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Chronic daily headaches – Symptoms and causes
Most people have headaches from time to time. But if you have a headache more days than not, you might have chronic daily headaches.
Rather than a specific headache type, chronic daily headaches include a variety of headache subtypes. Chronic refers to how often the headaches occur and how long the condition lasts.
The constant nature of chronic daily headaches makes them one of the most disabling headache conditions. Aggressive initial treatment and steady, long-term management might reduce pain and lead to fewer headaches.
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition.
There are short-lasting and long-lasting chronic daily headaches. Long-lasting headaches last more than four hours. They include:
- Chronic migraine
- Chronic tension-type headache
- New daily persistent headache
- Hemicrania continua
This type typically occurs in people with a history of episodic migraines. Chronic migraines tend to:
- Affect one side or both sides of your head
- Have a pulsating, throbbing sensation
- Cause moderate to severe pain
And they cause at least one of the following:
- Nausea, vomiting or both
- Sensitivity to light and sound
Chronic tension-type headache
These headaches tend to:
- Affect both sides of your head
- Cause mild to moderate pain
- Cause pain that feels pressing or tightening, but not pulsating
New daily persistent headache
These headaches come on suddenly, usually in people without a headache history. They become constant within three days of your first headache. They:
- Often affect both sides of your head
- Cause pain that feels like pressing or tightening, but not pulsating
- Cause mild to moderate pain
- Might have features of chronic migraine or chronic tension-type headache
- Affect only one side of your head
- Are daily and continuous with no pain-free periods
- Cause moderate pain with spikes of severe pain
- Respond to the prescription pain reliever indomethacin (Indocin)
- Can become severe with development of migraine-like symptoms
In addition, hemicrania continua headaches are associated with at least one of the following:
- Tearing or redness of the eye on the affected side
- Nasal congestion or runny nose
- Drooping eyelid or pupil narrowing
- Sensation of restlessness
When to see a doctor
Occasional headaches are common, and usually require no medical attention. However, consult your doctor if:
- You usually have two or more headaches a week
- You take a pain reliever for your headaches most days
- You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches
- Your headache pattern changes or your headaches worsen
- Your headaches are disabling
Seek prompt medical care if your headache:
- Is sudden and severe
- Accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness or difficulty speaking
- Follows a head injury
- Gets worse despite rest and pain medication
The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause.
Conditions that might cause nonprimary chronic daily headaches include:
- Inflammation or other problems with the blood vessels in and around the brain, including stroke
- Infections, such as meningitis
- Intracranial pressure that’s either too high or too low
- Brain tumor
- Traumatic brain injury
Medication overuse headache
This type of headache usually develops in people who have an episodic headache disorder, usually migraine or tension type, and take too much pain medication. If you’re taking pain medications — even over-the-counter — more than two days a week (or nine days a month), you’re at risk of developing rebound headaches.
Factors associated with developing frequent headaches include:
- Female sex
- Sleep disturbances
- Overuse of caffeine
- Overuse of headache medication
- Other chronic pain conditions
If you have chronic daily headaches, you’re also more likely to have depression, anxiety, sleep disturbances, and other psychological and physical problems.
Taking care of yourself might help ease chronic daily headaches.
- Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted.
- Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly.
- Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.
- Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese.
- Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy — such as walking, swimming or cycling. To avoid injury, start slowly.
- Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation.
- Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.
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 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 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.
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
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 stress headaches usually start 2-3 days after a head injury. You’ll feel:
- A dull ache that gets worse from time to time
- Trouble concentrating
- Memory problems
- Tiring quickly
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
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 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.
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.
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.
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.
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.
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.
When should you worry about a headache?
Most headaches don’t point to any underlying illness or injury and can be treated at home.
Headaches are really common. In fact, Headache Australia says they’re one of the most common symptoms experienced by humans, with more than 5 million Australians affected by headaches and migraines.
Even though it’s so common, if you’ve got a headache that’s sudden, severe or lasting, you might be worried that there’s a serious problem. So how do you know when a headache is something you can treat at home, or when you should see your doctor?
Let’s explore what a headache is, how you might treat it at home and when you should get medical advice.
What is a headache?
Technically, a headache can be any pain in the head, face or neck area. Headaches might be caused by muscle tension, nerve pain and dehydration, be a symptom of another illness, or be bought on by certain foods and drinks or medications.
There are two overarching types of headache: primary and secondary. Primary headaches are the most common, describing headaches that ‘just happen’ without an underlying illness or injury causing them. These include tension headaches, migraines and cluster headaches. Secondary headaches have a separate cause, like an existing illness, hormonal changes, sinus or tooth inflammation or a side effect of medication or drugs.
Beyond these two broad classifications, Headache Australia lists 36 different types of headache. You can read more about different types of headaches, from hot-dog headaches to hangovers, on the Headache Australia website.
How to treat a headache
Because there are so many different types of headache, there are lots of different ways they can be treated.
If your headaches are frequent, keeping a diary that lists when you get headaches might help you figure out what triggers them. If there’s an obvious cause, like a tight neck, dehydration, or having too much caffeine, you might be able to avoid headaches by changing your behaviour or lifestyle.
When you have a headache, the below steps can help relieve the pain.
- rest and relax in a quiet space with good ventilation
- drink plenty of water
- put a cool cloth or ice pack on your head
- splash your face with cold water
- if you have a tension headache, massage your neck, jaw, shoulders and head
- talk to your pharmacist about what pain medication you can take – this might change depending your health, if you are taking any other medications and the type of headache you have.
Try these tips for preventing headaches:
- eat regularly, fuelling your body with nutritious foods, as dropping blood glucose levels can trigger headaches
- drink plenty of water, more if you’ve been exercising or it’s a hot day to avoid dehydration
- make sure you aren’t in a room that is too hot or too cold, and has plenty of fresh air
- exercise regularly
- try not to sit or stand in the same position for too long, as this can cause muscle tension
- avoid chocolate, caffeine, alcohol and tobacco, all of which can cause headaches
- see your optometrist for an eye test
- and avoid overusing headache medicines – too frequent use can cause ‘rebound’ headaches.
When should you see a doctor about a headache?
Headaches not only cause you pain, but can result in loss of productivity and income. If you have ongoing headaches, it’s important to see your doctor to try and figure out the cause, rather than just put up with the pain. Keep in mind that most headaches do not point to a serious illness, extra worry about your headache might make it worse!
See your doctor if your headaches are frequent, you’ve had a headache for more than a few days, or your headaches are causing you stress or worry.
Rarely, a headache might be a sign of a serious medical condition. You should seek immediate medical attention if you:
- have a sudden, very severe headache, and it’s the first time it’s happened
- are experiencing any of the signs of stroke including a dropped face on one side; droopy mouth or eye; cannot lift one or both arms; or have slurred or garbled speech
- have a headache accompanied by a stiff neck and fever
- have signs of severe dehydration or heat stroke
- may have been poisoned by ingesting, inhaling or touching a substance, or being bitten or stung by a poisonous animal or plant (call the Queensland Poisons Information Centre helpline on 13 11 26 for advice 24 hours, 7 days a week)
- or have injured your head from a fall, blow or bump.
Headaches – Illnesses & conditions
Most headaches are not serious. In many cases, you can treat your headaches at home.
Complete our self-help guide to check your symptoms and find out what to do next.
When to get professional advice
Your local pharmacy can provide:
- advice about headaches
- treatments to help relieve headaches
Tension headaches are the most common type of headache. They’re what we think of as normal, ‘everyday’ headaches. They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it.
Normally, tension headaches are not severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours, but can last for several days.
What causes tension headaches?
The exact cause is unclear, but tension headaches have been linked to things such as:
How to treat tension headaches
You can usually treat tension headaches with painkillers such as paracetamol and ibuprofen. Lifestyle changes may also help, for example:
Migraines are less common than tension headaches. They’re usually felt as a severe, throbbing pain at the front or side of the head. Some people also have other symptoms, such as:
- increased sensitivity to light or sound
Migraines can stop you carrying out your normal daily activities. They usually last at least a couple of hours. Some people find they need to stay in bed for days at a time.
How to treat migraines
Most people can treat their migraines with over-the-counter medication from the pharmacist.
