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When a Headache Won’t Go Away

The average tension headache — the most common type of headache — lasts about four hours. But for some people, severe headaches drag on much longer, sometimes for several days. And these “never-ending headaches” can even cause anxiety.

“Typically, headaches that are longer than a day and disabling are migraines,” says headache expert Peter Goadsby, a neurologist at the University of California San Francisco. “The median duration for migraines is about a day.” In fact, some migraines can last up to 72 hours, according to the American Migraine Foundation.

Severe Headache and Your Quality of Life

Although a long headache may be tiring and frustrating, it’s likely not fatal, says Dr. Goadsby. “Having an attack that’s longer than a day doesn’t necessarily mean anything dreadful,” he says. But a headache that persists can take a real toll on your quality of life.

For example, migraineurs know that when their headache begins they may lose a day of productive work or family time. According to the Migraine Research Foundation, 90 percent of migraine sufferers can’t work or function during a migraine. Arranging for strategies to deal with that one day might be bearable, but being out of commission for two or even three days can be more difficult. Even the worry over an impending migraine, especially for those whose headaches are long or severe, can interfere with daily life.

Here are some possible causes for a headache that never seems to end:

  • Rebound headache If you’ve been taking a lot of over-the-counter medications to relieve headache pain, you may experience another kind of low-grade headache every time the medication wears off. These kinds of headaches may seem to come and go.
  • Depression It can be a contributing factor to long-term headaches in a number of ways. Generalized aches and pains are often among the symptoms of depression, and depression may also interfere with your ability to maintain a healthy routine, such as getting enough sleep and maintaining a healthy diet, which can help prevent migraines and headaches. A study published in October of 2017 in the International Review of Psychiatry showed that people with migraines were two to four times more likely to develop a major mood disorder in their lifetime.

How to Cope

Here are ways to cope with a headache that never seems to end:

  • Treat the pain. If you don’t have a prescription and are relying on over-the-counter (OTC) medications, follow the dose recommendations carefully. If you find yourself taking these more than two days a week, prescription medication may be a better option. Bear in mind, too, that taking OTC pain medication more than three days per week may trigger rebound headaches. If you have been prescribed a medication for headache or migraine pain, take the amount your doctor has recommended. But check in with your medical team before you take more than the prescribed amount, even if that dose doesn’t appear to be working.
  • Treat related problems. Attend to other health concerns, such as sleep disturbances, and get any needed depression treatment, such as antidepressants.
  • Rest and relax. Sleep disorders and migraine appear to have a bidirectional relationship, according to a paper published in Therapeutic Advances in Neurological Disorders in December 2017. Insomnia is more likely if you have migraines, and migraines are more likely if you aren’t getting enough sleep. Even if you can’t fall asleep, resting and using relaxation techniques may help you feel better.
  • Get the support you need. If your headache lasts for two (or more) days, you may need to enlist some help from family and friends while you recover.

Preventing Long Headaches

The best strategy for headaches is to avoid them if you can. Here are some prevention tips:

  • Maintain a healthy weight. Although being overweight doesn’t cause migraines, it can increase your chances of developing a migraine, according to the American Migraine Foundation.
  • Try preventive medications. Talk to your doctor about medications that can prevent migraines, rather than treating the pain when it comes. While preventative treatments rarely eliminate migraine, they can reduce the frequency and severity of attacks.
  • Avoid triggers. Pay attention to the things that seem to set off a headache. Triggers can include certain foods, drinking too much alcohol or not getting enough sleep. Migraines can also be triggered by change, says Goadsby, so it’s a good idea to stay well-balanced and make healthy choices.
  • Seek depression treatment. If depression or anxiety is a problem for you, therapy may help. Cognitive behavioral therapy (CBT) is an approach that can help with headache prevention and coping. A metanalysis published in the British Journal of Pain in November 2015 showed that CBT can improve some headache-related outcomes.

Though it’s rare, a severe headache can indicate a life-threatening emergency, such as an infection, or bleeding in or around the brain. According to the Mayo Clinic, you should seek immediate medical attention if your headache comes on all of a sudden, appears after an injury, or is accompanied by any of these signs or symptoms:

  • Fever
  • Stiff neck
  • Confusion
  • Seizure
  • Double vision
  • Difficulty speaking
  • Weakness and numbness

Types, Causes, Symptoms, Diagnosis, Treatment

Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different treatments.

Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.

Common Types of Headaches

There are over 150 types of headaches, but the most common types include:

Tension Headaches

Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms.

Migraine Headaches

Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, they may look pale, feel dizzy, and have blurry vision, fever, and an upset stomach. A small number of children’s migraines include digestive symptoms, like vomiting, that happen about once a month.

Cluster Headaches

These headaches are the most severe. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.

They’re called cluster headaches because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. Each headache attack lasts 15 minutes to 3 hours. They can wake you up from sleep. The headaches may disappear completely (your doctor will call this remission) for months or years, only to come back later. Men are three to four times more likely to get them than women.

Chronic Daily Headaches

You have this type of headache 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours. It’s usually one of the four types of primary headache:

  • Chronic migraine
  • Chronic tension headache
  • New daily persistent headache
  • Hemicrania continua

Sinus Headaches

With sinus headaches, you feel a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, like a runny nose, fullness in the ears, fever, and a swollen face. A true sinus headache results from a sinus infection so the gunk that comes out of your nose will be yellow or green, unlike the clear discharge in cluster or migraine headaches.

Posttraumatic Headaches

Posttraumatic stress headaches usually start 2-3 days after a head injury. You’ll feel:

  • A dull ache that gets worse from time to time
  • Vertigo
  • Lightheadedness
  • Trouble concentrating
  • Memory problems
  • Tiring quickly
  • Irritability

Headaches may last for a few months. But if it doesn’t get better within a couple of weeks, call your doctor.

Less Common Headaches

Exercise Headaches

When you’re active, the muscles in your head, neck, and scalp need more blood. Your blood vessels swell to supply them. The result is a pulsing pain on both sides of your head that can last anywhere from 5 minutes to 48 hours. It usually hits while you’re active or just afterward, whether the activity is exercise or sex.

