How do headaches develop and what triggers them. What are the most effective ways to prevent headache pain. How can you identify your personal headache triggers. Why is staying hydrated crucial for headache prevention. How can lifestyle changes reduce headache frequency.

Understanding the Root Causes of Headaches

Headaches can be a debilitating and frustrating experience, often disrupting our daily lives and productivity. To effectively combat this common ailment, it’s crucial to understand its underlying causes. Headaches are typically categorized into two main types: primary and secondary.

Primary Headaches: The Common Culprits

Primary headaches are not symptoms of an underlying medical condition but are the condition itself. They often result from:

• Stress and tension
• Environmental factors
• Sensitivity to smells, lights, or sounds
• Chemical imbalances in the brain

Secondary Headaches: Signs of Underlying Issues

Secondary headaches are symptoms of other medical conditions. These may include:

• Concussions or whiplash injuries
• Sinus infections
• Dehydration
• High blood pressure

Understanding the type of headache you’re experiencing is the first step in developing an effective prevention strategy.

Identifying Your Personal Headache Triggers

Headache triggers can vary significantly from person to person. What causes a splitting migraine in one individual might have no effect on another. This is why it’s essential to identify your personal triggers.

The Power of a Headache Journal

One of the most effective ways to identify your headache triggers is by maintaining a headache journal. This involves recording:

• Date and time of headache onset
• Duration of the headache
• Intensity of pain (on a scale of 1-10)
• Activities performed before the headache
• Foods and drinks consumed
• Sleep patterns
• Stress levels
• Menstrual cycle (for women)

By consistently logging this information, patterns may emerge, helping you pinpoint specific triggers. Are your headaches more frequent on days you skip meals? Do they occur after consuming certain foods or drinks? Does lack of sleep seem to be a contributing factor?

Common Headache Triggers to Consider

While triggers can be highly individual, some common culprits include:

• Hormonal changes (especially in women)
• Weather changes
• Certain foods and additives (e.g., MSG, aspartame)
• Alcohol and caffeine
• Strong odors
• Bright or flickering lights
• Loud noises
• Physical exertion
• Lack of sleep or changes in sleep patterns

Dietary Modifications for Headache Prevention

What we consume can have a significant impact on our likelihood of experiencing headaches. By making mindful choices about our diet, we can potentially reduce the frequency and severity of headaches.

Foods and Drinks That May Trigger Headaches

While individual responses vary, some common dietary triggers include:

• Processed meats containing nitrates
• Aged cheeses
• Chocolate
• Alcohol, especially red wine
• Foods containing MSG or aspartame
• Citrus fruits
• Nuts and nut butters
• Pickled or fermented foods

If you suspect certain foods might be triggering your headaches, try eliminating them from your diet for a few weeks and observe any changes in your headache patterns.

The Role of Hydration in Headache Prevention

Dehydration is a common yet often overlooked cause of headaches. Staying properly hydrated can significantly reduce your risk of developing a headache. But how much water should you drink?

While individual needs vary, a general guideline is to consume at least 8 glasses (64 ounces) of water per day. However, factors such as climate, physical activity, and overall health may increase your hydration needs. Pay attention to the color of your urine – if it’s pale yellow, you’re likely well-hydrated.

Balancing Caffeine Intake

Caffeine can be both a friend and foe when it comes to headaches. In moderation, it can help alleviate headache pain by constricting blood vessels. However, excessive caffeine consumption or sudden withdrawal can trigger headaches.

If you’re a regular coffee drinker, try to maintain a consistent intake. If you decide to cut back, do so gradually to avoid withdrawal headaches. Remember, caffeine is found not only in coffee but also in tea, chocolate, and some sodas.

Lifestyle Adjustments to Reduce Headache Frequency

Beyond dietary changes, several lifestyle modifications can significantly impact your susceptibility to headaches.

The Importance of Regular Sleep Patterns

Both too little and too much sleep can trigger headaches. Aim for 7-9 hours of quality sleep each night. Establish a consistent sleep schedule, even on weekends, to regulate your body’s internal clock.

Stress Management Techniques

Stress is a common trigger for tension headaches and migraines. Incorporating stress-reduction techniques into your daily routine can help prevent stress-related headaches. Consider trying:

• Meditation or mindfulness practices
• Deep breathing exercises
• Yoga or tai chi
• Regular exercise
• Journaling
• Talking to a therapist or counselor

The Role of Exercise in Headache Prevention

Regular physical activity can reduce the frequency and severity of headaches by releasing endorphins, improving sleep quality, and reducing stress. However, it’s important to start slowly and gradually increase intensity to avoid exercise-induced headaches.

Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, as recommended by health authorities.

Environmental Modifications to Prevent Headaches

Our surroundings can play a significant role in triggering headaches. By making some simple adjustments to your environment, you may be able to reduce your headache frequency.