If your migraines are severe, you may need to be prescribed stronger medication by your GP. This may be able to relieve and prevent your migraines.
Read further information about migraines
Cluster headaches are a rare type of headache. They occur in clusters for a month or two at a time around the same time of year.
Cluster headaches are excruciatingly painful. They cause intense pain around one eye, and often occur with other symptoms, such as a:
- watering or red eye
- blocked or runny nose
Pharmacy medications don’t usually ease the symptoms of a cluster headache. Your GP can prescribe specific treatments to ease the pain and help prevent further attacks.
Medication and painkiller headaches
Some headaches are a side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or medication-overuse headache.
A medication-overuse headache will usually get better within a few weeks once you stop taking the painkillers that are causing it. But, pain may get worse for a few days before it starts to improve.
Headaches in women are often caused by hormones, and many women notice a link with their periods. The combined contraceptive pill, the menopause and pregnancy are also potential triggers.
You may be able to help reduce headaches associated with your menstrual cycle by:
Other causes of headaches
Headaches can also have a number of other causes, including:
- drinking too much alcohol
- a head injury or concussion
- a cold or flu
- temporomandibular disorders – problems affecting the ‘chewing’ muscles and the joints between the lower jaw and the base of the skull
- sinusitis – inflammation of the lining of the sinuses
- carbon monoxide poisoning
- sleep apnoea – a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing
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:
- Lack of sleep
- Sensory triggers such as bright lights, loud noises and pungent smells
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:
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.
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.
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).
10 Surprising Causes of Constant Headaches
Tension headaches can be caused by everything from dehydration to undiagnosed diabetes or an autoimmune disease. But stress is the most commonly reported trigger for tension headaches, the Mayo Clinic explains.
A tension headache feels tight, like your head is in a vice, and can occur on both sides and commonly hits later in the day as tension builds. “It’s a tight, oppressing feeling,” Dr. Hutchinson explains.
If you’re experiencing constant headaches, chances are they’re either tension headaches or migraines.
So what does it mean if you have constant headaches?
Technically, for your headaches to be considered chronic, they need to go on for 15 days or longer per month, for at least three consecutive months, SELF reported previously. That being said, if you have recurring headaches for, say, two weeks, that doesn’t mean you should discount your pain—you should still see your doctor.
The causes of constant, headaches—whether tension or migraine—range from totally minor to pretty major. Here are 10 things your headaches could be telling you about your health.
1. You’re stressed.
“Unresolved stress can really contribute to headache,” Dr. Hutchinson says. As mentioned, tension headaches happen when the muscles of the neck and scalp tense up, and this can be a physical response that your body has to stress and anxiety, MedlinePlus explains.
If you’re suffering from constant headaches, stop and think about what’s going on in your life. How stressed are you? And are you just pushing your stress under the rug instead of dealing with it?
Fix it: This is where stress management and self-care techniques become crucial. These techniques can range from lifestyle changes to psychotherapeutic interventions. like cognitive behavioral therapy, which can help you better cope with anxious thoughts. Everyone’s stress and anxiety management methods are different, as SELF reported previously; but oftentimes a mix of techniques that you can do on your own and/or with a mental health professional is best.
2. You’re dehydrated.
“With any kind of headache, a person needs to look at their health habits,” Dr. Hutchinson says. One important thing to look at is water intake, as dehydration can cause headaches. The exact connection is unknown, but experts believe it has to do with the way blood volume drops when you’re not getting enough water. Lower blood volume means less oxygen is getting to the brain.
Fix it: Keep an eye out for obvious signs of dehydration, including having yellow pee, feeling thirsty, and having a dry mouth. Then, drink more water (of course). You can also up the number of foods with high water content in your diet (think: celery, watermelon, and tomatoes).
The amount of fluids you need to consume depends on different factors, like your age and physical activity levels. But as a general rule of thumb, women should consume about 2.7 liters (91 ounces) of water (from drinks and food) each day, and roughly 3.7 liters (125 ounces) of water daily for men, according to the National Academies of Sciences, Engineering, and Medicine.
3. You’re anemic.
Anemia is a condition where you lack enough red blood cells to properly transport oxygen to tissues throughout your body, the Mayo Clinic explains. It can bring on symptoms including fatigue, feeling weak, shortness of breath, and others. “More severe anemia can cause headache,” Dr. Hutchinson says.
There are different causes of anemia, including having an iron deficiency, having lower-than-normal levels of B-12 and/or folic acid, or having a chronic health condition, like sickle cell anemia, that leads to anemia.
Tension Headaches | Michigan Medicine
Is this topic for you?
This topic is about tension headaches in adults. If you are looking for information about migraine headaches, see Migraine Headaches.
What is a tension headache?
Most headaches are tension headaches. These headaches tend to happen again and again, especially if you are under stress. They are not usually a sign of something serious. But they can be very painful and hard to live with.
Tension headaches can last from 30 minutes to 7 days.
If you have a headache on 15 or more days each month over a 3-month period, you may have chronic tension headaches. This type of headache can lead to stress and depression, which in turn can lead to more headaches.
Tension headaches are very common. Symptoms can start in childhood, but they are more likely to occur during middle age.
Some people have both tension headaches and migraine headaches.
What causes tension headaches?
Doctors don’t know for sure what causes tension headaches. Experts once thought that tension or spasms in the muscles of the neck, face, and head played a role. Now they think that a change in brain chemicals also may be a cause.
Tension headaches are one of the most common types of headaches. They can be brought on—or triggered—by things such as stress, depression, hunger, and muscle strain. Tension headaches may come on suddenly or slowly.
What are the symptoms?
Symptoms of tension headaches include:
- A headache that is constant, not throbbing. You usually feel the pain or pressure on both sides of your head.
- Pressure that makes you feel like your head is in a vise.
- Aching pain at your temples or the back of your head and neck.
This is different than migraine headaches, which usually cause throbbing pain and start on one side of your head.
Tension headaches tend to come back, especially when you are under stress.
Pain from a tension headache is usually not severe and does not get in the way of your work or social life. But for some people, the pain is very bad or lasts a long time.
How are tension headaches diagnosed?
A doctor can usually diagnose tension headaches by asking you questions about your health and lifestyle and by examining you.
How are they treated?
Most people can treat their tension headaches with over-the-counter pain relievers like acetaminophen (such as Tylenol) or aspirin (such as Bayer).
But if you take these pain relievers more than 3 times a week, you may get rebound headaches. These are different from tension headaches. Rebound headaches usually start after pain medicine has worn off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine.
Your doctor may prescribe medicine if you get chronic tension headaches.
Can you prevent tension headaches?
Even with treatment, most people still have some headaches. But with treatment, you will probably have them less often. And when you do get them, they probably won’t be as bad.
Home treatment may help you avoid headaches. You can:
- Try to reduce stress.
- Make sure you sleep, exercise, and eat on a regular schedule.
- Make sure you practice good posture. Stand and sit up straight.
- Try not to strain your eyes when you use your computer.
- Get treatment for depression or anxiety if you have those health problems.
- Try using a headache diary. Every time you get a headache, write down the date, the time, and what you were doing and feeling before your headache started. This may help you and your doctor find out what is causing your headaches. Then your doctor can use the diary to plan your treatment.
The cause of tension headaches is not clear. In the past, doctors believed that tension or spasms of the muscles of the neck, face, jaw, head, or scalp played a role in causing these headaches. Now they think a change in brain chemistry may also help cause a tension headache.
Tension headaches are the most common type of headache. They can be brought on—or triggered—by things such as stress, depression, hunger, and muscle strain. Tension headaches may come on suddenly or slowly.
Chronic tension headaches often occur along with other health problems such as anxiety or depression.
Symptoms of tension headaches include:
- A constant headache that does not throb or pulse. You usually feel the pain or pressure on both sides of your head.
- Tightness around your forehead that may feel like a “vise grip.”
- Aching pain at your temples or the back of your head and neck.
Unlike migraines, tension headaches usually don’t occur with nausea, vomiting, or feeling sensitive to both light and noise. But light or noise could make your headache worse. Tension headaches usually aren’t bad enough to keep you from doing your daily activities.
Tension headaches can last from 30 minutes to 7 days.