Hemicrania Continua

Hemicrania continua is a chronic, ongoing headache almost always affects the same side of your face and head. Other symptoms include:

  • Pain that varies in severity
  • Red or teary eyes
  • Runny or stuffy nose
  • Droopy eyelid
  • Contracted iris
  • Responds to the pain medication indomethacin
  • Worse pain with physical activity
  • Worse pain with drinking alcohol

Some people also notice migraine symptoms like:

  • Nausea and vomiting
  • Sensitivity to light and sound

There are two types:

  • Chronic: You have daily headaches.
  • Remitting: You have headaches for 6 months. They go away for a period of weeks or months and come back.

Hormone Headaches

You can get headaches from shifting hormone levels during your periods, pregnancy, and menopause. The hormone changes from birth control pills and hormone replacement therapy can also trigger headaches. When they happen 2 days before your period or in the first 3 days after it starts, they’re called menstrual migraines.

New Daily Persistent Headaches (NDPH)

These may start suddenly and can go on for 3 months or longer. Many people clearly remember the day their pain began.

Doctors aren’t sure why this type of headache starts. Some people find that it strikes after an infection, flu-like illness, surgery, or stressful event.

The pain tends to be moderate, but for some people, it’s severe. And it’s often hard to treat.

Symptoms can vary widely. Some are like tension headaches. Others share symptoms of migraine, such as nausea or sensitivity to light.

Call your doctor if your headache won’t go away or if it’s severe.

Rebound Headaches

You might also hear these called medication overuse headaches. If you use a prescription or over-the-counter pain reliever more than two or three times a week, or more than 10 days a month, you’re setting yourself up for more pain. When the meds wear off, the pain comes back and you have to take more to stop it. This can cause a dull, constant headache that’s often worse in the morning.

Rare Headaches

Ice Pick Headaches

These short, stabbing, intense headaches usually only last a few seconds. They might happen a few times a day at most. If you have one, see the doctor. Ice pick headaches can be a condition on their own, or they can be a symptom of something else.

Spinal Headaches

Talk to your doctor if you get a headache after you have a spinal tap, a spinal block, or an epidural. Your doctor might call it a puncture headache because these procedures involve piercing the membrane that surrounds your spinal cord. If spinal fluid leaks through the puncture site, it can cause a headache.

Thunderclap Headaches

People often call this the worst headache of your life. It comes suddenly out of nowhere and peaks quickly. Causes of thunderclap headaches include:

  • Blood vessel tear, rupture, or blockage
  • Head injury
  • Hemorrhagic stroke from a ruptured blood vessel in your brain
  • Ischemic stroke from a blocked blood vessel in your brain
  • Narrowed blood vessels surrounding the brain
  • Inflamed blood vessels
  • Blood pressure changes in late pregnancy

Take a sudden new headache seriously. It’s often the only warning sign you get of a serious problem.

What Causes Headaches?

The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves in your blood vessels and head muscles switch on and send pain signals to your brain. But it isn’t clear how these signals get turned on in the first place.

Common causes of headaches include:

  • Illness. This can include infections, colds, and fevers. Headaches are also common with conditions like sinusitis (inflammation of the sinuses), a throat infection, or an ear infection. In some cases, headaches can result from a blow to the head or, rarely, a sign of a more serious medical problem.
  • Stress. Emotional stress and depression as well as alcohol use, skipping meals, changes in sleep patterns, and taking too much medication. Other causes include neck or back strain due to poor posture.
  • Your environment, including secondhand tobacco smoke, strong smells from household chemicals or perfumes, allergens, and certain foods. Stress, pollution, noise, lighting, and weather changes are other possible triggers.
  • Genetics. Headaches, especially migraine headaches, tend to run in families. Most children and teens (90%) who have migraines have other family members who get them. When both parents have a history of migraines, there is a 70% chance their child will also have them. If only one parent has a history of these headaches, the risk drops to 25%-50%.

Doctors don’t know exactly what causes migraines. One theory suggest that a problem with the electric charge through nerve cells causes a sequence of changes that cause migraines.

Too much physical activity can also trigger a migraine in adults.

Getting a Diagnosis

Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms.

The first step is to talk to your doctor about your headaches. They’ll give you a physical exam and ask you about the symptoms you have and how often they happen. It’s important to be as complete as possible with these descriptions. Give your doctor a list of things that cause your headaches, things that make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem.

Most people don’t need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays won’t help. An EEG (electroencephalogram) is also unnecessary unless you’ve passed out when you had a headache.

If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist.

How Are Headaches Treated?

Your doctor may recommend different types of treatment to try. They also might suggest more testing or refer you to a headache specialist.

The type of headache treatment you need will depend on a lot of things, including the type of headache you get, how often, and its cause. Some people don’t need medical help at all. But those who do might get medications, electronic medical devices, counseling, stress management, and biofeedback. Your doctor will make a treatment plan to meet your specific needs.

What Happens After I Start Treatment?

Once you start a treatment program, keep track of how well it’s working. A headache diary can help you note any patterns or changes in how you feel. Know that it may take some time for you and your doctor to find the best treatment plan, so try to be patient. Be honest with them about what is and isn’t working for you.

Even though you’re getting treatment, you should still steer clear of the things you know can trigger your headaches, like foods or smells. And it’s important to stick to healthy habits that will keep you feeling good, like regular exercise, enough sleep, and a healthy diet. Also, make your scheduled follow-up appointments so your doctor can see how you’re doing and make changes in the treatment program if you need them.

Types, Causes, Symptoms, Diagnosis, Treatment

Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different treatments.

Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.

Common Types of Headaches

There are over 150 types of headaches, but the most common types include:

Tension Headaches

Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms.

Migraine Headaches

Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, they may look pale, feel dizzy, and have blurry vision, fever, and an upset stomach. A small number of children’s migraines include digestive symptoms, like vomiting, that happen about once a month.

Cluster Headaches

These headaches are the most severe. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.

They’re called cluster headaches because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. Each headache attack lasts 15 minutes to 3 hours. They can wake you up from sleep. The headaches may disappear completely (your doctor will call this remission) for months or years, only to come back later. Men are three to four times more likely to get them than women.

Chronic Daily Headaches

You have this type of headache 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours. It’s usually one of the four types of primary headache:

  • Chronic migraine
  • Chronic tension headache
  • New daily persistent headache
  • Hemicrania continua

Sinus Headaches

With sinus headaches, you feel a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, like a runny nose, fullness in the ears, fever, and a swollen face. A true sinus headache results from a sinus infection so the gunk that comes out of your nose will be yellow or green, unlike the clear discharge in cluster or migraine headaches.