Lighting Considerations

Bright or flickering lights can trigger headaches in some individuals. Consider these strategies:

• Use natural light when possible
• Install dimmer switches to control light intensity
• Use anti-glare screens on electronic devices
• Wear sunglasses outdoors, especially on bright days

Managing Noise Levels

For those sensitive to sound, noise can be a significant headache trigger. Try these tips:

• Use noise-cancelling headphones in loud environments
• Create a quiet space in your home for relaxation
• Use white noise machines to mask disruptive sounds
• Consider soundproofing options for your living or working space

Addressing Scent Sensitivities

Strong odors can trigger headaches in some people. To minimize this risk:

• Opt for unscented personal care and cleaning products
• Use natural air fresheners like essential oils (if not a trigger)
• Ensure good ventilation in your living and working spaces
• Avoid heavily perfumed environments when possible

The Role of Posture and Ergonomics in Headache Prevention

Poor posture and improper ergonomics can lead to tension in the neck and shoulders, potentially triggering headaches. By making some simple adjustments, you can reduce this risk significantly.

Proper Sitting Posture

When sitting, especially for extended periods:

• Keep your feet flat on the floor or on a footrest
• Maintain a small gap between the back of your knees and the chair
• Keep your knees at or below the level of your hips
• Support your lower back with a small pillow or rolled towel if needed
• Keep your shoulders relaxed, not hunched or rounded

Ergonomic Workstation Setup

If you spend a lot of time at a desk or computer, consider these ergonomic tips:

• Position your monitor at eye level to avoid neck strain
• Keep your keyboard and mouse at a height that allows your elbows to bend at about 90 degrees
• Use a chair with good lumbar support
• Take regular breaks to stand, stretch, and move around

The Importance of Regular Movement

Staying in one position for too long can lead to muscle tension and headaches. Set reminders to move regularly throughout the day. Simple stretches or a short walk can make a significant difference.

When to Seek Professional Help for Headaches

While many headaches can be managed with lifestyle changes and over-the-counter treatments, there are times when professional medical help is necessary.

Red Flags: When to See a Doctor Immediately

Seek immediate medical attention if you experience:

• Sudden, severe headache often described as a “thunderclap”
• Headache accompanied by fever, stiff neck, confusion, or rash
• Headache following a head injury
• Headache with weakness, numbness, or difficulty speaking
• New onset of headaches after age 50
• Headaches that worsen with coughing, exertion, or sudden movement

Chronic Headache Management

If you’re experiencing frequent headaches (more than 15 days per month), it’s important to consult a healthcare provider. They may recommend:

• Prescription medications for prevention or treatment
• Lifestyle modifications
• Alternative therapies such as acupuncture or biofeedback
• Referral to a headache specialist or neurologist

Remember, headaches that significantly impact your quality of life should always be evaluated by a medical professional. They can help determine the underlying cause and develop an appropriate treatment plan tailored to your specific needs.

By implementing these strategies and working closely with healthcare providers when necessary, many people find they can significantly reduce the frequency and severity of their headaches, leading to improved quality of life and overall well-being.

6 Easy Tips You Can Do to Prevent Headaches: South Valley Neurology: Neurologists

6 Easy Tips You Can Do to Prevent Headaches: South Valley Neurology: Neurologists

Headache pain is often brought on by stress, chemical imbalances, or sensitivity to sound, lighting, or smells. To overcome this type of nagging discomfort, you need to make some modifications.

Preventing a headache is not about popping a couple aspirin. It involves learning the triggers for the pain and avoiding activities or behaviors that cause a throbbing or unrelenting headache.

So, how should you begin? Read the following information to get a clue on how to stay healthier and prevent headaches. Use the following tips to prevent headaches and stay healthier and pain-free.

What causes headache pain?

Before you read the tips below, it helps to know a little about headache pain and how it develops. Neurologists categorize headaches as primary headaches and secondary headaches. Primary headaches are headaches that result from stress, the environment, and sensitivity to smells, lights, or sounds. Knowing about these triggers will help you prevent a headache from happening.

Secondary headaches are headaches that develop from an underlying medical condition. For example, you may have suffered a concussion or whiplash. If you’re plagued with headaches, the injury may have affected your nerves and therefore your resilience to pain.

To prevent regular headache or migraine pain, again, you’ll need to know what activities or circumstances break down your immunity. For instance, some women may experience a pounding migraine if they’re exposed to a noxious odor. Others may get a headache from lighting that is too bright. If you attend a concert or sporting event, you may suffer head pain as well.

1. Figure Out What is Causing Your Headaches

Everyone is different and headaches take on different forms too. That is why it’s helpful to know what causes the pain so you can take measures to prevent it. One of the most debilitating types of headache pain is migraine pain or the pain experienced from a tension headache.

Either type of headache can disrupt your day and keep you from enjoying regular activities. Some of the things that can lead to severe head pain include emotional stress, the menstrual cycle, skipping a meal, changes in the weather, or irregular sleeping patterns. Some people who over-exercise and others who smoke regularly suffer from headaches as well.