If you have a headache on 15 or more days each month over a 3-month period, you may have chronic tension headaches.
When to Call a Doctor
or other emergency services if:
- You have symptoms of a stroke, such as:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
Call your doctor now or go to the emergency room if:
- You have a fever and a stiff neck.
- You have new nausea and vomiting, or you cannot keep food or liquids down.
Watch closely for changes in your health, and be sure to contact your doctor if:
- Your headache wakes you up at night.
- Your headaches get worse or happen more often.
- You start to have new symptoms.
- You have any problems with your medicine.
- Your headaches occur after physical exercise, sexual activity, coughing, or sneezing.
- Your life is disrupted by your headaches (for example, you miss work or school regularly).
Watchful waiting is a wait-and-see approach. If your headache gets better on its own, you won’t need treatment. If it gets worse or you get headaches often, you and your doctor will decide what to do next.
Watchful waiting and using over-the-counter pain medicines work well if your tension headaches don’t keep you from doing the things you want to do. But if your headaches are disrupting your life, talk to your doctor about other treatments that you could try.
Who to see
Most health professionals can recognize and treat tension headaches. You may seek treatment from any of the following:
If you think that your headaches are caused by depression or anxiety, talk to your doctor. Treating these problems may help reduce how bad your headaches are and how often you get them.
Exams and Tests
Finding out the type of headache you have
A doctor can usually diagnose tension headaches by asking you questions about your health and lifestyle and by examining you.
It can be hard to know which type of headache you have, because different types can have the same symptoms. But the treatments may be different, so it’s important to find out which type you have.
Finding other possible causes
In very rare cases, headaches can be caused by more serious health problems (such as brain tumors or aneurysms). But most headaches aren’t caused by anything serious, so you probably won’t need to have tests.
You can treat most tension headaches with:
- Over-the-counter pain medicines.
- Prescription drugs if you have chronic or very bad headaches.
- Avoiding things that trigger your headaches.
- Meditation and other ways to lower your stress.
Over-the-counter medicines to stop headaches
Medicines can help you feel better. But they can also be dangerous, especially if you don’t take them the right way. Be safe with medicines. Read and follow all instructions on the label.
Try these drugs first. Most doctors recommend that you try over-the-counter drugs first if you have mild to moderate headaches. They may have fewer side effects than prescription drugs. These medicines include:
- Acetaminophen, such as Tylenol.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (for example, Bayer) and ibuprofen (for example, Motrin).
- Medicine that combines aspirin, acetaminophen, and caffeine, such as Excedrin.
- Don’t take this medicine too often. Try not to take over-the-counter drugs more than 3 times a week, because you may get rebound headaches. These are different from tension headaches. They are usually triggered after pain medicine has worn off, prompting you to take another dose. After a while, you get a headache whenever you stop taking the medicine.
Prescription medicines to prevent headaches
Your doctor may recommend that you take a prescription medicine every day to prevent headaches. You may want to try a prescription medicine to prevent a headache if:
- You are using over-the-counter medicines to stop headaches more than 3 times a week.
- Over-the-counter medicines to stop headaches aren’t working well for you.
Your doctor may have you try one or more medicines, such as an antidepressant or a medicine that prevents seizures. These medicines can help prevent headaches even if you don’t have depression or seizures.
You may be able to prevent or reduce tension headaches by learning what causes your headaches and trying to avoid those triggers. For more information, see Living With Tension Headaches.
How you think can affect how you feel. So finding ways to relax and stop negative thoughts may help prevent headaches.
You may want to try:
- Techniques to stop negative thoughts.
- Progressive muscle relaxation.
- Ways to manage your time.
- Breathing exercises.
- Guided imagery.
For more information, see Living With Tension Headaches.
Treatment if headaches get worse
If you continue to have tension headaches while you are getting treatment, you and your doctor may want to try another treatment.
You may have to try different drugs or doses. If you have already tried several medicines, your doctor may order tests (such as an MRI or CT scan) to find out if a health problem is causing your headaches.
Other things to think about
- Even with treatment, you will most likely still get some tension headaches. But you probably will get them less often. And they may hurt less when you do get them.
- If you also have depression or anxiety, talk to your doctor. Treatment for these health problems also may help you have fewer headaches.
Finding and avoiding the things—or triggers—that lead to tension headaches can reduce how often you get headaches and how bad they are when you do get them.
Headache triggers can include:
Using a headache diary can help you find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you were doing before the headache started. This information can help you avoid things that bring on your headaches. And the diary also can help your doctor plan your treatment.
If you have headaches caused by muscle tension in your neck, shoulders, and upper back, pay attention to your posture during your daily activities. You also can try muscle relaxation and other ways to reduce muscle tension.
Your doctor also may prescribe medicine to help prevent tension headaches.
Living With Tension Headaches
You may have fewer headaches—and less pain when you do get them—if you:
- Find and avoid triggers for your headaches.
- Keep a headache diary to find out what triggers your headaches.
- Take over-the-counter drugs to stop a headache.
- Take medicine as your doctor advises to stop or prevent a headache.
- Reduce stress with relaxation and positive-thinking methods.
Find and avoid triggers
You can reduce how many headaches you have by finding out what triggers them and avoiding those things. Triggers may include stress, hunger, and lack of sleep.
Use a headache diary
Use a headache diary to find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you were doing when the headache started. This information can help you avoid things that bring on your headaches. A diary also may help your doctor plan your treatment.
Take medicines as your doctor advises
If you have mild to moderate headaches, your doctor probably will want you to take over-the-counter medicines to stop your headaches. These include medicines like acetaminophen (such as Tylenol) and ibuprofen (such as Advil). Be safe with medicines. Read and follow all instructions on the label.
If over-the-counter medicines don’t stop your headaches well enough—or you get a lot of headaches—your doctor may prescribe medicine to prevent headaches.
Don’t take medicine too often. Talk to your doctor if you’re taking medicine more than 3 days a week to stop a headache, or if you have a headache on more than 15 days a month. Taking too much over-the-counter pain medicine can lead to more headaches. These are called rebound headaches.
One Man’s Story:
“I hold my stress in my shoulders and neck. My shoulders are always up around my ears. A lot of times, I leave at the end of the day with a big headache.”—Jerry
Read more about how Jerry reduced his stress.
Stress can cause tension headaches.
You can lower your stress with positive thinking and relaxation methods. Research shows that you can change how you think. And how you think affects how you feel. Try these techniques on your own or with help from a therapist or counselor trained in muscle relaxation, meditation, biofeedback, or cognitive-behavioral therapy.
Learn how to lower your stress with these topics:
You also can learn to stop thinking all the time about things that bother you.
Seek help if you think that your tension headaches may be linked to depression or anxiety. Treating these health problems can reduce how often you get headaches.
Your doctor may recommend medicine to treat or prevent tension headaches.
You might only need to take an over-the-counter medicine for pain. These medicines usually have fewer side effects than prescription drugs. Always be safe with medicines. Read and follow all instructions on the label.
Over-the-counter drugs to stop headaches
Over-the-counter medicines that you can use to stop a headache include:
- Acetaminophen (such as Tylenol).
- Aspirin (such as Bayer).
- Ibuprofen (such as Advil).
- Naproxen (such as Aleve).
- Medicine that combines aspirin, acetaminophen, and caffeine (such as Excedrin).
Try to avoid taking over-the-counter drugs more than 3 times a week, because you may get rebound headaches. These are different from tension headaches. They usually occur after headache medicine has worn off. This leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine.
Prescription drugs to prevent headaches
Your doctor may recommend that you take a prescription medicine every day to prevent headaches. You may want to take this medicine if:
- Over-the-counter medicines don’t work to stop your headaches.
- You’re taking over-the-counter medicines to stop headaches more than 3 times a week.
- You get a headache more than 15 days a month.
Medicines used to prevent tension headaches include:
- Antidepressants, such as amitriptyline.
- Seizure medicines, such as topiramate.
- Medicines that relax muscles, such as tizanidine.
- Antianxiety medicines, such as buspirone.
