in any way physically?

Did you suffer any head trauma such as a fall, bump of any kind?

Record all food and drink 24 hours prior to the headache.

Record if any other family members have ever been diagnosed with migraines.

Tests your doctor may order:

Your doctor will need to see any records of past headache history, diagnostic studies that were performed by other medical professionals, and your general medical history.

Your doctor may schedule blood chemistry and urinalysis tests that will determine if you have any other medical conditions, rule out thyroid problems or infections, which may be the cause of your headaches.

You may be asked to undergo a CT scan, which is a computerized tomography. You may also have to have a MRI, which is a magnetic resonance imaging scan. These scans will be able to tell if you have a sinus problem, or if you have a tumor or have had a stroke. These scans can also show any skull fractures, malignant diseases, concussions, hematomas and other causes of headaches.

Your doctor may order a lumbar puncture (spinal tap), sinus X-ray, or neurological and ophthalmology tests.

Who Are At Risk For Spinal Headaches and What Can Be Done About Them

There are several medical procedures that can put individuals at risk for spinal headaches. These medical procedures include a spinal tap also called a lumbar puncture, having spinal anesthesia given to you before an operation or like in having an epidural while in labor.

These medical procedures require that a puncture be placed into the tough membrane that surrounds the spinal cord. When someone has a spinal tap, a sample of the fluid that surrounds the spinal cord is withdrawn. This fluid is called cerebrospinal fluid. When someone is having spinal anesthesia before a surgical procedure or to relieve the pains of childbirth, a medication is injected into the spinal canal in order to numb the nerves in the lower half of your body. When spinal fluid leaks out through the tiny puncture site during the procedure, the leakage of fluid may cause you to have what is called, a “spinal headache”. This type of headache is also called a “post-lumbar puncture headache”. Usually these headaches resolve on their own without any medical treatment. If the spinal headache lasts longer than 24 hours, you should seek medical treatment for the headache. One thing that you can do to immediately relieve the spinal headache is to lie down flat.

The spinal headache can vary in intensity from mild to severe enough to be incapacitating. The headache usually worsens when you sit up or stand. The pain will decrease if you lie down.

Other symptoms you may have besides the headache are:

Dizziness

Nausea

Visual changes

Ringing in the ears

The spinal headache happens because when the spinal fluid leaks out it causes a decrease in the pressure exerted by the spinal fluid on the brain and spinal cord. This decrease in pressure leads to a headache.

The individual will usually first feel the spinal headache within 12 to 24 hours after the spinal procedure.

Typically when receiving an epidural anesthesia the injection is given outside the membrane so technically a headache should not result BUT if the technician giving the epidural accidentally punctures the membrane, than fluid can leak out and a headache result.

Spinal headaches are more common in women than men, and in those who are between 20 and 40 since they are the ones typically having spinal punctures and epidurals for childbirth. Anyone male or female, young or old can have a spinal tap as it is used to diagnose certain diseases such as meningitis.

You should always tell your doctor if you experience a headache after receiving a spinal procedure, especially if you notice any of the above symptoms. When calling the doctor remind them that you had a recent spinal procedure done. Your doctor will ask about the duration and intensity of your headache and when it started. Usually all that is needed is an exam. Some doctors will know what it is as soon as you tell them about your spinal procedure.

Treatment for a spinal headache is to lie flat on a bed or other flat surface, to rest and take oral pain relievers. If the headache does not improve after taking this measure and within 24 hours the doctor may decide to give you an epidural blood patch. This is when a small amount of your blood is injected into the space over the puncture hole in order to form a clot to seal the hole, which will restore the normal pressure in the spinal fluid and bring you relief from your headache.

Sometimes caffeine is delivered directly into your bloodstream, because caffeine relieves spinal headaches within just a few hours. Caffeine constricts the blood vessels within your head. Haven’t we all dreamed of having a caffeine drip when we are overly tired?

