Managing Headaches: Causes, Types, and Treatments

There are many different types of headache disorders, some of which are quite serious. Finding ways of managing headaches is essential to your quality of life. Some of the more common types of headache disorders include migraine headaches, tension headaches, and cluster headaches. According to The World Health Organization (WHO) about 47% of adults suffered with at least one headache within the last year, making headache disorders one of the most common nervous system disorders. Headache pain can affect people across all ages, racial background, geographical location, and socioeconomic status. The underlying cause of headaches is not always understood, and treatment often focuses on the symptoms rather than the underlying cause.

Millions of people suffer from headache disorders that can be debilitating in some cases. Luckily there are various lifestyle changes, traditional medicinal options, and alternative treatment options available to headache sufferers to manage symptoms and improve quality of life.

Types of Headaches

While there are numerous headache disorders, the 3 most common types of primary headache disorders include:

Tension headache.

Tension headaches are the most common type of primary headache disorder. They are characterized by a dull, aching pain that is typically located on both sides of the head. Tension headaches can be triggered by a number of factors, including stress, anxiety, fatigue, and muscle tension.

• This is the most common type of headache disorder.
• Usually begin during the teenage years and increase in frequency in the 40’s.
• Women are more affected than men.

Migraine.

Migraine headaches are a type of primary headache disorder that is characterized by a severe, throbbing pain that is typically located on one side of the head. Migraine headaches can be accompanied by a number of other symptoms, including nausea, vomiting, and sensitivity to light and sound.

Migraine headaches are believed to be caused by changes in the levels of serotonin and other neurochemicals in the brain. They can be triggered by a number of factors, including stress, anxiety, fatigue, and changes in estrogen levels.

• Usually start during puberty and then increase in frequency from 35-45 years of age.
• Women are more affected than men.
• Family history of migraine increases the risk of migraine.
• Hormonal changes that occur just before or after menstruation may trigger migraine.

Cluster headache.

Cluster headaches are a rare type of primary headache disorder. They are characterized by severe, recurring pain on one side of the head. Cluster headaches occur in cycles, with periods of remission between attacks.

Cluster headaches often begin at night, and the pain may be so severe that it wakes people from sleep. The pain is typically located behind one eye or in the temple area. Some people may experience a sense of restlessness or agitation before an attack.

There is no known cure for cluster headaches, but there are treatments that can help relieve symptoms. These treatments include medications such as triptans, ergotamines, and corticosteroids; oxygen therapy; and nerve blocks (see more below).

• This type of headache is relatively uncommon (1 in 1000 people).
• Usually affects individuals in their early 20’s.
• Men are more affected than women.
• Family history of cluster headaches, particularly having a sibling or parent with the disorder, increases the risk of cluster headache.
• Smoking is associated with this headache disorder as most sufferers are also smokers.
• Alcohol consumption may trigger a cluster headache.

Cause of Headaches

Tension headaches are typically related to stress; however, they may also be caused by musculoskeletal disorders of the neck and upper back, sleep issues, and eyestrain. A tension type headache often has throbbing pain.

The exact cause of migraines isn’t fully understood; however, environmental and genetic factors seem to play a role. Changes to the brainstem and the way in which it interacts with the trigeminal nerve may be involved. Additionally, brain chemical imbalances, including serotonin and calcitonin gene-related peptide, may also play a role.

The underlying cause of cluster headache also remains unknown. However, abnormalities in the hypothalamus are believed to play a role. This belief is based on the fact that cluster headaches follow a seasonal pattern and occur regularly over the course of 24-hour periods suggesting that the biological clock of the body, located within the hypothalamus, is somehow involved in this type of headache disorder.

Various other factors can increase the risk of headaches including:

• Dehydration
• Hunger
• Over-use of medication.
• Mental health issues including anxiety and depression.

Diagnosing Headaches

Primary headache disorders can often be diagnosed by a doctor after taking a thorough history of patient symptoms. In some cases, imaging studies, such as computed tomography (CT) and/or magnetic resonance imaging (MRI) may be used.

A CT scan or a computed tomography (CT) scan provides an easier way of diagnosing vascular headache by using a standardized method. Clear images of organs such as the head muscle, joint and vein system as well as anomalies like tumors and hemorrhages are possible using contrasting dyes. Symptoms of migraine attacks include increased sensitivity to light and sound, headache, nausea and auras that can cause visual disturbance.

In cases where the headache is believed to be caused by nerve irritation, a diagnostic nerve block may be utilized. During this procedure, a steroid often combined with an anesthetic, is injected into the area of the affected nerve. If the patient reports pain relief following the nerve block procedure, their headaches are likely the result of nerve irritation, inflammation, or damage.

Lifestyle Changes for Headache Management

In many cases, managing headaches and their symptoms can be done by making simple lifestyle changes including:

• Exercise Regularly.
• Maintaining proper posture.
• Taking breaks as needed, particularly when the neck is in an awkward or strained position.
• Learning strategies to cope with stress.
• Getting enough regular sleep.
• Quitting smoking.
• Practicing stress relief methods and relaxation exercises
• Staying hydrated.
• Eating a healthy foods and a balanced diet.
• Minimizing or avoiding alcohol consumption.
• Avoiding medication over-use.

Options For Headache Treatment

Over-the-counter pain relievers and anti-inflammatory medications are often the first-line treatment option for headaches. For severe or persistent headaches, triptans and opioids may be recommended. However, opioids should be used with caution as there is a risk of addiction.

Antiseizure medications including topiramate, gabapentin, and carbamazepine may also be recommended for acute migraine treatment. Learning to identify triggers of migraine headaches may also help to prevent migraines.

A headache diary will help you pinpoint the causes for headache symptoms. You may feel irritable if the headache is causing the pain or the symptoms. Check with a healthcare professional for a possible trigger. Use this information to determine the treatment plan. Understanding your triggers will make it easier to avoid these.

A change in lifestyle can help you manage frequent headaches and other symptoms. You should take the medication daily for optimum effect. Your provider may require that you test several different drugs before identifying the right one for you.

For acute cluster headaches, oxygen inhaled through a mask can provide relief. Triptans, in the injectable form, are also effective for acute cluster headaches. Octreotide is another option but is not usually as effective as triptan medications. Local anesthetics, given intranasally, may help to relief cluster headache pain in some patients. And dihydroergotamine, in the injectable form, may also provide relief from cluster headache.

Complementary and alternative therapies (CAM) are also available for patients with headache disorders. Acupuncture and biofeedback have been found to provide symptom relief for patients with tension headaches. Additionally, massage therapy, physical therapy, and chiropractic manipulation may also help to relieve symptoms of tension headaches as these treatments aim to relieve muscle tension and improve joint function.

Conclusion

Millions of people suffer from headache disorders that can be debilitating in some cases. Luckily there are various lifestyle changes, traditional medicinal options, and alternative treatment options available to headache sufferers to manage symptoms and improve quality of life.

Sources

https://www.amjmed.com/article/S0002-9343(17)30932-4/fulltext

https://www.mayoclinic.org/diseases-conditions/cluster-headache/diagnosis-treatment/drc-20352084

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974268/

http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/risk-factors/con-20026358
http://www.mayoclinic.org/diseases-conditions/tension-headache/basics/risk-factors/con-20014295