Botulinum toxin type A (BTX-A) is sometimes injected into the muscles in the face and head to treat headaches. In the past, doctors thought that spasms caused tension headaches. But BTX-A injections do not seem to help with symptoms of tension headaches.footnote 1 And BTX-A may cause weakness of the facial muscles and may make it hard for you to swallow.
What to think about
- The type of tension headache you have may help your doctor decide which drug to prescribe.
- There are other things you can try besides daily medicine. For example, you could use cognitive-behavioral therapy or biofeedback.
- The medicine that you take may cause side effects. Some side effects may last for a few weeks or for as long as you take the medicine.
- You may have to try several different drugs or types of drugs before you find the one that is right for you. Make sure to tell your doctor how well a drug stops your headaches.
- Certain pain medicines can cause a bad reaction if you take them with other medicines. Before you begin taking pain medicines, be sure to let your doctor know about all of the drugs you take. This includes over-the-counter medicines and complementary treatments (such as herbs).
Using other treatments along with medicines may help you stop a tension headache or prevent one.
If you decide to try one or more of these treatments, make sure your doctor knows. He or she may have advice on how to use other treatments safely. Other treatments for headaches include:
- Jackson JL, et al. (2012). Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: A meta-analysis. JAMA, 307(6): 1736–1745. DOI: 10.1001/jama.2012.505. Accessed February 1, 2016.
Other Works Consulted
- Digre KB (2016). Headaches and other head pain. In L Goldman, A Shafer, eds., Goldman-Cecil Medicine, 24th ed., vol. 2, pp. 2356–2364. Philadelphia: Saunders.
- Haghighi AB, et al. (2010). Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura: A randomised, double-blind, placebo-controlled, crossed-over study. International Journal of Clinical Practice, 64(4): 451–456.
- Headache Classification Committee of the International Headache Society (2013). The international classification of headache disorders, 3rd ed. (beta version). Cephalalgia, 33(9): 629–808. DOI: 10.1177/0333102413485658. Accessed February 1, 2016.
- Holland S, et al. (2012). Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78(17): 1346–1353.
- Kedia S, et al. (2014). Neurologic and muscular disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 776–861. New York: McGraw-Hill.
- Ropper AH, et al. (2014). Headache and other craniofacial pains. In Adams and Victor’s Principles of Neurology, 10th ed., pp. 1310–1390. York: McGraw-Hill Education.
Current as of:
August 4, 2020
Author: Healthwise Staff
Kathleen Romito MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Martin J. Gabica MD – Family Medicine
90,000 What to do if your head hurts constantly?
We all have headaches, though not so often. But what if the head hurts constantly, and not three times a month? The reason can be both in the way of life and in the deterioration of health.
How lifestyle affects headache
If you suffer from a regular headache, pay attention to your habits. Discomfort can come from fatigue, hunger, lack of sleep, overexertion, or stress.To relieve pain, try changing your routine for at least a couple of weeks:
- Go to bed early – a person needs at least 8 hours of sleep to rest. But don’t sleep for more than 10 hours. In this case, the oxygen and blood sugar levels will drop and cause a headache.
- If you sit for a long time at books, a computer, or your work is connected with looking at small details – be distracted every half hour. Get up, stretch, do not strain your eyes for at least a couple of minutes.
- Stop drinking alcohol. It affects blood pressure and affects the state of blood vessels in the head.
Try to avoid stressful situations and negative emotions. If your headache isn’t caused by illness, then these simple tips can help you avoid it.
To relieve pain, you can take an analgesic (the doctor will help you choose which medicine is right for you), have a snack, lie down to sleep for half an hour, ventilate the room and do a head massage.
When to go to a neurologist
There are very few diseases that affect nerve tissues and the brain. May cause headache:
- Neuralgia of the facial and trigeminal nerves – with it, the nerve fibers are pinched and inflamed, which can cause you to constantly feel pain;
- Neoplasms. Both benign and malignant tumors press on the vessels, increase intracranial pressure. The head hurts only on the side where the tumor is located.The disease can be suspected by a general deterioration of the condition, fever, lethargy and fatigue.
If the causes of the headache are not clear, the neurologist will refer you to an MRI or CT scan of the brain – they will quickly determine the cause of the discomfort. And if everything is in order with the brain itself, a competent neurologist will be able to find the source of the pain and send it to the doctor of the required specialty.
Heart and spine as a cause of pain
Often the head hurts due to problems with the heart and blood vessels.Usually older people are prone to this, but some diseases are common among young people:
- High and low blood pressure. The head hurts when the weather changes, with a sharp rise, dizziness may begin and it darkens in the eyes. This is due to vascular tension and oxygen starvation of the brain.
- Vascular diseases. With them, the pain lasts for several hours in the eye area, and blood may flow from the nose.
- Sclerosis and pinched vessels are inevitable companions of atherosclerosis and scoliosis.Due to the reduced lumen of the vessels, less oxygen enters the brain, the head begins to ache either over the entire area, or in the back of the head and temples.
- Stroke – thrombosis or rupture of the vessels of the brain. Severe dull pain appears, a person may lose mobility on one side of the face or body, and stop distinguishing familiar objects. At the first symptoms of a stroke, it is necessary to urgently call an ambulance – after a few hours, the brain will begin to die.
To detect pressure problems, you just need to monitor your condition.It is no coincidence that at every appointment with a therapist, you must measure your blood pressure. Do not be alarmed if it changes on some day: this is completely normal. But vascular disease can only be seen on MRI of the brain or magnetic resonance angiography. You will be referred for these examinations in order to accurately establish a diagnosis if it did not work out right away.
If you have back problems, the headache is most likely due to them. Any curvature of posture, an increase in bone tissue on the vertebrae, hernia and protrusion lead to pinching of blood vessels.And because of this, oxygen and nutrients cannot enter the brain, which causes pain, fatigue and drowsiness. Much less often, the pain from the spine radiates to the head. This happens with injuries, hernias and curvatures of the cervical and upper thoracic regions.
A neurologist and an orthopedic surgeon deal with problems of the spine. The doctor will pay attention to the curvature of the back, first of all, even on a simple visual examination. To clarify the diagnosis, the doctor may prescribe an X-ray, MRI or CT scan of the damaged spine.
Headache after injuries and illnesses
Pain can be caused by two types of injuries: damage to the skull and spine. The reason for their discomfort is different:
- With traumatic brain injury, a hematoma is formed, which increases intracranial pressure. It squeezes blood vessels and proximal parts of the brain. If the skull is damaged, debris can get inside and cause bleeding. In this case, the pain occurs some time after the injury. The eyes will darken, dizziness and nausea will begin.There is pain all over the head, but at the site of the injury it is especially strong.
- In case of spinal injuries, large vessels are clamped, which causes oxygen starvation. If the neck is injured, then the head will ache simply from the proximity of the injury.
In both cases, you must immediately consult a doctor. To clarify the nature and extent of the injury, the doctor can do an X-ray or MRI, but only after the acute phase has passed.
Diseases can affect headache both directly and indirectly:
- Severe infections can lead to inflammation of the brain structures, thinning of the vessel walls and destruction of the meninges.
- With flu, colds, sore throats and any other respiratory illness, breathing is impaired. And because of the smaller amount of incoming air, oxygen starvation and headache begin.
In these conditions, there is no point in going to a neurologist complaining of a headache. It is better to tell your doctor about it so that he can analyze the situation, adjust the treatment or refer you to hospitalization.
Are there any other reasons due to which the head hurts constantly?
Possible and even very likely! May cause headache:
- Medicines .For many drugs, pain is listed as a side effect.
- Hormonal failure . It can be both physiological (pregnancy, adolescence, menopause) and pathological (disruption of the thyroid gland, adrenal glands, ovaries). Hormones control our entire body, and when their concentration changes, the state of health will inevitably deteriorate.
- Mental diseases and pathological conditions . With neuroses, panic attacks and depression, headaches are not uncommon.Physiologically, they are also caused by hormones and oxygen deprivation, however, to get rid of the pain, you have to cope with mental ailments.
- Constant exposure to allergens can provoke headaches due to nasal congestion (and hence lack of oxygen) and pressure changes.
- Constant exposure to toxic substances causes respiratory distress and irritates mucous membranes.
There may be much more rare diseases, for example, multiple sclerosis or parasite infestation, which lead to the destruction of brain tissue.