Maintain a Headache Journal

To determine what is causing your head pain, you may want to keep a journal. Doing so will help you see what you were doing before your head started aching.

For instance, maybe you work out at the gym on Monday, Wednesday, and Friday. You notice, on those days, that you often suffer a headache – not before exercise but after a workout session. In this case, you might ask the following:

• Am I overdoing it whenever I exercise? If so, how can I modify my workout routine?
• Am I getting enough nutrients before and after a workout?
• Am I possibly suffering from dehydration (another precursor of head pain)
• Am I too rushed on the days I exercise?

Ask these questions to see what, exactly, you’re doing or not doing that is giving you problems. You may need to set aside more time for exercise or rehydrate after your workout session.

2. Review What You’re Eating and Drinking Each Day

It also helps to record what you’re eating or drinking each day. Do you notice, on some days, you’re headache-free? If so, review what you ate and what you drank.

Some foods produce headache pain. For example, foods or drinks that lead to a headache may include processed meats, chocolate, and alcohol. Also, look at the additives in some of the foods or beverages you consume. Ingredients, such as monosodium glutamate and aspartame, can cause your head to hurt.

Some people’s heads will hurt too if they stop drinking coffee or they don’t get their coffee fixed each day. If you notice your head hurts when you skip your morning brew, you’re probably experiencing a caffeine withdrawal. Other people get headaches when they are not drinking enough water. It’s really important to stay hydrated to help prevent triggering a headache.  

Other headache sufferers are surprised to find out that they’re headache is triggered from foods, such as potato chips, peanuts, nuts, chicken livers, smoked fish, pickled foods (such as sauerkraut or pickles), certain breads, beans, avocados, or garlic. Even donuts and cakes can lead to a headache.

3. Review Treatments for Headaches

It helps, as well, to review headache treatments. Some people take too much pain medication for ongoing headaches and end up experiencing rebound headaches. Therefore, you should consult with a neurologist who can recommend the right treatment path for you. The good news is there are a lot of great treatment options available today.

There are natural treatments you should try as well. For example, if you experience tension headaches, you often can reduce the symptoms by walking. Drop what you’re doing and get outside in the fresh air. The pain associated with a tension headache will not get worse if you exercise. Breathing in fresh air cleans out your lungs and removes the toxins you may have breathed that led your head to hurt.

If you experience a migraine, make sure you receive a faster recovery by turning down lights and lying down using a cool compress on the headache site.

4. Consider Alternative Therapies and Supplements

Some natural supplements prevent headaches. For example, these products include magnesium glycinate and coenzyme Q10. If you suffer from migraines, a supplement, such as coenzyme Q10, has been shown, through research, to offer an effective way to prevent head pain. If you do consider supplementation, speak to your doctor first to ensure the supplements won’t interfere with what you may be taking medicinally and that you take an appropriate dosage.

5. Practice Meditation and Deep Breathing

Taking time to meditate each day or practicing deep breathing are two activities that calm people who are under stress or experience anxiety. Devote time in your day to experience a little peacefulness. Not only will it rejuvenate you, it will prevent you from developing headache pain.

6. Balance Things Out in Your Life

How’s your work-life balance? How much time do you spend on work and how much time do you devote to family activities? Sometimes, headaches develop because you’re spending too much time on work and not enough time with friends or loved ones.

Slow Down and Take It Easier

Use the above suggestions to prevent headache pain, balance your time, and live a healthier, more fulfilled life. If you have recurring headaches or have suffered from a specific injury, you’ll need to see a neurologist find out the exact cause of your pain.

Managing tension headaches at home Information | Mount Sinai

Tension-type headache – self-care; Muscle contraction headache – self-care; Headache – benign – self-care; Headache – tension- self-care; Chronic headaches – tension – self-care; Rebound headaches – tension – self-care

The most common cause of tension-type headaches is muscle contraction in the head, neck or shoulders.

Headaches are usually caused by either muscle tension, vascular problems, or both. Migraines are vascular in origin, and may be preceded by visual disturbances, loss of peripheral vision, and fatigue. Most headaches can be relieved or ameliorated by over-the-counter pain medications.

A CT or CAT scan (computed tomography) is a much more sensitive imaging technique than X-ray, allowing high definition not only of the bony structures, but of the soft tissues. Clear images of organs such as the brain, muscles, joint structures, veins and arteries, as well as anomalies like tumors and hemorrhages may be obtained with or without the injection of contrasting dye.

Symptoms of a migraine attack may include heightened sensitivity to light and sound, nausea, auras (loss of vision in one eye or tunnel vision), difficulty of speech and intense pain predominating on one side of the head.

When You Have a Tension Headache

Hot or cold showers or baths may relieve a headache for some people. You may also want to rest in a quiet room with a cool cloth on your forehead.

Gently massaging your head and neck muscles may provide relief.

If your headaches are due to stress or anxiety, you may want to learn ways to relax.