Posttraumatic Headaches

Posttraumatic stress headaches usually start 2-3 days after a head injury. You’ll feel:

  • A dull ache that gets worse from time to time
  • Vertigo
  • Lightheadedness
  • Trouble concentrating
  • Memory problems
  • Tiring quickly
  • Irritability

Headaches may last for a few months. But if it doesn’t get better within a couple of weeks, call your doctor.

Less Common Headaches

Exercise Headaches

When you’re active, the muscles in your head, neck, and scalp need more blood. Your blood vessels swell to supply them. The result is a pulsing pain on both sides of your head that can last anywhere from 5 minutes to 48 hours. It usually hits while you’re active or just afterward, whether the activity is exercise or sex.

Hemicrania Continua

Hemicrania continua is a chronic, ongoing headache almost always affects the same side of your face and head. Other symptoms include:

  • Pain that varies in severity
  • Red or teary eyes
  • Runny or stuffy nose
  • Droopy eyelid
  • Contracted iris
  • Responds to the pain medication indomethacin
  • Worse pain with physical activity
  • Worse pain with drinking alcohol

Some people also notice migraine symptoms like:

  • Nausea and vomiting
  • Sensitivity to light and sound

There are two types:

  • Chronic: You have daily headaches.
  • Remitting: You have headaches for 6 months. They go away for a period of weeks or months and come back.

Hormone Headaches

You can get headaches from shifting hormone levels during your periods, pregnancy, and menopause. The hormone changes from birth control pills and hormone replacement therapy can also trigger headaches. When they happen 2 days before your period or in the first 3 days after it starts, they’re called menstrual migraines.

New Daily Persistent Headaches (NDPH)

These may start suddenly and can go on for 3 months or longer. Many people clearly remember the day their pain began.

Doctors aren’t sure why this type of headache starts. Some people find that it strikes after an infection, flu-like illness, surgery, or stressful event.

The pain tends to be moderate, but for some people, it’s severe. And it’s often hard to treat.

Symptoms can vary widely. Some are like tension headaches. Others share symptoms of migraine, such as nausea or sensitivity to light.

Call your doctor if your headache won’t go away or if it’s severe.

Rebound Headaches

You might also hear these called medication overuse headaches. If you use a prescription or over-the-counter pain reliever more than two or three times a week, or more than 10 days a month, you’re setting yourself up for more pain. When the meds wear off, the pain comes back and you have to take more to stop it. This can cause a dull, constant headache that’s often worse in the morning.

Rare Headaches

Ice Pick Headaches

These short, stabbing, intense headaches usually only last a few seconds. They might happen a few times a day at most. If you have one, see the doctor. Ice pick headaches can be a condition on their own, or they can be a symptom of something else.

Spinal Headaches

Talk to your doctor if you get a headache after you have a spinal tap, a spinal block, or an epidural. Your doctor might call it a puncture headache because these procedures involve piercing the membrane that surrounds your spinal cord. If spinal fluid leaks through the puncture site, it can cause a headache.

Thunderclap Headaches

People often call this the worst headache of your life. It comes suddenly out of nowhere and peaks quickly. Causes of thunderclap headaches include:

  • Blood vessel tear, rupture, or blockage
  • Head injury
  • Hemorrhagic stroke from a ruptured blood vessel in your brain
  • Ischemic stroke from a blocked blood vessel in your brain
  • Narrowed blood vessels surrounding the brain
  • Inflamed blood vessels
  • Blood pressure changes in late pregnancy

Take a sudden new headache seriously. It’s often the only warning sign you get of a serious problem.

What Causes Headaches?

The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves in your blood vessels and head muscles switch on and send pain signals to your brain. But it isn’t clear how these signals get turned on in the first place.

Common causes of headaches include:

  • Illness. This can include infections, colds, and fevers. Headaches are also common with conditions like sinusitis (inflammation of the sinuses), a throat infection, or an ear infection. In some cases, headaches can result from a blow to the head or, rarely, a sign of a more serious medical problem.
  • Stress. Emotional stress and depression as well as alcohol use, skipping meals, changes in sleep patterns, and taking too much medication. Other causes include neck or back strain due to poor posture.
  • Your environment, including secondhand tobacco smoke, strong smells from household chemicals or perfumes, allergens, and certain foods. Stress, pollution, noise, lighting, and weather changes are other possible triggers.
  • Genetics. Headaches, especially migraine headaches, tend to run in families. Most children and teens (90%) who have migraines have other family members who get them. When both parents have a history of migraines, there is a 70% chance their child will also have them. If only one parent has a history of these headaches, the risk drops to 25%-50%.

Doctors don’t know exactly what causes migraines. One theory suggest that a problem with the electric charge through nerve cells causes a sequence of changes that cause migraines.

Too much physical activity can also trigger a migraine in adults.

Getting a Diagnosis

Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms.

The first step is to talk to your doctor about your headaches. They’ll give you a physical exam and ask you about the symptoms you have and how often they happen. It’s important to be as complete as possible with these descriptions. Give your doctor a list of things that cause your headaches, things that make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem.

Most people don’t need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays won’t help. An EEG (electroencephalogram) is also unnecessary unless you’ve passed out when you had a headache.

If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist.

How Are Headaches Treated?

Your doctor may recommend different types of treatment to try. They also might suggest more testing or refer you to a headache specialist.

The type of headache treatment you need will depend on a lot of things, including the type of headache you get, how often, and its cause. Some people don’t need medical help at all. But those who do might get medications, electronic medical devices, counseling, stress management, and biofeedback. Your doctor will make a treatment plan to meet your specific needs.

What Happens After I Start Treatment?

Once you start a treatment program, keep track of how well it’s working. A headache diary can help you note any patterns or changes in how you feel. Know that it may take some time for you and your doctor to find the best treatment plan, so try to be patient. Be honest with them about what is and isn’t working for you.

Even though you’re getting treatment, you should still steer clear of the things you know can trigger your headaches, like foods or smells. And it’s important to stick to healthy habits that will keep you feeling good, like regular exercise, enough sleep, and a healthy diet. Also, make your scheduled follow-up appointments so your doctor can see how you’re doing and make changes in the treatment program if you need them.

Are Your Daily Headaches a Sign of Something More Serious?