At the first visit, the doctor will ask you about everything that may be related to the cause of the pain. Probably will refer you to another specialist: endocrinologist, psychotherapist, allergist. In the case of an incorrectly selected medicine, the doctor can prescribe an analogue without side effects. For diagnostics, you may need:
- MRI or CT of the brain,
- MRI of the cervical spine,
- blood test for hormones,
- general and biochemical blood test,
- tests for allergens.
There are many causes of headaches and can be difficult to identify quickly. However, the diagnostic methods are very similar, and you do not have to spend a lot of time on examinations. And, even if the fifth doctor can cure you, and not the second, getting rid of a constant headache is worth all the time spent on it.
Russian Interregional Society for the Study of Pain
Public Discussion of Clinical Guidelines
Public discussion of clinical guidelines
Public Discussion of Clinical Guidelines
Public discussion of clinical guidelines
Back pain is an interdisciplinary problem 2021
April 14, 2021, ONLINE
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Psychology of pain.Author’s course P.P. Kalinsky
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Classification of headache and its treatment, which doctor to contact
Classification of headache and its treatment.
14 December 2018
Headache is the most common complaint among patients seen by a neurologist. According to the classification, there are 2 types of headaches: primary and secondary.
Primary headaches include tension headache, migraine, trigeminal neuralgia, and cluster headache. Secondary headaches can occur due to neck pathology, with the abuse of analgesics, after head injuries, against the background of infections.
Let’s consider the most common options.
Migraine is usually characterized by severe throbbing headache accompanied by nausea, intolerance to bright light and strong odors, and general weakness. The pain is usually one-sided. The duration of an attack can be from several hours to three days.
Tension headache is most often mild, but may recur regularly and last for up to a week. The nature of the pain is pressing or squeezing, it can spread both to the entire head and to its part – the back of the head, forehead, crown.This type of pain occurs in those who, by the nature of their activity, often experience prolonged muscle tension (forced posture while working at a computer, driving a car, an uncomfortable position during sleep), are constantly exposed to psycho-emotional stress.
Cluster headache of a pulsating nature, usually unilateral, in the forehead or eye, sometimes accompanied by redness, swelling, lacrimation. Attacks usually last from 20 minutes to an hour and a half, but in severe cases, they can be repeated several times a day for several weeks.
Headache caused by infections, usually accompanied by fever, chills.
With meningitis, headache is acute, throbbing, with a temperature of 37.5 degrees and above, vomiting.
Post-traumatic headache occurs when a bruise or concussion of the brain, damage to the skull or cervical spine. The nature and location of pain directly depends on the type of injury.
Sinus headache is caused by inflammation in the sinus area, usually accompanied by mucosal edema, nasal congestion, and a runny nose.This type is characterized by painful sensations in the frontal and paranasal parts of the face.
Trigeminal headaches usually last only a few seconds but are very painful. Pain occurs in any area of the face while eating or talking. The most common causes of trigeminal lesions are caries, stomatitis, malocclusion, and sinusitis.
To establish the cause of the headache, you should consult a specialist (neurologist) who will prescribe the necessary additional examination, establish the cause of the disease and prescribe the necessary treatment.
This article was prepared by a neurologist of the first qualification category Petrochenko Marina Nikolaevna
About 20% of all headaches are caused by migraines. In 75% of cases, migraine manifests itself as a sudden, intense, one-sided, paroxysmal headache of a pulsating and periodically repetitive nature that can last about several hours, which is accompanied by nausea and vomiting, and the intensity of which increases with head movement.Migraine is dominantly inherited. Moreover, it is 3 times more common in women than in men. In addition, it mainly begins to manifest itself in young and middle age, and shows a decrease in old age.
As a rule, caused by migraine, headache lasts from 4 to 72 hours, and its intensity increases with exercise. Migraine sufferers often have disorders such as depression, anxiety, and panic disorder.In patients who are sensitive to migraine, various factors can cause headaches. The most common factors include certain foods and additional ingredients (wine, chocolate, caffeine, cheese), fasting or skipping meals, excessive or insufficient sleep, strong odors, changes in atmospheric pressure, intense light changes (bright blinking), psychological disorders, hormonal changes, menstrual bleeding, drugs and exercise.In about 15% of cases, migraine headache is accompanied by one of the most painful phases, called aura, which is a harbinger of migraine, followed by neurological symptoms lasting no more than 1 hour. Most often, during the aura, visual disturbances such as the appearance of blind spots, flashes of light or zigzags can be observed, tingling or numbness in the fingertips is less common, there are speech difficulties or difficulty in finding words, hallucinations and other visual disturbances.Paresthesias are the second most common type of aura. With such manifestations, numbness occurs, similar to “creeping creeps”, which begins unilaterally from the tips of the fingers and extends to the area of the arm and shoulder, reaching the area of the face, nose and mouth. In addition, although rare, symptoms such as with aura can also be observed: impaired speech, hearing and smell, dizziness and hallucinations. The headache usually begins within 5-30 minutes immediately after the onset of the aura.
Symptoms in classic migraine include loss of vision, weakness, sensory disturbances, and headache that lasts for several minutes. The duration of attacks for classic migraine can be several hours, for general migraine, this duration can take several days. Painful sensations can be accompanied by increased sensitivity and anxiety to light and sound. At the same time, symptoms such as abdominal pain and diarrhea may appear in other parts of the body.
Treatment of migraine, along with taking medications, also includes the elimination of factors that can cause it. Meanwhile, if migraine pain attacks occur more often than 3 times a month, while their intensity is strong enough and causes neurological disorders and certain inconveniences in everyday life, preventive treatment should be added to the existing treatment.
Arising spontaneously and irregularly, cluster headaches represent a pronounced pain syndrome in the areas of the projection of the brain onto the walls of the cranium.The causes of this type of headache are still unknown. The intensity of the pain is very high and can last for 30 minutes on average. Most often, pain occurs around the eyes, in the temporal region, behind the ears, and around the proximal molars of the mandible. The pain usually comes on at night and causes sleep disturbance. The severity of the pain is so great that it can lead to suicide attempts in order to get rid of the pain. Autonomic symptoms that characterize cluster headache include bleeding of the eyeballs, watery eyes, nasal congestion, runny nose, sweating of the forehead and face, drooping eyelids, decreased pupils, and swelling of the eyelids.Unlike patients with migraines, patients with cluster pain, rather than being in a dark room, prefer to stay in lighted rooms, go out into the fresh air and take walks. The duration of periods of cluster headache can vary in each patient in different ways. Most often they last for 2-3 months. A completely painless, calm period lasts for 6 months to 1 year. Painful periods occur almost every day, sometimes there may be several bouts of pain per day.In 4% of cases, pain can be bilateral. This pain is most often observed in men, while heredity does not matter.
There is a wide variety of different drugs that are used to treat cluster headache. Meanwhile, in the event that drug treatment is ineffective, it will be possible to turn to surgical methods of treatment.
90,000 causes, types and treatment. What to do with frequent headaches?
Most people who experience headaches prefer to “drown” them with pills, not thinking that such a reaction of the body in itself is an indicator of problems.Painful sensations as such are not a disease, but can be almost the only symptom that makes it possible to diagnose a number of dangerous diseases in time.
Causes of headache
Depending on the type, pain is indicative of various problems in the body.
Headache in the temples can be caused by a variety of reasons – from sudden changes in blood pressure to intoxication or infection.For some diseases, temporal lobe pain is a symptom that allows an early diagnosis.
The causes of headache in the back of the head are most often diseases such as cervical osteochondrosis, cervical spondylosis, induration (increased tone) of the muscles of the cervical spine, hypertension.
The occurrence of headache in the forehead may indicate inflammatory diseases such as frontal sinusitis, increased intracranial pressure, pinching of the occipital nerve.This type of pain is accompanied by such serious illnesses as meningitis, pneumonia, malaria, typhoid.
Pain in the eye area can be a symptom of autonomic dysfunction, migraine, as well as glaucoma and a number of other eye diseases. Failure to see a doctor on time can lead to serious vision problems.