Over-the-counter pain medicine, such as aspirin, ibuprofen, or acetaminophen, may relieve pain. If you are planning to take part in an activity that you know will trigger a headache, taking pain medicine beforehand may help.

Avoid smoking and drinking alcohol.

Follow your health care provider’s instructions about how to take your medicines. Rebound headaches are headaches that keep coming back. They can occur from overuse of pain medicine. If you take pain medicine more than 3 days a week on a regular basis, you can develop rebound headaches.

Be aware that aspirin and ibuprofen (Advil, Motrin) can irritate your stomach. If you take acetaminophen (Tylenol), DO NOT take more than a total of 4,000 mg (4 grams) of regular strength or 3,000 mg (3 grams) of extra strength a day to avoid liver damage.

Preventing Tension Headaches

Knowing your headache triggers can help you avoid situations that cause your headaches. A headache diary can help. When you get a headache, write down the following:

• Day and time the pain began
• What you ate and drank over the past 24 hours
• How much you slept
• What you were doing and where you were right before the pain started
• How long the headache lasted and what made it stop

Review your diary with your provider to identify triggers or a pattern to your headaches. This can help you and your provider create a treatment plan. Knowing your triggers can help you avoid them.

Lifestyle changes that may help include:

• Use a different pillow or change sleeping positions.
• Practice good posture when reading, working, or doing other activities.
• Exercise and stretch your back, neck, and shoulders often when typing, working on computers, or doing other close-up work.
• Get more vigorous exercise. This is an exercise that gets your heart beating fast. (Check with your provider about what kind of exercise is best for you.)
• Have your eyes checked. If you have glasses, use them.
• Learn and practice stress management. Some people find relaxation exercises or meditation helpful.

If your provider prescribes medicines to prevent headaches or help with stress, follow instructions exactly on how to take them. Tell your provider about any side effects.

When to Call the Doctor

Call 911 or the local emergency number if:

• You are experiencing “the worst headache of your life. “
• You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a headache before.
• You have a fever with your headache.
• A headache starts suddenly.

Schedule an appointment or call your provider if:

• Your headache pattern or pain changes.
• Treatments that once worked no longer help.
• You have side effects from your medicine.
• You are pregnant or could become pregnant. Some medicines should not be taken during pregnancy.
• You need to take pain medicines more than 3 days a week.
• Your headaches are more severe when lying down.

Garza I, Whealy MA, Robertson CE, Smith JH. Headache and other craniofacial pain. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley’s and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 102.

Jensen RH. Tension-type headache – the normal and most prevalent headache. Headache. 2018;58(2):339-345. PMID: 28295304 pubmed.ncbi.nlm.nih.gov/28295304/.

Rozental JM. Tension-type headache, chronic tension-type headache, and other chronic headache types. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.

Last reviewed on: 11/9/2021

Reviewed by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

questions to the neurologist about the types, causes and treatment of headaches

Important questions for the doctor

30. 03.22

Ekaterina Kushnir

asked about headaches

Author profile

Kirill Skorobogatykh

neurologist, cephalgologist

We talked to Kirill Skorobogatykh — neurologist, cephalologist, head of the University Clinic and headaches, author of the book “Knock Your Head. The whole truth about migraines and other headaches.

Cephalgologists specialize in the diagnosis and treatment of various types of headaches. You will find out what headaches are, how they are treated, when you need to go to the doctor, whether an examination is always required and what cannot cause a headache.

What will you learn

• What are the headaches and what are the most common?
• Why do primary headaches occur: migraine, tension headache?
• Can stress and anxiety cause headaches?
• Can a headache be caused by hypertension, osteochondrosis, occluded blood vessels or intracranial pressure?
• When should I see a doctor if I have a headache?
• How does a doctor understand why a person has a headache, what examinations are needed?
• What if a chronic headache interferes with work?
• How is chronic headache treated, is it possible to influence the frequency of attacks?
• How to choose a doctor or clinic for headache treatment?

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

What are the types of headaches and what are the most common?

Headache is one of the most common symptoms encountered in medicine. There are many types of headaches, about 300. There is an International Classification of Headaches – this is a useful tool for doctors in different countries to speak the same language.

International classification of headaches

All headaches are divided into two large groups: primary and secondary.

Secondary headaches is when the head hurts because of another illness. For example, a person hit his head – this is a secondary headache from an injury, or fell ill with the flu – this is a secondary headache from an infectious disease.

There are many secondary headaches, but they are quite rare. If you take 20 people with a headache, then only one or two of them will have secondary headaches.

Adult Headache Assessment – Uptodate

Primary Headaches – This includes migraine, tension-type headache, or TTH, and a range of other pain conditions. Such pains are much more common than secondary ones. In the case of a primary headache, the head hurts not because there is some kind of disease, problems with the vessels of the neck or something else – it hurts because the brain is not working properly.