Don’t fret just yet. The pounding pain in your head may be annoying, but it doesn’t necessarily indicate a bigger problem.

There it is again — the throbbing in your dome. If you’re bothered by frequent headaches, you may be concerned that you have a more serious condition, such as a brain tumor or an aneurysm. And while those and other dangerous conditions can be marked by headaches, it’s likely that your pain is primary. In other words: It’s probably not the result of another condition.

Unfortunately, doctors don’t know what causes most headaches. According to some estimates, only 10 percent of headaches have a known cause. But there are contributing factors that can trigger chronic headaches, such as:

  • Alcohol
  • Caffeine
  • Dehydration
  • Hunger
  • Lack of sleep
  • Sensory triggers such as bright lights, loud noises and pungent smells
  • Stress

Chronic headaches can also be linked to other disorders, including depression, anxiety, sinus infections, allergies and temporomandibular joint dysfunction, also known as TMJ. In order to figure out your headache pattern and identify your triggers, you may want to keep a headache diary to share with your doctor. The National Headache Foundation provides a handy template.

Here are a few common types of chronic headaches:

Tension headache

This is the most common type of headache and it’s likely that you’ve had more than one of these in your life. But for some people, they occur almost every day. Tension headaches affect both sides of your head with a pressing, moderate pain. Over-the-counter medications like ibuprofen (Advil) or acetaminophen (Tylenol) often help, but taking them for long periods of time can lead to headaches called “medication overuse” or “rebound” headaches. Instead, you may want to try meditation, relaxation techniques or heat therapy.

Migraine

Migraines, although less common, are more severe. The pain is intense, may pulsate and can be accompanied by nausea, sensitivity to light or sound, vomiting or visual disturbances called “auras.” Often, migraines only affect one side of the head, although they can affect both. They also affect women more often than men. Prescription medications are available to treat migraines, but you also may benefit from simply resting in a quiet, dark room and using hot or cold compresses.

Cluster headache

Men are more likely to have these more sudden headaches, which are often marked by pain on one side of the head, behind the eye. They tend to happen in clustered periods of time, even multiple times a day, then disappear for a while. Eyes tend to water, and a restless feeling is common. These headaches usually require prescription medicines.

New daily persistent headache (NDPH)

If you suddenly get frequent headaches, you may have NDPH. The symptoms of NDPH can mimic tension headaches or migraines, but NDPH occurs in people who don’t have a history of headaches. Often, people with NDPH can remember exactly when the onset happened. Your doctor may need to run tests to make sure these headaches aren’t secondary — that is, a symptom of a serious underlying condition.

Although daily headaches might not be the result of a dangerous problem, they can affect your quality of life and shouldn’t be considered “normal.”

“Progressive symptoms of more severe or frequent headaches, or any headache that is also associated with other neurological symptoms, should be evaluated by a physician,” says Jonathan J. Russin, MD, a neurosurgeon at Keck Medicine of USC and assistant professor of clinical neurological surgery at the Keck School of Medicine of USC. “Even using these criteria, the majority of headaches will not represent an underlying problem. An exception is a ‘thunderclap’ headache, which refers to the sudden onset of the worst headache of your life. This type of headache should always be evaluated by a physician whether it is associated with other symptoms or not.”

By Tina Donvito

Concerned about your headaches? If you are in the Los Angeles area, schedule an appointment with one of our specialists or call (800) USC-CARE (800-872-2273).

When to Go to the Emergency Room for a Headache or Migraine

Headache is one of the most common reasons for an emergency room visit. Some people go due chronic headache or Migraine problems that do not go away with treatment, and in other cases, headache is a symptom of another medical problem.

The best reason for an ER visit is for unusual symptoms that are new to you. You may seek attention to make sure there is no chance of another problem such as aneurysm or meningitis. A severe headache that starts very suddenly (within a second or two) can mean another disorder such as stroke.

New symptoms such as a fever, weakness, vision loss or double vision, or confusion are some of most concerning symptoms. If you have a new symptom and serious, life-threatening medical problems such as liver, heart or kidney disease, are pregnant, or have a disorder that affects your immune system such as HIV infection, an ER visit may be more essential.

For many patients, an ER visit for headache or Migraine happens after a long period of severe headache lasting days or weeks. After long time of experiencing severe headaches, you may reach the “last straw” and no longer be able to deal with the problem.

ER doctors are not specialists in headache and Migraine, and their goals are to make sure there is no serious, life-threatening problem and help reduce suffering. Different ER doctors have different ways to treat acute headaches and Migraine: there is no universal protocol for emergency treatment of headache disorders.

When going to the ER, be sure to mention:

  • your symptoms, including any that are new or unusual for you;
  • any medications you have taken, especially in the last few days; and
  • if you have had good results from a particular medication regimen, that can be helpful to the ER.

Often ER doctors will want to order tests such as a CT scan of the head or spinal tap to make sure there is no bleeding in the brain, large stroke or meningitis. If you are having your typical severe headache or Migraine, and no new symptoms, the chance these tests will be helpful are extremely low and you have the right to refuse them (see 5 Things Migraine and Headache Patients and Doctors Should Question).

The majority of persons coming to an ER for severe headache or Migraine do not get lasting results from the medications given in the ER, so having a good long-term plan and relationship with an outpatient doctor who treats your headache disorder is very important. If you have even occasional long-lasting headaches or Migraines, a good migraine preventive plan is very important, and you should have at least one rescue medication to prevent future ER visits.

 

© Dr. Michael Marmura, 2014. All rights reserved.
Last updated February 26, 2014.

Chronic Daily Headache – an overview

Integrative Therapy

There is considerable overlap with migraine in an integrated treatment approach to TTH. Lifestyle issues of stress management, sleep, exercise, and diet are central to effective management and need to be reviewed carefully. The caregiver can guide the patient through a meticulous review of these factors in both work and home environments. It is important to remember that individuals with baseline TTH may develop conditions that abruptly amplify the pain. Examples include sinus and tooth infections, head and neck trauma, errors in refraction, glaucoma, cervical disk disease, depression, and occult hypertension.

A thorough examination may lead to discovery of tender areas and trigger points in the head, the neck, or the shoulders that promote or sustain head pain. Observation of the patient while sitting, walking, and lying down can provide useful clues to musculoskeletal imbalances. Examination of temporomandibular joints is important in all patients since clenching, bruxism, and joint disease all can contribute to TTH.

