Headaches are one of the most prevalent and frustrating pains, with as many potential causes as remedies. Whether debilitating or a minor annoyance, headaches are not something that one can easily ignore.
Dr. James Moren of Bellingham is a family physician and a board-certified headache specialist; one of only a few in Washington. A fellow with the American Headache Society, Moren shared his knowledge about the causes and treatments of headaches.
How common are headaches?
About half of all adults get at least one headache a year. Tension headaches, which account for up to 90 percent, are usually treated at home.
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Headaches are not equal opportunity problems. The most common headache presented to a doctor is the migraine, which affects about 1-in-6 women between puberty and menopause. The most common childhood headaches are migraines, with a slightly higher incidence in boys. Meanwhile, men get more cluster headaches than women.
Some sources say there are more than 200 types of headaches, but the main ones are migraine, tension, and cluster headaches.
What are tension headaches?
Most tension headaches are associated with tightness in muscles of the head, face, jaw, or neck. They are shorter in duration than a migraine, and usually don’t involve light sensitivity.
Tension from stress can be helped with counseling, biofeedback, hypnosis, acupuncture, or relaxation techniques, such as yoga with deep breathing. Sometimes, the cure might be finding a new job.
Perhaps 90 percent the world’s population has had a tension headache.
How do I know if it’s a migraine?
Migraines are usually accompanied by sensitivity to light, and sometimes auras or nausea. They can last up to three days and occur in a pattern, such as the week before menstruation.
They usually affect one side of the head and tend to run in families. Several medications are effective for migraine pain.
What is a cluster headache?
Affecting only about 2 percent of the population, and more men than women, cluster headaches are severely painful, recurrent episodes, usually on one side of the head, or relentless pressure behind one eye. A runny nose or drooping eyelid sometimes accompanies it.
The pain might last 45 to 90 minutes, and occur several times a day, often at the same time of day or night and for up to eight weeks a year.
Unlike a migraine, where quiet rest helps, cluster headaches can cause sufferers to pace the floor in agony. Once known as the “suicide headache,” there is now effective treatment for it.
What is a “secondary headache?”
Secondary headaches refer to head pain resulting from another ailment, such as a head or neck injury, high blood pressure, muscle pain, ingestion of some medications, or even fasting or psychological disorders.
What causes headaches?
External triggers include barometric pressure or excessive sunlight. Diet and lifestyle triggers include dehydration, alcohol, chocolate, bananas, even aged cheese.
Internal triggers include stress, hormones, missing a meal, and sleeping too much or not enough.
Depression, anxiety disorders, post traumatic stress disorder and bipolar disorder, coupled with childhood domestic problems or abuse, can increase a person’s susceptibility to migraines.
Rare genetic disorders can also cause headaches.
Are headaches a modern phenomenon?
Headaches have been around as long as humans have. Early humans bored skull holes to free evil spirits within. Other early treatments included leeches and bloodletting.
The noted Greek physician Hippocrates prescribed herbs to induce vomiting. South American slaves were treated by holding an electric eel.
What are the best household cures for headaches?
If you’ve had success before, use what works for you.
If you’re still experimenting, try ibuprofen at 800 mg. Two aspirin, or Tylenol or caffeine, and aspirin and acetaminophen combinations, such as Excedrine Migraine, might work. Caffeine increases the absorption of the medication and has some analgesic properties.
Lie quietly in a dark room and try cold or heat compresses on the neck or head.
When should I see a doctor?
Consult a health-care provider when a headache is unlike any you’ve had before, or is the worst headache you’ve ever had.
Also seek help if you’re over 40 and get a headache for the first time, or if you experience numbness, tingling or vomiting, with or without a headache.
Generally, check with your doctor anytime something doesn’t feel right.
Can everyone be helped?
Most people can get better, but physicians can’t help patients who aren’t honest about their substance abuse, drinking or smoking, or who won’t take the necessary steps to get better. If your doctor can’t help, consider contacting a neurologist or headache specialist.