According to statistics, migraine affects about 15% of the world’s population. In Russia, about 20% of the working-age population aged 18 to 65 have migraine. Another 30% of Russians suffer from tension headache.

At the same time, every third person has chronic headaches – that is, attacks more often than 15 days a month.

Headache statistics in Russia – International Headache Association

When I lecture doctors, I ask the same question in different audiences: “Have you ever had migraine attacks?” Those who have migraine always turn out to be about 44-55%, that is, about half. This does not mean that migraines are more common among neurologists – I think that they can simply diagnose themselves, understand what kind of headache they have.

When should I see a doctor if I have a headache?

Many people suffer from headaches, not everyone gets to the doctor. However, any person who regularly has a headache should consult a doctor to understand what his diagnosis is and receive appropriate treatment.

When to See a Doctor for a Headache – Mayo Clinic

Unfortunately, many self-medicate and go to the doctor when they are out of control. For example, when the head hurt once a month, and began to hurt every other day, or when conventional drugs stopped helping.

You need to see a doctor urgently if certain symptoms appear, doctors call them “red flags”. They help to suspect secondary headaches.

Such symptoms are grouped into a SNOOP mnemonic rule.

Primary or secondary headache? – American Headache Association PDF, 299 KB

S – systemic symptoms. For example, when a rash appears on the body along with a headache, a temperature or something else.

N – neurological symptoms. That is, not just a headache, but at the same time, for example, vision is lost, an arm or leg is weakened.

O – sudden thunderous pain, when the intensity of the pain increases in a couple of minutes and reaches 10 points on a 10-point scale. This is a serious symptom, it can talk about a brain hemorrhage.

P – change in the pattern of headache, its character. For example, earlier the pain was on both sides of the head and was squeezing, but now it hurts on one side behind the eye. At the same time, it should be taken into account that a change in only the frequency of headache – it hurt once a week, but it became more frequent – usually does not speak of secondary headaches, this is typical for migraine and HDN.

How does a doctor understand why a person has a headache, what examinations are needed?

Headaches rarely require instrumental and laboratory tests, i. e. blood tests, MRI, ultrasound and others.

Migraine – An MSD Physician’s Guide

A diagnostic search is structured like this:

1. A neurologist tries to rule out secondary headaches. They are rare, but this is the first thing to do. It is not necessary to prescribe an examination for everyone – only for those who have threatening symptoms, those same “red flags”. In such cases, an MRI may be prescribed, less often an ultrasound of the vessels of the neck – usually if the doctor suspects their damage as a result of an injury.
2. If there are no red flags, then the headache is primary. Examinations are not needed here, the diagnosis is made according to the patient’s survey. Primary headaches are associated with disruption of the brain, it cannot be assessed by other diagnostic methods.

For example, a diagnosis of migraine is made if there are headache attacks that last from four hours to three days, accompanied by nausea and / or increased sensitivity to light and sound. At the same time, the pain meets any two of the four criteria: the head hurts on one side more than on the other, the pain throbs, it is of moderate intensity or strong, and worsens from movement.

Tension headache has a different set of symptoms. In this case, the pain is not intense, not throbbing, not one-sided, does not increase with physical activity, without nausea, discomfort from light and sound. That is, such an “anti-migraine”.

8 ways to prevent or manage a migraine attack

It’s good for patients to keep a headache diary for a month before seeing a doctor – this helps in diagnosis. The diary can be kept in different applications, there is a chat bot in Telegram called Migrebot.

European and American headache clinics generally do not accept patients who do not keep a diary because it saves time. With a diary, the reception is more efficient, patients can tell how many times and how much their head hurt, what happened before the attack, how long the headache lasted, and so on.

Headache Diary – British Migraine Foundation

Headache Diary Template

Bot helps track headaches

Why do primary headaches occur: migraine, tension headache?

Migraine. The trigeminal nerve is responsible for almost any pain in the head area. All fibers of the trigeminal nerve, like the roots of a tree, gather at one point in the brain, it is called the trigeminal nucleus.

Pathophysiology of Migraine – Journal of the International Association for the Study of Pain

People with migraine experience sudden electrical activity in this area, causing them to feel a headache. Various factors can influence the activity of this zone and, consequently, migraine attacks: hunger, alcohol, lack or excess of sleep, hormone fluctuations due to the menstrual cycle, and others.

Such a feature of the brain is genetically incorporated, such as, for example, eye color. For some, seizures will be rare, for others they will be frequent, they can manifest themselves in different ways, but the general mechanism is the same.

Also, in people with migraine, at the very beginning of an attack, even before the onset of pain, the hypothalamus is activated – this is an important brain area that regulates sleep and wake cycles, eating behavior, mood and much more. It can be assumed that migraines can originate in this part of the brain.

How to treat migraine in children and adolescents

Tension headache. Less is known about the mechanisms of its occurrence. It is believed that rare attacks of tension headache may be associated with incorrect head position, uncomfortable posture, emotional stress.