Patient education in ergonomics, upper body posture, and breathing is often useful in treating TTH. Mind-body approaches are equally effective in migraine and TTH and are usefully integrated into a treatment plan. The effectiveness of biofeedback, stress management, guided imagery, and self-hypnosis is well documented in TTH.72 Time-contingent and limited use of analgesics is the rule along with education about the risks of analgesic rebound headache.

We have found that a combination of sleep hygiene and regularization of daily schedules is effective in reducing pain in motivated and compliant patients. The botanicals for sleep described previously for migraine can be equally effective for those with TTH. We strongly encourage patients to reduce sugar, caffeine, and other stimulant intake along with increasing omega-3 fatty acid consumption to reduce sympathetic nervous system stimulation and to enhance production of anti-inflammatory prostaglandins (see Chapter 88, The Anti-Inflammatory Diet). Detoxification from unneeded drugs is part of TTH management. One often overlooked area is hydration. Poorly hydrated muscles tend to cramp and contract painfully.

Pharmaceuticals have a limited role because of the risk of rebound and also because they tend to reduce the patient’s motivation to attend to the lifestyle changes needed to prevent headache. NSAIDs should be medium to long acting and strictly limited in number per week. Although muscle relaxants might be expected to work, experience is that they are of short-term benefit only and tend to lead to psychological dependence and rebound headache. Triptans are rarely effective in TTH.

When TTH occurs daily or almost daily without evidence of an underlying organic condition, analgesic rebound headache is considered, especially when there is use of more than a total of 20 doses of analgesics, plus decongestants, plus muscle relaxants and caffeine per week. Heavy caffeine use can be tapered over 2 to 3 weeks along with other short-acting analgesics. Pain is managed with patient education, long-acting NSAIDs, massage, heat, biofeedback, relaxation, and slow-stretch exercises.

Chronic daily headache is often caused by excessive use of medications, including over-the-counter analgesics. Integrating nonpharmacologic approaches early in the course of treatment for migraine can help prevent development of difficult-to-treat chronic headaches.

Biomechanical
Chiropractic and Other Manipulative Techniques

We identified only four clinical trials pertaining to spinal manipulation for TTH. One study demonstrated a 50% reduction of headache severity after a single 10-minute cervical manipulation session.73 Another study demonstrated a 57% reduction in pain intensity and a 64% reduction in analgesic medicine use over a 2-week period after two cervical spine manipulation treatments, compared with treatment with ice packs.74 The third study found no differences between chiropractic stimulation and amitriptyline use on completion of a 6-week course of treatment, but patients who received chiropractic stimulation had fewer headaches on follow-up 6 weeks after discontinuation of treatment.75 Finally, an RCT comparing soft tissue therapy plus spinal manipulation with soft tissue therapy plus placebo laser treatment for episodic TTH did not show a statistical difference in outcomes between the two arms.76

Bioenergetics
Acupuncture

A recent three-arm, RCT involving 270 patients with TTH demonstrated that a course of up to 12 acupuncture treatments over 8 weeks is associated with significantly improved clinical outcomes compared to no acupuncture but not compared to a sham-acupuncture comparison group.77 These findings suggest either that placebo effects play an important role or that sham acupuncture is associated with some physiologic changes that result in improved clinical outcomes, or both. Further research is needed to tease apart placebo effects from physiologic changes associated with the insertion of acupuncture needles. The available evidence suggests that patients with TTH may benefit from a course of acupuncture treatments.

Therapies to Consider

In general, therapies that promote mind-body connections have the greatest potential for reducing TTH pain. Although evidence supporting the following approaches is sparse, they may prove useful to some patients: mindfulness meditation, naturopathy, Reiki, healing touch, magnet therapy, aroma therapy, magnesium supplementation, prolotherapy, Tai Chi, yoga, traditional Chinese medicine and Ayurvedic medicine.

PREVENTION PRESCRIPTION

Notice physiologic reaction to stressful situations in the home and work environments, especially muscle contraction, breathing patterns, heart rate, and gastrointestinal responses.

Develop a daily relaxation routine that focuses on the muscles of head and neck and on the posture.

Maintain adequate sleep, regular aerobic exercise, and daily hydration.

Ensure regular consumption (or supplementation) of omega-3 fatty acids.

Be alert to conditions that may contribute to or intensify head pain, such as sinus and dental infection, jaw clenching, head and neck thrusting, and depression.

Check for hypertension at least twice a year.

Consult a physician if symptoms of weakness, sensory loss, poor coordination, difficulty with speech, fever or syncope occur with TTH.

THERAPEUTIC REVIEW

Tension-Type Headache

Emphasis is placed on lifestyle and mind-body techniques and reduced reliance on medication.

▪ Lifestyle

Stress management, sleep hygiene, nutrition, ergonomics, regular aerobic exercise

▪ Nutrition

Increase omega-3 fatty acid intake. Reduce sugar, caffeine, tobacco, alcohol intake

▪ Sleep and Exercise

Sleep hygiene

Exercise aerobically three times per week

▪ Supplements and Herbals

Melatonin, 6-10 mg qhs

Valerian root, 100-300 mg qhs

▪ Pharmaceuticals

Time-contingent NSAIDs

Muscle relaxants

Limit total of both decongestants and caffeine to less than 20 doses per week

▪ Mind-Body

Biofeedback and relaxation

Relaxation training, stress management, cognitive-behavioral therapy, neurolinguistic programming, mindfulness meditation

▪ Biomechanical

Manipulative therapy, massage, craniosacral therapy

▪ Bioenergetic

Acupuncture, 6-10 sessions with additional follow-up as needed

Cluster Headache | Peter O’Donnell Jr. Brain Institute | Condition

Combating Cluster Headaches on Every Front

A cluster headache is a relatively rare type of headache that affects less than 0.5% of the population. It’s called a cluster headache because it tends to occur daily for weeks to months at a time and then disappear for a month or more.  

Unlike migraines, cluster headaches are more common in men than women, although the proportion of women diagnosed with cluster headache has risen over the past 20 years. The headaches can start at any age and often begin in a person’s 20s or 30s.

Specialists at UT Southwestern offer compassionate, personalized care for people with cluster headaches, from making an accurate diagnosis to creating a comprehensive approach for treating this confounding condition.

