Headache

There are many different causes of headaches, including hormones, stress, hunger, lack of sleep, smoking or frequent use of commonly used pain medications like aspirin and acetaminophen. Some people suffer migraine headaches after eating foods high in tyramine, such as aged cheeses, smoked fish, cured meats and some types of beer.

Everyone gets a headache now and then. But if your headaches are frequent or severe and start to affect your life or your work, it’s time to seek help.

Overview

Symptoms

There are several different types of headaches with different headache symptoms. A tension headache may cause mild to moderate pain that:

  • Is band-like around the forehead or back of the head and neck
  • Affects the front, top or sides of the head
  • Usually begins gradually
  • Can last anywhere from minutes to days

A migraine headache may cause moderate to severe pain that:

  • Is pounding or throbbing
  • Affects the whole head or moves from one side to the other
  • Can last from a few hours to a few days
  • May be accompanied by nausea, vomiting, light sensitivity, dizziness, fatigue and changes in vision

A cluster headache may cause intense pain that:

  • Is throbbing or constant
  • Is located behind one eye or in the eye region
  • Lasts for minutes or hours, but may recur multiple times a day 
  • Occurs regularly, often at night

A sinus headache may cause pain that:

  • Is deep or constant
  • Is located in the cheekbones, forehead or bridge of the nose
  • Gets worse with sudden head movement
  • Occurs with other sinus symptoms

Diagnosis

To help your doctor with a headache diagnosis and developing a treatment plan for the type of headaches you are having, keep a headache calendar or diary. 

Write down when you get a headache, how bad it is on a scale of 1 to 10, and what you took to help the pain.

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Treatment Options

Depending on your diagnosis, your doctor may prescribe medication or recommend lifestyle changes for your headache care. 

Preventive medications are used to reduce the number and severity of headaches. Acute medications are used to stop a headache as soon as possible. Rescue medications are taken when the acute treatment doesn't work.

If your doctor prescribes a medication for your headaches:

  • Try to keep current with refills. Having medications on hand avoids having to scramble for refills during an acute headache attack.
  • Treat headaches early and aggressively.
  • Do not take immediate-relief medications for more than two days per week or else rebound headaches may occur. Your doctor may recommend that you take your preventive medications on a daily basis.
  • Treat nausea aggressively. A prescription medication called Reglan (metoclopramide) is usually the best choice. Even if you do not have nausea, Reglan allows headache medications to be absorbed better, especially if taken 15 to 20 minutes before the other headache medications. Reglan should be taken at the first sign of a serious headache.

There are things you can do to lower your risk of getting a headache:

  • Stick to a regular schedule. Try to eat, sleep and wake at approximately the same time each day.
  • Try to identify headache triggers (food, alcohol, prolonged hunger, sleep deprivation, etc.) and avoid these triggers whenever possible.
  • Learn acupressure (finger acupuncture) for headaches. It is simple and often effective for mild to moderate headaches. 
  • Make an effort to reduce stress in your life. Learn and practice relaxation techniques, such as deep breathing or imagery. Biofeedback can be very helpful for headache sufferers.

Discuss associated medical conditions, such as depression, anxiety, insomnia and substance overuse/abuse (nicotine, alcohol, caffeine), with your doctor. Successful headache treatment requires that these associated conditions be treated effectively.

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