Mechanisms of chronic tension headache – Journal of the International Association for the Study of Pain

There is also chronic tension headache, when attacks occur more than 15 times a month. In such cases, it is assumed that the problem is that the brain system responsible for pain relief is working worse. Because of this, bouts of pain occur, often associated with concomitant depressive or anxiety disorders.

The branches of the trigeminal nerve are responsible for sensitivity in the head area. Activation of a nerve nucleus in the brain may be the cause of migraine The branches of the trigeminal nerve are responsible for sensation in the head region. Nerve nucleus activation in the brain may cause migraine

Can stress and anxiety cause headaches?

Stress and anxiety often accompany migraines and many other types of primary headaches. Stress can cause tension headaches for the first time or worsen migraines. For example, earlier a person had mild attacks, in which the usual painkiller helped, and against the background of a stressful situation, the attacks became more severe, the pills stopped helping.

Reducing stress prevents headaches – Mayo Clinic

Depressive and anxiety disorders are also more common in people with headaches. Most likely, these conditions have common biological mechanisms within the brain. Perhaps they are associated with the work of neurotransmitters – substances with which the brain cells communicate, or with something else.

It is important for a neurologist at the appointment to assess whether a person has anxiety disorders or depression, and if they do, then treat them in parallel with the treatment of migraine. Both anxiety and depression exacerbate migraine – these are some of the factors that can make a rare migraine frequent, leading to its progression.

Link Between Depression, Anxiety, and Migraine – Migraine Foundation of America

Can a headache be caused by hypertension, osteochondrosis, occluded blood vessels, or intracranial pressure?

Hypertension. High blood pressure can cause headaches in rare cases when pressure numbers are more than 180/120 mm. rt. Art., that is, in a hypertensive crisis.

If the pressure numbers are lower, then the opposite is true: a headache is usually the factor that led to an increase in blood pressure. In principle, it can increase pain in any part of the body.

Hypertension and headaches – Medscape

Intracranial pressure. Intracranial pressure increases for two groups of reasons:

1. Something has formed inside the skull: for example, a tumor or a hematoma. The skull cannot stretch, as a result, the pressure inside grows. This rarely happens. In addition, in addition to a headache, there will be other symptoms, in particular neurological ones: speech, coordination, movement, and sensitivity disorders. In this case, the cause will be visible on the MRI.
2. Idiopathic increase in intracranial pressure – the pressure has increased, but it is not clear why. This is more common in overweight women. In this case, headaches are accompanied by visual impairment: flashes before the eyes, narrowing of the visual fields. These disorders progress rapidly, sometimes to complete blindness. If such a case is suspected, an examination of the fundus by an ophthalmologist is necessary. If intracranial pressure is increased, the doctor will see swelling there, because the fluid that washes the brain also washes the optic nerve – the pressure in the fundus also increases.

Intracranial pressure – NHS

Osteochondrosis. We often use this term to refer to the natural changes in the spine that await everyone in old age. The presence of hernias and protrusions is in no way associated with the occurrence of a headache.

Cervicogenic Headache – Migraine Foundation of America

Extremely rare headache associated with changes in the cervical spine, when there is subluxation of the joint and sprain of the ligament. In this case, the pain will be on one side, it is felt as if in an arc from the neck to the head. And most importantly, it occurs only after neck movements. Such a headache is called cervicogenic.

Vessels of the neck. Headache due to pinched neck vessels is a myth. If blood does not reach the brain, there will be no pain: a person will either faint or develop a stroke with neurological symptoms: speech impairment, facial asymmetry, paresis of the arms or legs.

Changes in the vessels of the neck that are found on ultrasound, such as asymmetry of blood flow, tortuosity, and so on, are variants of the norm, and not the cause of headache.

Neck vessels can sometimes be a source of headache when damaged. In this case, the wall of a large vessel – the vertebral or carotid artery – is exfoliated – an unpleasant pain appears, which can radiate to the back of the head. This is called vessel dissection.

Arterial dissection – Uptodate

This happens after car accidents when there is a sharp movement of the head, or when certain exercises are not performed correctly, for example, a headstand.

Dissecting an artery splits its wall, usually after an injury Dissecting an artery splits its wall, usually after an injury

What if a chronic headache interferes with work?

Economic losses and reduced quality of life due to headaches are big problems. There is such an indicator as the number of years lived with disability. It is important because it characterizes the burden on the healthcare system.

Global burden of disease: migraine is the second leading cause of disability – Headache Journal

There are many chronic diseases that do not kill a person, but require frequent visits to doctors and treatment. Among these diseases, migraine is in second place in the world in terms of the number of years that a person lives incapacitated, it is only ahead of back pain.

Migraine attacks often start at a young age and usually last a lifetime. If we take a typical example – a 55-year-old woman, suffers from migraine since the age of 15, attacks on average once a week – then in 40 years she spent 5.5 years in an attack. But during an attack, more than half of the people need bed rest, they cannot work.