The cause of frequent headaches can be a number of factors: stress, overexertion, various infectious diseases and inflammatory processes, food intolerance and many others.Regular repetition of painful sensations indicates that the problems in the body are of a chronic nature and require an obligatory visit to a specialist for diagnosis and treatment.
Severe headaches are often caused by causes such as migraines, pressure drops, sinusitis, traumatic brain injury and infectious diseases. If the painful sensations increase, this is a sure sign of abnormalities in the work of the body.
Prolonged headaches are especially dangerous, as they are symptoms of such serious diseases as meningitis, nervous system damage (arachnoiditis, encephalitis), tuberculosis, syphilitic damage to the nervous system, parasitic diseases.Prolonged pain may also indicate a brain tumor.
The cause of the throbbing headache is most often migraine. But this does not exclude other possible diseases: otitis media, eye diseases (for example, glaucoma), sinusitis, problems with cerebral vessels (vascular lesions of the brain, impaired cerebrospinal fluid outflow, impaired venous outflow), various infections. The degree of danger of this type of pain depends on their location, strength and duration.
Severe headache is often caused by spasms of the cerebral vessels in cervical osteochondrosis, hypertensive crisis. The most dangerous are vascular accidents – rupture of an aneurysm, intracranial hemorrhage. In addition, stress, nervous tension, taking certain medications and eating unhealthy foods can cause pain.
Types of disease
Migraine is usually characterized by severe throbbing headache, accompanied by nausea, intolerance to bright light and strong odors, and general weakness.The pain is usually one-sided. The duration of an attack can be from several hours to three days. The most susceptible to migraines are women between the ages of 25 and 35.
Tension headache (tension type pain, the most common and common headache) is most often mild, but can recur regularly and last up to a week. The nature of the pain is pressing or squeezing, it can spread both to the entire head and to its part – the back of the head, forehead, crown.This type of pain occurs in those who, by the nature of their activity, often experience prolonged muscle tension (forced posture while working at a computer, driving a car, an uncomfortable position during sleep), are constantly exposed to psycho-emotional stress.
Cluster headache (Hortonian) – one of the most severe types of pain. A person experiences prolonged bouts of very strong painful sensations of a pulsating nature. Usually the pain is one-sided, in the forehead or eye area, sometimes accompanied by redness, swelling, tears.Attacks usually last from 20 minutes to an hour and a half, but in severe cases, they can be repeated several times a day for several weeks. Most often, middle-aged men are susceptible to this type of pain.
Headache caused by infections , usually accompanied by fever, chills. With ARVI and influenza, the pain is not too strong, usually in the temporal, frontal parts or near the eyes. Patients show typical symptoms of colds: cough, runny nose, weakness.As you recover or after taking antipyretic drugs, the painful sensations decrease or disappear. With meningitis, the headache is acute, throbbing, with a temperature of 37.5 degrees and above, an additional symptom is vomiting. In this case, the patient needs urgent hospitalization. Less common are other infectious and bacterial diseases, in which the nature of the headache can be different, but almost always it is accompanied by other neurological symptoms.
Post-traumatic headache occurs with a bruise or concussion of the brain, damage to the skull or cervical spine.The nature and location of pain directly depends on the type of injury. Painful sensations can appear immediately or over time.
Sinus headache occurs due to inflammation in the sinus area, usually accompanied by swelling of the mucous membrane lining the sinuses and nasal cavity, nasal congestion and a runny nose. This type is characterized by painful sensations in the frontal and paranasal parts of the face, which can continue until the underlying disease is completely cured.
Headaches associated with increased intracranial pressure , very severe, may be accompanied by nausea, intolerance to bright light. As a rule, the entire surface of the head hurts, sometimes the area around the eyes. Painful sensations “pressing” or “bursting”. Most often, this type of pain is observed in patients who have ever had a head injury, as well as after birth injuries.
Trigeminal headaches usually last only a few seconds, but are very painful.Pain occurs in any area of the face while eating or talking. According to most doctors, caries, stomatitis, malocclusion, and sinusitis are the most common causes of trigeminal lesions and associated headaches. The risk group, therefore, includes everyone who has problems with the condition of the dental cavity.
When contacting the clinic with complaints of headache, the patient goes through several stages of examination.To begin with, the doctor, during the survey, clarifies the nature and duration of pain sensations, their localization, accompanying and provoking factors. For the initial diagnosis of some diseases, it is enough to undergo an examination by specialists: a neurologist, otolaryngologist, dentist, ophthalmologist. But in some cases, modern medical research is indispensable.
- Electroencephalography (EEG) – allows you to judge the state and work of the brain as a whole, to notice deviations from normal functioning, to identify vascular brain lesions, indirect signs of a tumor, hematoma.
- X-ray – helps to determine the presence of hydrocephalus, trauma, sinusitis.
- Magnetic resonance imaging (MRI) is used to diagnose tumors, chronic and acute cerebrovascular accidents, the consequences of stroke, sinusitis and many other diseases.
- Computed tomography (CT) – shows the presence of hemorrhages, changes in the structure of the brain tissue, cerebral vessels. CT scan of the brain allows you to determine the presence of tumors, cysts, aneurysms, thrombosis, atherosclerosis.
- Electromyography (EMG) – used to diagnose diseases of the neuromuscular system, nerve damage.
- Ultrasound diagnostics (US) of the head reveals atherosclerosis, various problems with blood vessels (anomalies in the development of blood vessels, changes in the lumen of the arteries, changes in the course of the arteries in the canal associated with severe osteochondrosis), aneurysms, blood flow pathology.
- Laboratory research methods are mainly used to detect infections and inflammations in a patient, autoimmune processes and disorders of cholesterol metabolism.
An alternative view of the causes and diagnosis of headaches
Traditional Chinese Medicine (TCM) treats this problem differently. For an oriental doctor, pain is a symptom of an imbalance in the body. Various pathogenic factors can upset the balance:
- external pathogens are wind, cold, dampness and heat. They can affect the body both individually and in combination;
- internal factors – pathologies of the spleen, liver, kidneys.The pathology of internal organs is caused by excessive consumption of sweet and fatty foods, overstrain, a lifestyle in isolation from the biological clock, depression, prolonged use of antidepressants and other drugs, as well as trauma to the branches of blood vessels (collateria).
External and internal pathogens disrupt the circulation of the vital energy Qi and blood. This causes intoxication of the body, and the result is a headache.
Diagnosis of headache by doctor TCM
Diagnostics according to the traditions of the East is carried out without instrumental studies and analyzes.The TCM doctor interrogates the patient, assesses the body odor, the condition of the eyes, skin, hair, looks at the posture, the patient’s movements, listens to the voice volume, breathing rate. He pays special attention to pulse diagnostics.
During the diagnosis, a Chinese specialist determines the root cause of the disease and prescribes an individual treatment program. Depending on the cause, one of eight diagnoses is made:
- Migraine. Stagnation of blood.
The headache spreads throughout the affected area.Periodically, there may be a lack of response to treatment. It is accompanied by nausea, increased blood pressure, intolerance to loud noise or bright light. The pulse is weak. Tongue red or with red spots.
- Migraine. Lack of blood supply to the liver.
The reason is the dysfunction of the spleen, namely its inability to produce enough blood. The headache is accompanied by a rapid heartbeat, anxiety, poor appetite, lethargy, fatigue.The pulse is weak. Tongue – with a thin white coating.
- Migraine. The liver’s reaction to stress, anger.
The headache affects the right or left side of the head. It is accompanied by nausea, vomiting, dizziness, irritability, a feeling of suffocation, a flushed face. Dryness and a bitter taste in the mouth, ringing in the ears may appear. The pulse is tense. The tongue is red with a thin yellow coating.
- Migraine. Qi stagnation.
Headache often occurs from sleeping too long or not getting enough sleep.It is accompanied by the appearance of varicose veins, vascular network, irritability. Women may experience dark menstrual flow. The pulse is wavy.
- Headache. Cold wind attack.
Cold and wind impede the flow of Qi and blood. Acute pain extends to the back of the head and neck, and may be accompanied by bone and joint pain. The pulse becomes tense. The tongue is covered with a thin white coating.
- Headache. Damp wind attack and damp block.