Symptoms and Triggers

Cluster headaches are often seasonal. The attacks often awaken people from sleep at the same time each night. Most people experience more than one attack each day, often in the late afternoon or evening. About 10 to 20% of patients have chronic cluster headaches that never go away or have remission periods of less than one month.

Cluster headache pain comes on quickly and usually without a warning – an attack can last from 15 minutes to three hours. There might be other vague symptoms prior to an attack, such as mood changes, yawning, or food cravings.

Cluster headaches are excruciating – they are sometimes called “suicide headaches” – and patients often describe the pain as boring, stabbing, knifelike, or burning. 

The pain is located around the eyes and temple but can also extend to other areas such as the:

  • Jaw 
  • Cheek
  • Teeth
  • Nose
  • Side of the head

In most patients, the attacks occur on the same side of the head during a cluster period.

Most patients experience agitation or become restless during a cluster headache and prefer to pace, rock back and forth, go outdoors, or strike their head to distract themselves from the pain. Others prefer to sit still, but it is uncommon to want to lie down during an attack. 

Cluster headaches are often accompanied by involuntary symptoms, often on the same side of the head as the pain. These symptoms are caused by activity of specific nerves in the brain and head. They include:

  • Droopy eyelid
  • Small pupil
  • Eyelid swelling
  • Tearing
  • Bloodshot eye
  • Stuffy or runny nose
  • Flushing
  • Sweating

Some patients with cluster headaches also have symptoms that are more typical of migraine, such as:

  • Aura
  • Sensitivity to light or noise
  • Nausea
  • Vomiting

Most patients with cluster headaches are smokers or ex-smokers. Common triggers for cluster headaches include:

  • Alcohol
  • Odors such as those from solvents or perfume
  • Sleep
  • Smoking
  • Certain foods 

Diagnosis

To diagnose cluster headaches, UT Southwestern physicians will conduct a thorough evaluation of a patient’s medical history and perform a neurological examination.

Brain imaging is recommended for all patients with cluster headaches. Rarely, brain abnormalities (such as a tumor of the pituitary gland) can cause headaches that are very similar to cluster headaches.

Treatment Options

Cluster headaches can be a lifelong condition in most patients, although remission periods tend to get longer with age. To reduce the severity and the frequency of these headaches, three aspects of treatment are generally all started at the same time. 

Treating the Acute Attack

Because cluster headaches are relatively brief, oral medication is usually ineffective. Immediate treatment options might include:

  • Oxygen: 100% oxygen through a non-rebreather face mask at 7 to 12 liters per minute relieves the headache in more than half of patients. The oxygen should be used for 15 to 20 minutes. However, about 25% of patients have incomplete relief, experiencing only a delay in their headache after using oxygen.
  • Triptans: Injectable sumatriptan, sumatriptan nasal spray, and zolmitriptan nasal spray are often effective. Because cluster headaches occur multiple times a day, these treatments are expensive and often not covered by insurers in the quantity needed. Frequent use can lead to “rebound” headaches that are difficult to treat.
  • Ergots: Dihydroergotamine (DHE) injections and intravenous DHE are effective treatments. DHE nasal spray might also be considered. Other ergots are useful.
  • Lidocaine: A 10% solution (a local anesthetic) administered into the nose on a cotton swab or by nasal spray is effective in many patients.

Stopping the Cluster Period

In addition to treating the current attack, steroids might be prescribed to stop the cluster period, sometimes in combination with injection of an anesthetic into the greater occipital nerve. 

Steroid treatment is usually effective within days. Common side effects of steroid treatment include:

  • Insomnia
  • Increased appetite
  • Stomach pain 

Long-term side effects include ulcer, osteoporosis, fracture, diabetes, weight gain, glaucoma, and easy bruising. Because of these side effects, steroids cannot be used indefinitely – preventive treatment is also needed. 

Preventing Headaches Over the Long Term

Medications are often prescribed to prevent long-term recurrence. Possible medications include:

  • Verapamil: Perhaps the most effective long-term preventive treatment for cluster headaches. The dose needed for cluster headaches is substantially higher than the dose used for treating blood pressure (up to 960 mg daily). Constipation is a common side effect, although the drug is usually very well tolerated in people with cluster headaches. Because verapamil occasionally causes abnormal electrical conduction in the heart (prolonged QT interval), intermittent electrocardiogram (EKG) monitoring is performed when using high doses.
  • Lithium: Successfully used for many years as a preventive treatment for cluster headaches. A dose of 600 to 1,200 mg daily generally works within days. Short-term side effects include weakness, nausea, tremor, and slurred speech. Lithium blood levels, kidney function, and thyroid function must be monitored during treatment.
  • Topiramate: Approved by the U.S. Food and Drug Administration (FDA) for migraine prevention and also useful in cluster headaches. It is started at a low dose and increased as tolerated; the effect is seen in one to four weeks. Common side effects are drowsiness, weight loss, memory problems, and tingling. Kidney stones, the sudden onset of glaucoma, and allergy are rare but serious side effects.
  • Gabapentin: Administered in doses of 900 mg daily. This medication can be effective as quickly as one week after starting treatment. Drowsiness and dizziness are the most common side effects. 

Several studies of valproate have shown mixed results, but it seems to be effective. Weight gain, tremor, hair loss, and mood change are common side effects, and the drug cannot be used during pregnancy. 

Although methysergide can be very effective, this medication is no longer available. Testosterone replacement in men with low testosterone levels might improve the headaches.

Botulinum toxin injections have not been studied, but there are reports of their usefulness when oral medications fail.

Surgical Options

If cluster headaches persist despite medical treatment, surgical options might be considered. Surgical treatment of cluster headaches might include:

  • Occipital nerve stimulation: A lead is implanted over the occipital nerve in the back of the head/neck, which is connected to a battery-powered stimulator. The intensity of attacks seems to decrease sooner than the frequency, and improvement occurs in days to weeks.
  • Hypothalamic stimulation:  The hypothalamus is deep within the brain and regulates hunger, thirst, and circadian rhythms. Several studies using functional MRI and PET scans show that the hypothalamus is activated in patients with cluster headaches. Stimulation in this part of the brain counteracts the hyperactivity to reduce headache intensity and frequency. This procedure has significant risk and is not done at most medical centers.
  • Destructive surgery: A last resort, this procedure has serious risk.