Sometimes the doctor will inject saline solution into the space outside of the membrane that covers the spinal cord in order to put pressure on the lumbar puncture site and therefore stopping the cerebrospinal fluid leak that is causing the spinal headache. This treatment is not always successful because the body absorbs saline quickly so your headache may return.

When To See A Doctor About Your Headache

When To See A Doctor About Your Headache

Your headaches may be a signal that something else is wrong with your body.  Do you know the signs to look for that signals you need to contact your doctor?  You need to recognize these symptoms and be prepared to seek emergency care or make an appointment with your doctor for diagnostic tests.

You should ask yourself the question, “do you have headaches every day?”  If you have headaches more than 15 days during a month you may be diagnosed as having chronic daily headaches.  The pain you feel is a steady pain on either or both sides of your head.  Patients describe their pain as a dull, aching pain, or as if a rubber band is putting pressure on their head.

This chronic headache affects nearly five percent of adults.  Usually there is no underlying condition or disease present so treatment needs to focus on preventing these headaches.  If you are having headaches this many times a month, you should see your doctor.

If you need to take pain medication for headache pain more than two or three times a week, the problem may be caused by medication overuse.  Rebound headaches are dull, throbbing and pounding, and achy.  You may have it when you get up in the morning and it may stay with you through the day.  People who have migraines or stress and tension related headaches might be at risk for having rebound headaches from taking too much medicine.  If you are having rebound headaches, you might try reducing the medication that is causing the headaches.

Severe headaches and migraines may follow a specific activity.  Activities such as intense exercise, sex or even a bout of coughing can cause a headache.  If your headache is from overexercising it can last from a few minutes to a couple of days.

If your headache is a sex headache, it will normally occur at the point of orgasm and last for a few moments.  Sex headaches are caused by blood pressure change in your body because of sex.  It may be more serious if it last for a couple of hours.

When your headache follows a certain activity they usually don’t last long and treatment and does not call for treatment.  Usually an anti-inflammatory drug will take care of the problem.  If it happens more often or become more serious, a doctor should be consulted.  A doctor may recommend tests to see if there is an underlying cause and prescribe some medications for preventing them if possible.

You should know when you need emergency care!  If your headache comes on suddenly and is severe it may need emergency care.  If you have a fever associated with the headache, a stiff neck, difficulty speaking, or numbness in your body, this could be the onset of a stroke or other serious disease.

Emergency care is needed if you get a headache after a fall, bump, or other head injury. You may be experiencing a concussion or bleeding that should be treated immediately.  And, if your pain gets worse after you have taken an over-the-counter drug or have rested, it may be a sign of something more serious.

What You Need To Know About Migraines

A migraine can disable you with symptoms so severe, that you are unable to function. Migraines are painful and may be accompanied by other signs and symptoms including nausea, vomiting, and extreme sensitivity to light and sound. Migraine can be so severe as to incapacitate you for hours or even days.

The treatment for migraines has improved over the years.

How do you know if what you are experiencing is a migraine or not?

When you are experiencing a migraine you may have one or several symptoms such as a moderate to severe pain that is confined to one side of your head or it may be on both sides of your head. The pain pulsates or throbs. The pain gets worse if you try to do a physical activity. The pain will interfere with your ability to perform your regular activities. You have nausea and perhaps vomiting too. You are sensitive to light and to sound.

If you do not treat the migraine it can last anywhere from 4 to 72 hours. Some individuals have migraines several times a month and others have one just once or twice a year.

Some people experience migraines with auras and others do not experience migraines with auras. If you do experience auras before a migraine set in, you will notice that the aura appears about 15 to 30 minutes before the headache begins.

An aura may be like sparkling flashes of light, dazzling zigzag lines that enter your field of vision or you may experience slowly spreading blind spots in your vision. You may feel a tingling, or pins and needles sensations in one arm or leg. Rarely individuals who experience auras report weakness or language and speech problems.