To this we must add the prevalence of migraine among the working population – in our country it is 20%. It turns out that 20% of employees in any organization suffer from migraines.

At the same time, people with migraine feel stigmatized – “just have a headache, take a pill and go to work.” But this doesn’t always help. A person during an attack thinks worse, cannot analyze information normally, that is, it is almost impossible to work with his head. His condition is aggravated by the office environment, especially in open space: sound, light, conversations. Even if a person comes to work with a migraine, he will be unproductive.

Sick leave can be taken for migraine, especially for migraine status when the attack lasts longer than three days. However, migraine attacks can be frequent – 15 times a month or more, it is difficult to take a sick leave every time. Here we need a different approach, in particular, to choose the right therapy in order to reduce the frequency of attacks and quickly remove them.

How much does it cost to keep a migraine under control

It is better to discuss the problem with the employer and relatives. I call migraine a personal terrorist – attacks are unpredictable, it is impossible to predict when a person will fall out of the work process. It’s good if they understand at work that he missed the day not because he doesn’t want to work, but because it’s impossible to work. Or if the attack occurred at work, then the person needs time to recover.

Employers should make contact with people who have chronic headaches. For example, to equip dark rooms so that you can wait out the attack in silence, allow you to work remotely on the days of attacks or stay at home for a while until the pill works.

How is chronic headache treated, is it possible to influence the frequency of attacks?

Migraine. It is impossible to cure it completely, but it can be treated. There are three approaches to migraine treatment.

The first is the elimination of headache episodes. Common painkillers such as ibuprofen can help here. If they still do not help, then they use special preparations – triptans. Antiemetics may also be prescribed. If attacks are rare – up to four days a month, then such therapy will be enough.

Migraine Treatment – Mayo Clinic

The second option is preventive therapy to reduce the frequency of attacks. It is used if the attacks are frequent – more than four or five times a month, or so severe that nothing helps.

Various drugs are used here: some drugs that affect blood pressure and pulse, in particular beta-blockers, antidepressants, antiepileptic drugs, botulinum therapy. Such treatment reduces activity in the areas of the brain responsible for headache attacks. The mechanism of their action in migraine is not fully understood, but it is a standard therapy in all countries of the world.

Pharmacological prevention of episodic migraine in adults – recommendations of the American Academy of Neurology

There is also the newest group of drugs – monoclonal antibodies that block the action of the CGRP protein. This protein works inside the trigeminal nerve system: the more it is, the more pain. Monoclonal antibodies “turn off” this protein or the receptor for this protein for a long time. Injections should be done once a month or even every three months.

Monoclonal antibodies for migraine prevention – Medscape

Prophylactic therapy is considered effective if the frequency of attacks is reduced by at least half. Sometimes it is possible to remove them completely. The duration of therapy is usually six months to a year. The effect may be in a month, but the treatment needs to be continued longer so that the connections in the brain change.

Elimination of factors that can worsen migraine again. For example, if there is depression and anxiety disorders, they must be treated. Overweight, smoking, snoring, lack of physical activity can also affect. It is also important not to allow uncontrolled use of painkillers – this can cause an abuse headache, when the head hurts because of the drugs themselves. It can occur if you take painkillers more than two days a week. To prevent this, with an increase in seizures, prophylactic therapy should be immediately prescribed.

Tension headache. The most effective drug for chronic tension headache is amitriptyline. This is a weak and old antidepressant, while it is very effective for treating various pain syndromes. Other antidepressants are also used.

Also in chronic tension-type headache, many patients are diagnosed with anxiety disorders or depression. They can affect the chronicity of pain, it is important to treat them – it happens that after the treatment of such disorders, the headache also goes away.

Tension headache – Mayo Clinic

For migraine, botulinum toxin injections are given into points in different parts of the head For migraines, botulinum toxin injections are given into points in different parts of the head

How do I choose a doctor or clinic for headache treatment?

In Russia, people go to a neurologist with a headache, while abroad they go to a therapist, general practitioner or family doctor, because in most cases they can help.

Diagnoses like osteochondrosis or vegetovascular dystonia should be alert – there are no such diagnoses as the causes of headaches. In this case, you should get a second opinion. The same applies to situations where the doctor advised to “clean the blood vessels” or prescribed some kind of “vascular remedy”, of which we have a wagon and a small cart.