90,000 What is migraine: symptoms and treatment

Every tenth inhabitant of the planet knows what a migraine is, not from medical reference books, but from his own bitter experience. The disease begins to manifest itself even in childhood or adolescence, most often during puberty. Women, according to statistics, face this neurological disease much more often than men.

Abnormal headaches are caused by increased excitability of nerve cells in the brain.Such a violation leads to excessive sensitivity of neurons in relation to external and internal pathogens, the so-called triggers. These include alcohol, stress, strong odors, disturbed sleep patterns, diet, bright light, changes in the weather (pain occurs, for example, from heat). The causes of migraine in women are often associated with hormonal changes, including menstruation. Each patient has a personal set of triggers, and migraines can develop in completely different ways. Therefore, it is extremely important not to ignore the disease, but to study it in detail – in the future this will help determine how to treat migraine, how to effectively stop attacks and prevent their occurrence.

Symptoms and signs of migraine

Frequent headache is not the main and reliable symptom of migraine. The clinical picture of the disease is much more complicated. There are four stages of migraine, each of which has a specific set of symptoms. At the same time, not all patients show pronounced manifestations of all stages. Many, on the contrary, note the presence of only one or several of them.

  • Prodrom . Comes a few days or hours before the attack and can be expressed in the form of irritability, fatigue, depression, changes in appetite.
  • Aura . Lasts from five minutes to an hour and is characterized by specific sensations. Most often, visual effects appear in the form of blind spots, multi-colored zigzags, flashes of light. Numbness of the face and fingertips, difficulty speaking, and hearing loss may also occur. Migraine with aura occurs in only a third of all patients. In some it is a precursor to headache, in others it is an autonomous manifestation of migraine.
  • Headache .The most difficult stage. Lasts from a couple of hours to two to three days. The pain is very severe, throbbing or bursting. Most often it covers half of the head. Nausea, vomiting, and sensitivity to sound and light may occur.
  • Postdrome . The pain passes, but depression, irritability, and decreased concentration may persist for about a day.

Diagnostics

Migraine headaches can occur from several times a year to several times a month.The diagnosis is made if there have been about five attacks with the above symptoms throughout life. If you suspect you have a migraine, you need to seek medical help. Only a neurologist can confirm the disease and prescribe adequate treatment.

Diagnosis of migraine is carried out on the basis of patient complaints. Therefore, it is important to carefully prepare for your hospital visit. Ideally, it is worth keeping a headache diary for at least one month, where you should indicate in detail when the attack was, how long it lasted, what symptoms accompanied it, what painkillers you took.All these data will help the doctor make the correct diagnosis.

In order to exclude other neurological diseases for which migraine may be mistakenly mistaken, MRI and / or CT of the brain, blood tests, ultrasound of blood vessels, EEG and other examinations can be additionally prescribed.

Consequences of complications of migraine

In the absence of therapy, episodic migraine can be replaced by chronic migraine, which is characterized by up to fifteen attacks per month! The chronic form is more difficult to diagnose, and, most importantly, other complications may follow: depression, migraine status (headaches lasting more than three days), stroke, epilepsy.

Migraine at any stage worsens the quality of life, reduces the ability to work. Therefore, you should not self-medicate and hope that the attacks will stop on their own.

How to treat throbbing headaches and other manifestations of migraine

Let’s start with the bad news: there is no cure for migraines. So far, they have not found a way that will help get rid of the disease once and for all. But there is also good news: migraine pains are successfully “trainable”. That is, properly selected therapy helps to relieve or relieve pain, prevent frequent attacks.There are two possible options for what to do with migraine attacks.

  • Seizure treatment . First of all, analgesics (aspirin, ibuprofen, etc.) are used, and if they are ineffective, triptans (eletriptan, sumatriptan, etc.). Also, if necessary, use antiemetic drugs. The prescribed drugs are used at the very beginning of the attack – you should not endure the throbbing pain in the head until the last. However, it is also impossible to exceed the frequency and dose of medications. Choosing pain relievers on your own can only exacerbate the situation.To avoid complications, schedule an appointment with an experienced neurologist at Daily Medical Medical Center.
  • Prevention of an attack . If attacks are frequent, beta-blockers, antidepressants and anticonvulsants are prescribed, which affect vascular tone and neuronal excitability. Such therapy, as a rule, is long-term (up to a year), and should be carried out under the strict supervision of a physician. It will not help completely eliminate seizures, but will reduce their frequency by half or more.

Prevention

The increased excitability of neurons, which leads to migraines, is often a hereditary pathology, and therefore it is not always possible to prevent the development of the disease. However, you can trace what factors most often provoke attacks, and try to remove or minimize them.

  • Watch your food. Headaches are often caused by hunger, specific diets. Also provocateurs include dark chocolate, citrus fruits, nuts, fast food, beer, red wine.However, the reaction to these products is extremely individual.
  • Get rid of bad habits (smoking, alcohol).
  • Monitor your sleep patterns: both lack of sleep and excessive sleep can cause seizures.
  • Treat neurological diseases in a timely manner: depression, anxiety disorders, sleep disorders.
  • Avoid excessively bright light and very loud sounds.
  • Exercise regularly.Walking, running, swimming, fitness will be useful.

The author of the article: Ekaterina Vasilievna Chekha – neurologist, botulinum therapist of the second category, neurologist, botulinum therapist of the second category.

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90,000 Chronic daily headaches | Symptoms, complications, diagnosis and treatment

The continuous nature of chronic daily headaches makes them one of the most unpleasant headaches.Aggressive initial treatment and sustained long-term treatment can reduce pain and lead to fewer headaches later on. By definition, chronic daily headaches last 15 days or more per month for at least three months. True (primary) chronic daily headache is not caused by another condition.

There are short-term and long-term chronic daily headaches. Long-term is more than four hours.