Sometimes individuals will get a feeling or premonition that they are about to have a migraine a day or two before the headache starts because they experience feelings of elation or intense energy, crave sweets, become very thirsty, become drowsy or irritable and some go into a depression just before a migraine. Not all migraine sufferers experience premonitions or auras.

The migraines that children get tend to last a shorter period of time. The pain can also include nausea, vomiting, lightheadedness, and an increased sensitivity to light. They can also have all the signs and symptoms of a migraine but not have the head pain. It is important to talk to your child’s pediatrician if your child is suffering from frequent headaches so that a diagnosis can be made and treatment started.

What is a Sinus Headache?

Sinus headaches will accompany sinusitis. Sinusitis is a medical condition in which your sinus membranes become swollen and inflamed.

The signs and symptoms of a sinus headache are pain and pressure or fullness experienced in your cheeks, brow or forehead. The pain may worsen if you bend forward or lie down. You may notice yellow-green or blood-tinged nasal discharge. Your throat may be sore and you may have a cough. You may have an elevated body temperature and feel fatigued.

Individuals often confuse sinus headaches with tension headaches or even migraines as the symptoms are similar. Individuals who have sinus headaches usually do not have the nausea or vomiting or sensitivity to light those migraine sufferers will have.

A sinus headache can be preceded by a cold, by allergies, or a bacterial or fungal infection. Individuals who have impaired immune systems, or structural problems in the nasal cavity may have frequent sinus headaches. Pressure changes can also trigger a sinus headache.

Risk factors for sinus headaches, especially chronic sinus headaches are those who have asthma, those who have nasal growths also called polyps, those who are allergic to dust, mold or pollens, and those with a weakened immune system. Individuals who have conditions that affect the way mucus moves through the respiratory systems, such as those with cystic fibrosis are also prone to sinus headaches.

You will need to seek medical attention if your symptoms last longer than 10 days, you have a severe headache, or over-the-counter pain medication does not help to relieve the pain or if you have a fever that registers greater than 100.5 F (38 C).

It is not always easy to determine if what you have is a sinus headache or another kind of headache. Your doctor will ask you questions about your symptoms and duration of the headache. The doctor will perform a physical examination of your nasal passages and may press down on your sinus areas of your face to see if there are any tender areas. The doctor may use an endoscope to look up into your nasal passages with a light. The doctor may order a CT or MRI scan.

If the doctor diagnosis’s sinusitis and the cause of your headache is a sinus headache, you will be given medication to take. It is important to take the medication as prescribed for the entire period of time it is prescribed for in order to completely clear up your condition. You may be given a prescription for a nasal spray. As the sinus infection clears up your sinus headache will go away too.

When you first notice the symptoms of a sinus headache it may help to drink lots of water, use over-the-counter pain relievers, decongestants and saline nasal spray.

If your doctor determines that the cause of your sinusitis/sinus headache is a structural problem in your nasal passages, you may be recommended for surgery to correct the condition.

You can prevent sinus headaches by washing your hands with soap and water to avoid upper respiratory infections that may turn into sinusitis. It may be helpful to receive a flu shot every year, ask your doctor about this preventative method.

It is important to avoid substances that irritate your sinuses such as cigarette smoke, cigar and pipe smoke, and air pollutants including perfumes and pollens. It may be helpful to use a humidifier so that moisture can be added to dry indoor air and help to prevent sinusitis. To not get your indoor humidity too high though as that will promote the growth of mold and dust mites in your home. If using a humidifier you must make sure that it is clean and that it is free of mold.

What is a Migraine Headache?

Migraines are more intense than tension-type headaches or simple headaches. Migraines can be mild or severe. They are typically felt on one side of the head, and are not life threatening. A migraine attack usually involves more than just a headache it can also include symptoms such as nausea, vomiting, light and sound sensitivity. Statistics say as many as 28 million Americans suffer from migraine headaches. Kids, teens, adults and seniors can suffer from headaches. Migraines can occur in males or females. Migraines can occur in various family members.