Dull, severe or aching headache in the occiput and neck. It is accompanied by muscle numbness, fever, poor appetite, heaviness in the limbs, aversion to dampness and cold. Abdominal pain, vomiting, profuse urination, diarrhea may appear. The pulse is slow. Tongue – white, greasy.
- Headache. Liver Yin deficiency.
The pain is accompanied by night sweats, a burning sensation of the face, feet and palms, urinary dysfunction, dry eyes, dry stools, thirst, fatigue, day and evening.In women, among other things, hot flashes are also observed.
- Headache. Hot Wind Attack .
The pain is accompanied by redness of the face and eyes, fever, thirst, constipation. Rapid pulse. The tongue is covered with a yellowish coating.
The need for treatment in one way or another is determined by the doctor. Most often it is a neurologist, but different causes of headaches can lead you to the office and to a specialist of another profile, who will also prescribe the necessary procedures.Doctors strongly discourage hoping that “it will pass by itself.” The development of pain syndrome can lead to aggravation of problems, leading to muscle spasms, lymphostasis, and brain hypoxia.
The main types of treatment used for headaches:
- drug treatment. The patient is prescribed to take drugs in tablets or injections of anti-inflammatory drugs, which also have an analgesic effect or a local anesthetic effect. Sometimes it is enough to take over-the-counter drugs, and in some difficult cases, you have to go through a whole course of drug blockades using hormonal drugs;
- manual therapy.Helps with tension headaches and migraines. A chiropractor will identify the source of the pain and help you get rid of it. However, often only manual therapy is not enough, it is only an additional method of treatment;
- massage. Also not an independent method, but an important part of a comprehensive treatment. However, neurologists often prescribe massage for headaches after trauma, for chronic migraines, etc.;
- acupuncture – the main method of treatment in BMT, also recognized by the WHO.It consists in influencing certain points with short-term acupuncture. This activates the work of the organs associated with the nerve endings located at these points. The process of self-healing of the organism starts. Patients often feel better after just one or two therapy sessions. After a course of acupuncture, as a rule, not only headaches disappear, but also the general condition of the body improves. In addition to acupuncture, the BMT doctor can recommend Tuina acupressure, Guasha scraping massage and vacuum therapy to relieve muscle spasms and improve blood circulation;
- osteopathy.Another type of manual influence: an osteopath eliminates the causes of headaches by working with pathological changes in muscles, joints, and organs. It is prescribed in combination with other methods;
- physiotherapy. Treatment with ultrasound, exposure to direct or alternating current, magnetic field, heat and other physical phenomena. It has long been proven that the effectiveness of physiotherapy surpasses many other methods, therefore, this method is often prescribed for the treatment of headaches of various types;
- physiotherapy exercises.Another related method. Carefully selected and calculated loads help to cope with pain syndrome caused by injury or overstrain;
- botox injections. Prescribed for tension headaches and migraines. The drug is injected into areas of spasmodic muscles, which allows you to relieve the spasm and thereby stop the headache;
- Methods of extracorporeal hemocorrection (EG). They are prescribed for diseases such as atherosclerosis of the vessels of the brain. The therapy is based on “cleansing” the blood from excess cholesterol and other substances that form atherosclerotic plaques, which disrupt the blood supply to the organ.Also, EG, removing autoantibodies from the bloodstream, significantly increases the effectiveness of the treatment of multiple sclerosis and other diseases of the immune system;
- folk remedies. Of course, there are many ways to get rid of headaches, known since the days of our grandmothers. This is the application of various lotions to the sore spot, and aroma and phytotherapy. Their effectiveness is not always confirmed. It should be remembered that no folk “miraculous” recipes can replace going to the doctor and can only be an additional method of treatment.
Prevention of headaches
The best prevention is to find out the causes of pain and eliminate them completely. But subsequently, the pain syndrome can also arise due to other factors: overexertion, pressure surges, depression and many others. To reduce the risk of unpleasant sensations, you just need to avoid situations in which they can arise: try to get enough sleep, avoid overwork, do not abuse caffeinated drinks. Regular physical activity, healthy diet and fresh air are the main factors in maintaining the body in good condition.
In most cases, headaches quickly disappear without causing complications – most likely the cause is stress or overwork. However, if the pain does not go away for a long time or comes back again and again, do not postpone the visit to the doctor – this can be dangerous to health and even life.
4 causes of headaches: when should you go to the doctor? | Healthy life | Health
At the same time, neuropathologists believe that the source of the problem is in the brain, therapists – that it is in the vessels, and psychotherapists blame everything on stress.
And each of these specialists is right in his own way. There are many sources of headaches. This can be both lack of sleep, stress, osteochondrosis, a deficiency in the body of certain trace elements (potassium, copper, magnesium or phosphorus), and serious diseases, such as meningitis and even a brain tumor. Fortunately, only 5 out of 100 headache attacks warrant immediate hospitalization. In other cases, you can cope with the malaise on your own.
This hat does not suit your face
Doctors have such a concept – “neurotic helmet”, or “tension headache”.We are talking about discomfort that occurs as a result of increased tone of the muscles of the neck and scalp for a long time. The cause of this ailment, as a rule, is physical overwork and emotional distress, sometimes it is caused by excessive smoking and even clips or earrings that press on certain points on the ear.
“Neurotic’s helmet” is usually two-sided, it is distinguished by a dull, monotonous, diffuse nature of pain, as if the skull is squeezed with a hoop. It is episodic – less than 15 days a month and chronic – more than 15 days a month for six months.Experts have noticed that this “headdress” is more often worn by patients who are inclined to negatively assess life events, that is, inveterate pessimists. In this case, pain is a bodily expression of anxiety, a manifestation of accumulated experiences and complexes. This problem can be eliminated with natural sedatives (chamomile tea, peony tincture, passionflower) and autogenous training. Self-massage of the head helps a lot: it relieves that very muscle tension – the cause of unpleasant sensations.There is even such a technique – “combing out” the headache with a massage brush. This increases blood circulation and relaxes the muscles. Normal blood circulation is restored.
What to do: Massage your fingertips with the tip of the pencil. Find the most painful point and press on it (this is a kind of home reflexology). Respiratory gymnastics or aromatherapy helps a lot. Try 5-10 minute hot foot or hand baths. Instead of a water procedure, you can put a squeezed hot towel on your forehead, massage your neck and shoulders, drink green tea (but without chocolate and sweets).
The cause of the headache may be a spasm or vasodilation. Most often, this problem worries those who lead a sedentary, sedentary lifestyle. Another category of unfortunate people suffering from a similar headache is those with vegetative dystonia and osteochondrosis. In this state, the whole head splits at once. The pain is of a pulsating nature, “knocking at the temples”, the face looks puffy, the general condition is broken. For those who are susceptible to this ailment, the discomfort intensifies with a change in the weather and a few days before menstruation.During pregnancy, the frequency of headaches decreases or they stop altogether, but, unfortunately, they resume after childbirth, as soon as the period of breastfeeding ends. In this case, home remedies won’t help. We need medicines that stabilize blood vessels and relieve spasms (stugeron or no-shpa).
What to do: Wet compresses can relieve the pain a little – hot, if the face turns pale during an attack, and cold, if it turns red. Massage of the head and neck helps a lot.As a prevention of pain caused by blood vessels, experts recommend swimming. Admirers of traditional methods of treatment use herbal preparations containing hawthorn, dried cress, lemon balm. But in this case, you should not get carried away with coffee and preparations with caffeine.
A monster named “Migraine”
The term “migraine” was introduced by the ancient Roman physician Galen. This is a complex disease, the main symptom of which is attacks of unbearable pain strictly in one half of the head.Doctors associate this pathology with impaired metabolism of serotonin, a substance involved in the transmission of nerve impulses. By the way, women are more likely to suffer from migraines. If your mother suffered most of her life because of an unbearable headache, most likely, a similar fate awaits you. After all, migraines are usually inherited. The situation is aggravated if you lead the wrong way of life: you smoke, drink alcohol, exercise a little and are rarely out in the air.
The first headaches can be observed in childhood.They are fully manifested by the age of 25-40. The attack can last from 4 hours to 3 days, accompanied by nausea, sometimes vomiting, increased sensitivity to light and sounds. It is often preceded by such special effects as flickering flashes of light followed by a “veil in front of the eyes”, narrowing of the field of view, double image.