Recurrent headaches are common and usually do not require medical attention. However, consult your doctor if:

  • You usually have headaches two or more times a week
  • Most of the time you take pain reliever for your headaches
  • You need more than the recommended OTC pain relief dose
  • Changes in headache or worsening headaches

The causes of many chronic daily headaches are not well understood.True (primary) chronic daily headache has no identifiable underlying cause. Conditions that can cause non-primary chronic daily headaches include:

  • Inflammation or other problems with blood vessels in and around the brain, including stroke
  • Infections such as meningitis
  • Intracranial pressure too high or too low
  • Brain tumor
  • Traumatic brain injury

Factors associated with the development of frequent headaches include:

  • Anxiety
  • Depression
  • Sleep disorders
  • Overweight
  • Snoring
  • Excessive consumption of caffeine
  • Excessive use of drugs for headache
  • Other chronic pain conditions

Pain in the temple area – causes of occurrence, in what diseases it occurs, diagnosis and treatment

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct treatment, you should contact your doctor.

Pain in the temple area: causes of appearance, in what diseases it occurs, diagnosis and methods of treatment.

Definitions e

Temple pain is one of the most common complaints that leads patients to see a doctor.

In the bone structures of the skull and brain tissues, pain sensitivity is insignificant, therefore, the main sources of pain are blood vessels, meninges and cranial nerves.


Varieties of pain in the temple area

According to the International Classification of Headache 3 (2013), all headaches are subdivided:

  • into primary pains not associated with diseases of the brain and other structures of the head and neck;
  • secondary pain associated with other diseases;
  • painful cranial neuropathies, other facial and headaches.

Possible causes of pain in the temple area

Hypertension is one of the most common causes of headaches in the occiput and temples. With an increase in pressure, headache attacks occur, which may be accompanied by nausea, vomiting, “flies” in front of the eyes.

Tension headache is one of the most common reasons for visiting a neurologist and therapist. Patients describe it as squeezing, pressing.

Tension headache disrupts quality of life and performance, although it is considered benign and does not have serious consequences.

Migraine is the most common form of paroxysmal headache.

Migraine is characterized by the localization of pain in the temporomandibular-orbital region and the paroxysmal nature of the course.

If the pain is not paroxysmal, then it is not a migraine. Attacks can be on one side of the head, or on both, and also change their localization (right-left).

A headache attack can occur at any time of the day, more often during a night’s sleep in the morning or after waking up.The pain is pulsating, bursting, with a gradual increase in intensity over several hours. Before the onset of an attack, a so-called aura is possible (harbingers of pain, they are individual, but are often described as impaired vision, speech, dizziness). The pain increases in bright light, from loud noises and other stimuli, up to a change in head position. The attack can last up to several days.

Harris recurrent migraine neuralgia – characterized by the sudden onset of pain in the eye area on one side and spread to the temporal, frontal and zygomatic regions, and sometimes even to the neck.

Unlike migraines, there are no harbingers of pain.

The pain is burning, cutting, bursting, accompanied by redness of the eye and lacrimation from the painful side. Some patients experience a sensation of “bulging out of the orbit.” All these attacks are characterized by a certain seasonality or frequency. In this case, the duration of the attack ranges from 6-8 weeks to 3 months.

Pain in the temple area may occur immediately after drinking cold water or ice cream due to arterial spasm.In this case, the pain is breaking, constricting, sometimes throbbing.

Cold pain occurs in persons with hypersensitivity to the cold stimulus and with a high reactivity of the body.

“Sausage” headache (for English-speaking authors – hot dogs headache ) occurs when eating foods containing food additives such as sodium nitrate. In the process of a chemical reaction in the body, nitrate turns into nitrite, which has a vasomotor effect (controlling the process of contraction and relaxation of the muscular membrane of the walls of blood vessels, and, therefore, the lumen of blood vessels), and sensitive people can feel pain in the frontotemporal region.

A similar effect is sometimes seen when eating Chinese dishes (“a Chinese restaurant headache”), where monosodium glutamate is often used.

Giant cell arteritis is the world’s most common systemic vasculitis affecting large vessels. The favorite localization of this disease is the temporal artery. Most often, the pain is intense, accompanied by a limitation of the function of the corresponding temporomandibular joint, visual impairment with a gradual decrease, a thickened artery in the temple area is determined.

Without treatment, it can lead to permanent blindness of the eye from the side of the lesion.

In inflammatory diseases of the ear pain in the temporal and parotid region is possible, which are accompanied by fever, redness, edema in the ear, purulent discharge from the ear.
Meningitis develops when an infectious agent enters the lining of the brain, followed by an inflammatory process.

The headache is sudden, sharp, diffuse, prevails in the frontotemporal regions, sometimes accompanied by vomiting.

Neuralgia of the ear-temporal nerve often occurs after an inflammatory process or traumatic lesion of the parotid gland. It is characterized by burning, throbbing pain in the area of ​​the external auditory canal, temple, temporomandibular joint, radiating to the lower jaw. The pain is accompanied by increased salivation, redness of the skin over the affected area. Seizures are triggered by food and smoking.

Neuralgia of the ear node is manifested by bouts of burning pain in the temporal region lasting from several minutes to an hour.Can be accompanied by ear congestion and increased salivation.

With altitude (mountain) sickness , there is a change in the tone of the arteries due to a reduced oxygen pressure and a change in barometric pressure. Headache is accompanied by shortness of breath, palpitations, visual impairment.

The severity of symptoms depends on the rate of ascent to altitude.

The pain is relieved by applying cold to the temples and drinking cool water.

Traumatic damage to the temporal region can cause pain. This includes a wide group of pathologies: fracture of the temporal bone, dislocation of the temporomandibular joint, soft tissue contusion.

Subarachnoid hemorrhage occurs for various reasons, for example, as a result of a rupture of an aneurysm of the cerebral vessels, a person feels like a strong blow to the head, spilling hot liquid in the head, strong constriction, and then bursting. The pain can initially be localized in the corresponding part of the head – in the temporal region with a ruptured aneurysm of the internal carotid artery.

Damage to the temporomandibular joint (both inflammatory – arthritis and non-inflammatory – arthrosis, malocclusion) may be accompanied by pain in the parotid and temporal region. When the lower jaw moves, there may be a crunching and clicking in the joint, the pain intensifies when chewing and while talking.

Which doctor should I contact if I have pain in my temples?

If you experience intense and recurring pain in the temples, you should seek the advice of a specialist.

If pain persists after taking pain relievers or other symptomatic treatment previously prescribed by a doctor (for example, to lower blood pressure), and there are no signs of injury, then you should contact
a general practitioner or
pediatrician. Depending on the accompanying symptoms, you may need to consult a neurologist, rheumatologist, otolaryngologist, ophthalmologist.