Remember

1. Headaches can be secondary, that is, arising from any disease, and primary – associated with disruption of the brain. The latter are much more common.
2. Migraine is thought to be due to activation of the trigeminal nucleus in the brain, while tension-type headache is due to malfunctioning of the analgesic system. It’s genetic.
3. Headaches may first occur or worsen due to stress, and chronic headaches are often associated with depressive and anxiety disorders.
4. Usually a headache causes an increase in blood pressure, and not vice versa. An increase in intracranial pressure can cause headache, if it is suspected, the fundus should be checked. Osteochondrosis and the condition of the vessels of the neck do not affect the headache, except in cases of damage to the walls of the vessels.
5. Many people suffer from headaches, not everyone gets to the doctor. However, any person who regularly has a headache should consult a doctor to understand what his diagnosis is and receive appropriate treatment.
6. Headaches rarely require instrumental and laboratory examinations, i. e. blood tests, MRI, ultrasound and others. Usually, only a patient survey is needed for diagnosis.
7. Employers should make contact with people who have chronic headaches. For example, to equip dark rooms so that you can wait out the attack in silence, allow you to work remotely on the days of attacks or stay at home for a while until the pill works.
8. The treatment of migraine consists in the removal of attacks, their prevention and reduction in frequency. Antidepressants are commonly used to treat chronic tension headache.
9. It is better to consult a neurologist who specializes in the treatment of headaches. The chosen doctor must answer all questions in detail and clearly, as well as make existing diagnoses.

“Tension headache: what to do?”

Everyone has experienced a tension headache at least once. This is a tedious, constant pain that presses or squeezes the head like a hoop, which can last for days or even weeks, reducing the quality of a person’s life. One of the main causes of such a headache is stress and prolonged work at the computer. Most often, knowledge workers suffer from it. How to stop feeling the “iron cap” on your head? Osteopathic doctor Alexander Ivanov spoke about this in a new article for BUSINESS Online.

“Headache is a common complaint at the appointment of a neurologist-osteopath”
Photo: pixabay.com

THE MOST COMMON TYPE OF HEADACHE

Headache is a common complaint at the appointment of an osteopathic neurologist. Recently, parents with school-age children who have a headache often come to me. The drug treatment of such pain does not suit anyone, because there are many side effects, as they say, we treat one, we cripple the other. Therefore, people are looking for effective and non-drug ways to get rid of headaches. Earlier in my publications, I have already talked in general terms about tension headaches. Today I will give practical recommendations and exercises to get rid of headaches.

The person has pain all over the head, as if it were squeezed by a hoop or a helmet was put on it. The pain appears more often in the afternoon, towards evening, after work or school. The trigger of pain is stress and muscle tension. Occasionally it is accompanied by nausea. This pain lasts from several hours to days. The intensity is usually small, and the attack is relieved with the help of painkillers.

CAUSES OF VOLTAGE HEADACHE

Cause #1 Stress during the day. Psycho-emotional stress during the day leads to a malfunction of the anti-pain system, and ordinary nerve impulses from receptors turn into a source of pain. In addition, stress leads to excessive muscle tension in the neck and head, which also causes pain.

Reason #2 Violation of work ergonomics. For example, an uncomfortable posture for work, a high table or a low chair leads to overstrain of the muscles of the shoulder girdle and neck.

Reason number 3. Abuse of gadgets and long work at the computer. This is a common cause of headaches in office workers, students and schoolchildren. Earlier, I already had an article about the dangers of using gadgets.

Reason #4: Uncomfortable pillow and wrong sleeping position. Overexertion of the neck muscles during sleep can give tension pain. It usually appears in the morning after waking up. Earlier, I also wrote about how to choose a pillow and what position is better to sleep in.

Reason number 5. Hypodynamia, or lack of movement. Violation of blood circulation with a lack of movement during the day can also be the cause of the development of tension headache. Often this occurs in office workers during prolonged sitting. Therefore, it is important to do industrial gymnastics and break away from work every 40 minutes.

PREVENTION AND TREATMENT OF VOLTAGE HEADACHE

Headache prevention follows from an analysis of its causes. Think about what is most likely to cause your headache. You need to eliminate the cause first. Next, work goes with the muscles of the neck and head – this is the elimination of trigger (starting) muscles. Soft manual therapy (osteopathy) and physiotherapy exercises are important in this work.

However, in order to identify the cause and make a diagnosis, in any case, you need to consult a doctor. It can be a neurologist or an osteopathic neurologist. For the treatment of tension headache, it is desirable to use non-drug methods: osteopathy, therapeutic massage, acupuncture, physiotherapy exercises.

IVANOV STRETCH HEADACHE GYMNASTICS

1. Place both hands on the sides of the scalp (temples, crown). The fingers are spread out like a rake. Make light shaking movements of the head back and forth so that the hands slide over the head and massage the scalp. Exercise relaxes the fronto-occipital aponeurosis. Let’s do it for one minute.

Photo courtesy of Alexander Ivanov

2. A wooden comb can be used to massage the head. Comb your hair with a comb in all directions. This will improve blood flow and relax the aponeurosis of the head. Let’s do it for one minute.

Photo courtesy of Alexander Ivanov

3. Slider exercise. Place one hand on the forehead and the other on the back of the head. Move your hands first in different directions up and down, and then in one direction up or down. Let’s do it for one minute.

Photo courtesy of Alexander Ivanov

4. Grasp your head with your hands tightly from the sides. Further, having “glued” to the scalp, make its shift in different directions to the left-right, forward-backward, clockwise and counterclockwise, along an oblique line.