What to do: in the first phase of migraine, vasodilators are used: dibazol with papaverine, nicotinic acid, trental, stugerone. On the second – vasoconstrictor: ergot preparations.During an attack, you need to rest in a darkened room, as well as a light massage or warm hand baths with essential oils of lavender, lemon, peppermint, marjoram.
Scientists recently discovered that headaches can be associated with food intolerances in certain foods. The reason is in substances that affect blood vessels. First of all, it is tyramine, which can be found in chocolate, long-aged cheese, yogurt, sour cream, salted or pickled fish, canned seafood (crabs, shrimps), smoked meat, sausages, as well as in all types of beer.This substance is insidious in that its amount in products increases with long-term storage.
Another chemical element that causes the so-called sausage headache is sodium nitrate. And monosodium glutamate, found in many dishes and sauces of Chinese cuisine, is the source of the ailment with the sonorous name “Chinese restaurant headache.” If you are not a fan of oriental cuisine, do not rush to rejoice. It can be found in bouillon cubes, potato and corn chips, flavored croutons, and some dry soups.
Caffeine deserves special attention. It is curious that it causes unpleasant sensations not by its presence, but by its absence – this is the so-called abusal headache. In this case, people suffer from the lack of their favorite coffee, cola or tea. Abrupt withdrawal from these drinks is accompanied by throbbing headaches in the temporal regions, weakness, irritation, absent-mindedness, anxiety, fear, sleep disturbance and nausea.
What to do: Diet is a prerequisite for recovery.Switch to a diet that excludes the use of harmful foods. Herbal medicine, methods of cleansing the body and kinesiotherapy (a special method of physiotherapy exercises) have an excellent effect.
Do not postpone a visit to the doctor if the headache increases, the pills do not help, or the discomfort constantly recurs for several days and weeks. If the ailment is accompanied by visual impairment, dizziness, it is necessary to visit a specialist as soon as possible.
Only 5 out of 100 headache attacks are a reason for hospitalization
- Whole head – fever, colds, infectious diseases
- Forehead (both sides above the eye sockets) – eye diseases, incorrectly fitted glasses
- Temples on both sides, occiput – pulsating vascular headache (with hypertension)
- Hoop (passes through the forehead, temples, back of the head) – for tension headaches
- Behind the ear (on one side), temple – dental problems or otitis media
- Temple (one side) – migraine
Larisa Novikova, neuropathologist of the highest category
Of course, in the treatment of headaches, the normalization of the daily routine is of great importance, that is, compliance with the rules of a balanced diet, the obligatory alternation of work and rest, limitation of emotional stress (primarily negative), good sleep.Unfortunately, these measures are not always sufficient. And only a specialist can understand the true cause of a headache. If the use of first aid is not effective, do not postpone the visit to a specialist. After all, early diagnosis of the disease is the key to successful treatment.
– I am a happy person – I almost never have a headache. This attack happened to me only two or three times in my life.At the same time, in order to recover, I did not need to rest, or drink special teas or decoctions, or take wonderful baths. When this happened, the usual aspirin pill saved me. Apparently, this is just a feature of my body, which, seeing how others suffer, I am very glad.
– A warm, relaxing bath works best for me to relieve headache attacks. I always add stress-relieving agents to the water – salts, gels, balls and rose petals.If there is no time for water procedures, then I wipe my face with a piece of ice, in which I dilute an ampoule of collagen-elastin before freezing. The procedure kills two birds with one stone: the pain goes away and at the same time the contours of the face are tightened.
– You see, I live in such a rhythm that there is no time to pay attention to such trifles as a headache. I relieve unpleasant symptoms by drinking an analgin pill and turning on calm, pacifying, best of all, classical music.But if the problem occurs frequently, you need to see a doctor and look for the immediate cause of its occurrence. After all, a headache can be the result of a cold, overwork, problems with blood vessels.
Material provided by the magazine “AiF Pro Health” No. 12, 2008
90,000 Post-traumatic headache – treatment, symptoms, causes, diagnosis
Post-traumatic headache occurs after a head or neck injury. In fact, headache is the most common symptom that people experience after even a mild traumatic brain injury.
Pain may begin immediately or one week after injury. For many patients, especially those with severe trauma, headaches can be a problem for months, years, or a lifetime. If headaches develop within 2 weeks after injury and persist for more than a few months, it is considered a chronic phase of post-traumatic headache. Sometimes patients have headaches only a few months after the injury, but as a rule, the headaches usually start within a few hours or days after the injury.
It is very difficult to predict the possibility of developing chronic post-traumatic headache in trauma patients. In general, patients with a pre-existing headache or migraine have a higher risk. Patients with a family history of migraine may be at increased risk of developing chronic headaches. The severity of the injury can also help predict, but many patients have severe headaches for months or years after a trivial head injury.Auto collisions with a rear impact, without head injury, usually result in severe headaches and neck pain. Factors such as the angle of impact, where the patient was sitting in the car, and where the force vector on the head fell are key elements in the development of headaches.
Headaches are generally of two types:
- by type of HDN, which can be daily or occasional
- migraine headaches, which are usually more severe.
In some patients, post-traumatic migraine pain can be a serious problem, with recurrent severe headaches lasting from hours to days. In other patients, tension headache is the predominant problem. In many patients with PTHB, pain can be mixed.
Occipital pain is often associated with neck pain and is usually of muscle origin.
Types of injuries that cause post-traumatic headaches
- Car accidents
- Sports injuries
- Neck pain
- Headaches worse with exertion, coughing, bending or moving the head
- Double vision
- Memory Violations
- Loss of appetite
- Hearing impairment
- Nausea and vomiting
- Changes in smell or taste
- Problems with concentration
- Ringing in the ears
- Noise sensitivity
- Light sensitivity
- Sleep problems
- Muscle cramps in the head, neck, back and shoulders
The International Headache Society defines criteria for post-traumatic headache, such as:
- Headache that does not have typical characteristics and meets criteria C and D
- Presence of a head injury with all of the following symptoms:
- Without and with loss of consciousness, which lasted no more than 30 minutes
- Score on the Glasgow Coma Scale (- which is used to assess the level of consciousness after traumatic brain injury) equal to or greater than 139010
- Symptoms diagnosed as concussion
- Headache develops within seven days after traumatic brain injury
- One or the other of the following:
- Headache resolves within three months after head injury
- The headache has not disappeared, but the injury was less than three months ago
To diagnose this type of headache, as a rule, such types of studies as MRI, CT, PET, EEG are used, since a clear visualization of morphological changes in brain tissues and the exclusion of conditions that threaten a person’s life are required.
Medicines are the cornerstone of treatment. During the first three weeks of a headache, abortive medications are usually used. If the headaches continue after three weeks, then additional therapy is prescribed.
The choice of abortive therapy depends on the type of headache. The main medications for the treatment of post-traumatic tension headaches are analgesics, NSAIDs.Muscle relaxants are more effective for PTHB than for common tension headaches due to cervical spasm. But these drugs are only recommended for 1-2 weeks. If the pain persists, then in this case it is necessary to include preventive treatment. If post-traumatic headaches are of a migraine nature, then the same drugs are used as for migraines. Antiemetic drugs are effective for many patients. Primary abortive migraines include: Excedrin, Aspirin, Naproxen (Naprosyn or Anaprox), Ibuprofen (Motrin), Ketorolac (Toradol), Midrin, Norgesic Forte, Butalbital, Ergotamines, Sumatriptan, corticosteroids, drugs, and sedatives.
Abortive medications such as anti-inflammatories are usually used for the first 2 to 3 weeks after the injury. Most patients do not need to take preventive medications on a daily basis, and PTSD headaches gradually decrease over time.
The most commonly used prophylactic drugs are antidepressants, especially amitriptyline (Elavil) or nortriptyline (Pamelor) and beta-blockers.NSAIDs are often dual-use drugs, functioning as an abortive and preventative treatment. Antidepressants that are sedating, especially amitriptyline, often reduce daily headaches while also normalizing sleep. In severe cases, both beta blockers and antidepressants must be used. Non-drug treatments can include a variety of physiotherapy and acupuncture.