Common migraine symptoms:

Moderate to severe pain that is usually of a throbbing nature and on one side of the head

Nausea

Vomiting

Visual disturbances called “auras”

One to three headaches attacks each month

Other migraine symptoms that may be felt are:

A loss of appetite

Sensations such as feeling warm or cold

Paleness of skin

Fatigue

Dizziness

Diarrhea

Rarely fever

To be diagnosed with migraines you may see your normal medical doctor or you may see a neurologist, or possibly a headache specialist.

You will be asked about your medical history, family history especially any family history of migraines, and your personal headache history.

You may be asked to take some tests such as blood or urine tests, and scans (CT, MRI).

Migraine treatments:

Treatment options are different for each migraine sufferer. There is no one pat treatment for migraines.

Your doctor may put you on a prophylaxis (prevention medication)

One commonly used prophylaxis is TOPAMAX® (topiramate).

Your doctor may also put you on acute migraine pain relief such as AXERT® (almotriptan malate).

Pain relief therapy relieves not only the pain of the headache but also the nausea and other migraine symptoms. Most pain relief therapy works within 2 hours of treatment.

Relaxation techniques may also help to relieve the pain of migraines.

What Causes Your Headaches?

Scientists are still not sure what cause or multiple causes may be at the root of your headaches; they thought they understood it until recent findings. They now believe that both tension and migraine headaches have the same origin in the brain.

Did you know that you have an “anti-pain system” in your brain? It is located behind the eyes and nose, in the brain stem. What this center does is to respond to an incoming nerve signal of pain with a powerful pain-relieving effect. A nerve called the “trigeminal nerve”, is located in the brain stem too, and is thought to be where the pain of a headache originates. This nerve is the biggest one we have in our head and carries sensory impulses to and from the face. It can release a burst of neurotransmitters (chemicals that pass impulses from nerves). This transmission of impulses from nerve to nerve stimulates serotonin, which acts as a filter, screening out all of the weaker or repetitive impulses and admitting signals that are important. The more serotonin released the greater the screening action becomes. A high serotonin level correlates with sleep. When pain signals from the trigeminal nerve increased serotonin levels are initiated. It is thought that those who suffer headaches have low levels of serotonin. Scientists found out that when these individuals were injected with serotonin, the headaches go away.

There can also be underlying conditions for the headaches you experience such as when you have a common cold, flu, fever, ear infection, too infection, sinus infection, pneumonia, measles, mumps, tonsillitis, sinus blockage, or from coughing too much and getting a traction headache.

There are also lifestyle causes for headaches such as when you have a hangover from drinking too much, headaches from stress, or from fatigue. Headaches caused by tension, or from being over-tired. You can also get headaches from excessive smoking.

Eye conditions like glaucoma and eyestrain can cause some people to have headaches.

Certain medical procedures can lead to headaches such as having a spinal tap procedure done and having a headache afterwards as a result of spinal fluid leakage. The same is true for having an epidural, it can cause damage to the spinal area and cause headaches.

Certain systemic or metabolic conditions can have headaches as symptoms such as hypertension, thyroid disease, anemia, kidney failure, uremia, lead poisoning, and also various toxins can cause headaches.

Brain or head conditions can also lead to headaches such as meningitis, encephalitis, head injuries, brain injuries, concussion, and temporal arteritis, having heatstroke or sunstroke. Blood clots in the brain, can lead not only to stroke but the headache that can be a warning sign of stroke. A brain aneurysm can be heralded by a severe headache. If you have a brain tumor you can experience headaches.

What Causes Nighttime Headaches?

People over the age of 50 often report waking up from a sound sleep with a headache.  These are sometimes called alarm headaches and happen during the night or sometimes during an afternoon nap.  Often the patient does not experience headaches during the day.  Sometimes they happen at the same time every night that is why they are called “alarm” headaches.

Pain from these headaches can be mild to severe and can last anywhere from a few minutes to several hours.  Doctors are unsure of the cause of these headaches.  The headaches are called hypnic headaches and can be caused several factors.  A doctor can diagnose hypnic headaches with the patient’s medical history and other signs.

