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Headaches
are a very common medical problem-and a frequent cause of
missed school or work. As painful as a headache can be, it
rarely indicates a serious condition. By age 15, about 75%
of people experience headaches at least once in awhile. The
vast majority of headaches in young adults are vascular (caused
by dilated blood vessels), muscular (caused by muscle contractions),
or a combination of the two.
TYPE
OF HEADACHES
Headaches
are generally classified as tension headaches, cluster
headaches, or migraines.
TENSION
HEADACHE: Tension headaches are by far the most common type.
The symptoms are described as a feeling of constant pressure
or tightness around the head, often like a hatband that is too
tight. Tension headaches typically come on gradually, often
in the morning or early afternoon, and may worsen as the day
goes on. The pain can be mild to moderately severe--with a steady,
dull quality rather than a throbbing sensation. Tension headaches
may last a few hours or continue for several days. Over-the-counter
pain relievers, such as ibuprofen (Advil and others) and acetaminophen
(Tylenol and others), should take care of the pain.
It's
unclear what triggers tension headaches, but stress and fatigue
are believed to play a role. If you suffer from frequent tension
headaches, it may be helpful to keep a headache "diary" to identify
possible triggers. In your diary, record the time of day when
a headache occurs, your emotional state at the time, how much
sleep you had the night before, what you had to eat or drink
that day, and any other potentially relevant information. Reducing
stress, establishing regular sleep patterns, following a healthy
diet, and getting regular exercise may help prevent tension
headaches.
CLUSTER
HEADACHE: Cluster headaches are an extremely painful form
of headache. They are easy to distinguish from other types by
their severity, pattern of onset, and the location and quality
of the pain. Cluster headaches often awaken a person from sleep
(typically between 2 a.m. and 3 a.m.), but they can occur at
any time. The pain is described as excruciating, penetrating,
burning, or "like someone is boring a hole in your head," and
it is centered in or around one eye. During or after the headache,
the eye may weep and appear bloodshot and your nose may run.
These
headaches occur in "clusters"-happening several times a day,
often for several weeks or months at a time, with a headache-free
period before the next bout. Cluster headaches are more common
in men, typically beginning in adolescence or early adulthood.
Over-the-counter pain relievers are not as effective with this
type of headache. If you suffer from cluster headaches, your
doctor can prescribe an effective medication to treat the pain
(such as the anti-inflammatory drug indomethacin). A variety
of other medications may be tried, including a drug called ergotamine,
which may also help prevent attacks. During a cluster, it's
important to avoid alcohol and cigarettes because both can trigger
these excruciating headaches.
MIGRAINE:
Migraines are another extremely severe type of headache-one
that is more common in women. Like cluster headaches, migraines
are easy to distinguish from garden-variety headaches. Many
migraine sufferers experience warning symptoms several hours
or even several days before the headache. During this "prodromal"
phase, the individual may be more sensitive to light or odors
and may experience mood or appetite disturbances and increased
fatigue. Some migraines are preceded by an "aura"-odd visual
disturbances, such as sensations of flashing or bright light
or a reduced visual field. Tingling or numbness on one side
of the face or body also may occur. Women may have more migraines
during their menstrual periods.
The
headache itself comes on gradually--beginning on one side of
the head and spreading to the other--and is described as a pulsating
or throbbing pain. During the migraine, the person may be extremely
sensitive to light and noise and often experiences nausea, vomiting,
chills, and weakness. Migraines may last a day or longer. They
typically end with a gradual easing of pain, sometimes accompanied
by vomiting and then a deep sleep.
If
you suffer from migraines, see a doctor. Several types of effective
medications are available to reduce the severity and frequency
of attacks. The medication ergotamine and related drugs can
halt a migraine in progress. Several prescription migraine medications
are available in nasal, injectable, or suppository form to speed
drug delivery and bring faster relief. Self-help measures are
also very important in managing migraines. A variety of dietary
and lifestyle factors can trigger attacks. The most common dietary
triggers include alcohol (especially red wine); certain cheeses;
chocolate; and foods containing monosodium glutamate (MSG),
nitrites, or nitrates. Stress-reduction and relaxation techniques
also may help prevent migraines. In some women, birth control
pills are a contributing factor.
Although
headaches rarely indicate a life-threatening medical problem,
you should seek immediate medical care if you experience the
following:
-
The
"worst headache of your life" or any extreme headache
that is either your first bout with severe headache or
is different from other headaches you've experienced
-
Rapid-onset
(within a few minutes), excruciating headache
-
Head
pain that arises after a head injury
-
Headaches
with other unexplained symptoms, such as blurred vision,
stiff neck, rash, fever, or loss of consciousness
-
Numbness,
weakness, and visual disturbance in someone who doesn't
have a history of migraine.
-
A
severe headache that intensifies with activity or movement
