Managing Headaches: Causes, Types, and Treatments

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. Headaches affect people across all ages, racial background, geographical location, and socioeconomic status.

Types of Headaches

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

  • Tension headache.
    • 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.
    • 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.
    • 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.

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. 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, headache symptoms can be managed by making simple lifestyle changes, including:

  • Regularly exercising.
  • 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 sleep.
  • Quitting smoking.
  • Staying hydrated.
  • Eating a healthy, balanced diet.
  • Minimizing or avoiding alcohol consumption.
  • Avoiding medication over-use.

 

 

Treatment Options For Headaches

Over-the-counter pain 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. For migraine sufferers, antiseizure medications including topiramate, gabapentin, and carbamazepine may also be recommended.

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 headaches 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

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