There are treatments for “alarm” headaches.  They include having a small dose of caffeine before going to bed, using a prescribed medication, and using an anti-inflammatory medication.  Be careful of the dosage of caffeine you take before bedtime.  It could reduce the headaches by not allowing your body to fall asleep!

If your headaches happen while you are sleeping you should see your doctor immediately.  It may be a symptom of something more serious.  Cluster and migraine headaches can occur during sleep but rarely do they appear while you are sleeping.

There are other causes of nighttime headaches and some of them are serious.  Sleep apnea is a serious problem that causes headaches during sleep.  A machine may be indicated to check your sleep habits.  Sleep apnea is a dangerous problem if left untreated.

Another cause of nighttime headaches is an inflammation of the arteries in the head.  This is a serious problem that could lead to stroke.  Nighttime headaches may be a warning sign you need to take seriously.  Bleeding in the surface of the brain is another serious medical emergency.  Nighttime headaches may also suggest a brain tumor.

Nighttime headaches often are found in adults over 50 who are in good health with no other medical conditions.  Treatments for nighttime headaches are similar to what you would do if you had a headache during the day.  You may try tried-and-true over-the-counter medicines such as ibuprofen, aspirin, and acetaminophen.  Gently massaging the area of the headache may help ease the pain.  Small amounts of caffeine may also help.  You can experiment with a hot or cold compress on your neck and head.

Avoid stimulation before you go to bed and extreme amounts of caffeine.  Do not perform any physical exercise two hours before you retire for the night.  Take a soothing bath, read, and turn off the television at least half an hour before you go to bed.  These will not only help you sleep but will also reduce the risk of having nighttime headaches.

As with any medical condition, if the symptoms are recurring or nothing helps, consult your doctor.  They can exclude the other serious medical condition and begin to find the treatment for your nighttime or “alarm clock” headaches.  Do not be too concerned about nighttime headaches, but have them checked out if they recur often.

What Are Rebound Headaches?

A cycle of reoccurring headaches is known as rebound headaches. The cycle begins when you take too much headache medication. You take more than the label instructions say to take and then before you know it your body adapts to the level of medication and your head starts to hurt more intensely than previously. The only way to stop the cycle is to start reducing the amount of pain medication or to stop taking the pain medication all together. Ask your doctor for help if you suspect that you may be having rebound headaches.

What are the symptoms of rebound headaches?

Rebound headaches are associated with the overuse of pain medications, so the first symptom is that you are using pain medications more than 2 to 3 times a week on a consistent basis or you are taking a higher dose than is prescribed or directed to take on the bottle.

You have headaches everyday, even waking you up.

The pain is worse at the beginning of the headache.

The headache is persistent throughout the day.

You may experience nausea, anxiety, restlessness, irritability, and difficulty concentrating.

You may experience memory lapses.

Depression

Difficulties getting to sleep

The cause of rebound headaches:

Just about any pain medication can lead to this cycle of pain med – headache – pain med – headache. There are however some pain medications that are more likely to lead to rebound headaches than other medications will.

Medications such as aspirin, acetaminophen and ibuprofen which are common pain medications that are over-the-counter can lead to rebound headaches when higher than recommended doses are taken.

Pain medications that are the combination kind (contain more than one ingredient) such as caffeine, or are combined with aspirin and acetaminophen such as Excedrin. Prescription medications can be combination medications too such as Fioricet, Fiorinal and Esgic, and also the sedative butalbital.

Migraine medicines are also known to cause rebound headaches. Medications such as Ergomar, Imitrex, and Zomig.

Opiates, which are pain medications that are derived from opium or synthetic opium compounds, also contain combinations of codeine and acetaminophen such as Tylenol with Codeine No. 3 and No. 4.

Rebound headaches can also be caused by drugs such as caffeine as in drinking too many cups of coffee, drinking too many sodas that contain caffeine or any product that contains a mild stimulant may also trigger rebound headaches.