What are the main types of headaches. How can you distinguish between tension, migraine, and cluster headaches. What are effective treatments for different headache types. When should you seek medical attention for headaches.

Understanding the Three Main Types of Headaches

Headaches are a common ailment affecting millions of people worldwide. While most headaches are not serious and can be treated at home, it’s crucial to understand the different types and their characteristics. Dr. Elizabeth Loder, chief of the division of headache in the department of neurology at Harvard-affiliated Brigham and Women’s Hospital, emphasizes the importance of recognizing headache features to determine if medical attention is necessary.

There are three primary types of headaches: tension, migraine, and cluster. Each type has distinct characteristics and treatment approaches.

Tension Headaches: The Most Common Type

Tension headaches are the most frequently experienced type of headache. They typically present as a dull, squeezing pain on both sides of the head, often described as feeling like the head is in a vise. The pain may extend to the shoulders and neck. Episodes can last anywhere from 30 minutes to seven days.

What causes tension headaches? While the exact cause is unknown, common triggers include:

• Stress
• Fatigue
• Lack of sleep

How can you treat tension headaches? Most tension headaches can be effectively managed with:

• Over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatories like aspirin, naproxen (Aleve), or ibuprofen (Advil, Motrin)
• Non-medicinal remedies such as a warm shower, a nap, or a light snack

Migraines: Severe and Debilitating

Migraines are more severe headaches that can be quite debilitating. The pain is often centered on one side of the head, typically beginning around the eye and temple before spreading to the back of the head. Migraine episodes can last from 4 to 72 hours.

How can you identify a migraine? Dr. Loder suggests using the acronym POUND to remember the key features:

• P: Pulsating pain
• O: One-day duration of severe untreated attacks
• U: Unilateral (one-sided) pain
• N: Nausea and vomiting
• D: Disabling intensity

Are there warning signs before a migraine? In some cases, yes. Almost a quarter of people with migraines experience an aura beforehand, which may include:

• Visual disturbances (halos, sparkles, flashing lights, wavy lines)
• Numbness or tingling, often on one side of the body, usually in the face or hand
• Fatigue, depression, and irritability several hours before the attack

How can migraines be treated? Treatment options for migraines include:

• OTC pain relievers if caught early
• Prescription drugs such as triptans (rizatriptan, sumatriptan, zolmitriptan)
• Other medications and treatments, including botulinum toxin injections in some cases

Cluster Headaches: Intense and Cyclical

Cluster headaches are less common but extremely severe. They occur five times more often in men than in women. As the name suggests, these headaches come in clusters, with sufferers experiencing 1-8 headaches per day over a 1-3 month period, potentially recurring every few years.

What are the characteristics of cluster headaches?

• Severe pain on one side of the head
• Abrupt onset lasting 30 minutes to an hour on average
• Associated symptoms on the affected side: red and watery eye, drooping eyelid, runny nose
• Restlessness and agitation during attacks
• Common nausea and sensitivity to light and sound

How are cluster headaches treated? Treatment options include:

• High-dose oxygen during pain onset
• Sumatriptan, especially when given by injection
• Nasal or oral triptans
• Injectable galcanezumab (Emgality) for reducing episode frequency

Other Types of Headaches and Their Causes

While tension, migraine, and cluster headaches are the main types, other conditions or situations can also cause headaches. These are often short-lived and easily treated.

Sinus Headaches

Sinus headaches are typically caused by sinus infections. They present as pain over the forehead, around the nose and eyes, over the cheeks, or in the upper teeth. The pain usually resolves when the infection clears up.

Brain Freezes

Some individuals experience sharp, sudden headaches when consuming cold foods or drinks. These “brain freezes” typically subside within a few minutes. To prevent them, try warming cold food at the front of your mouth before swallowing.

When to Seek Medical Attention for Headaches

While most headaches are not cause for concern, certain symptoms or patterns may warrant medical attention. When should you consult a doctor about your headaches?

• If you experience a sudden, severe headache unlike any you’ve had before
• If your headaches become more frequent or severe over time
• If OTC medications no longer provide relief
• If your headaches are accompanied by other concerning symptoms such as fever, stiff neck, or neurological changes
• If your headaches interfere with daily activities or quality of life

Lifestyle Factors and Headache Prevention

While treatments are available for various types of headaches, prevention is often the best approach. What lifestyle factors can help prevent headaches?

• Maintaining a regular sleep schedule
• Managing stress through relaxation techniques or exercise
• Staying hydrated
• Avoiding known triggers, such as certain foods or environmental factors
• Practicing good posture to reduce tension in the neck and shoulders
• Limiting caffeine and alcohol intake

By understanding your headache patterns and implementing preventive measures, you may be able to reduce the frequency and severity of your headaches.

The Role of Diet in Headache Management

Diet can play a significant role in headache management, particularly for those who suffer from migraines. Are there specific dietary approaches that can help manage headaches?

Some individuals find that certain foods trigger their headaches. Common culprits include:

• Aged cheeses
• Processed meats
• Chocolate
• Artificial sweeteners
• MSG (monosodium glutamate)
• Caffeine (both consumption and withdrawal)

Keeping a food diary can help identify potential triggers. Once identified, eliminating these foods from your diet may help reduce headache frequency.

On the other hand, some dietary practices may help prevent headaches:

• Eating regular, balanced meals to maintain stable blood sugar levels
• Staying well-hydrated
• Consuming foods rich in magnesium, such as leafy greens, nuts, and whole grains
• Incorporating omega-3 fatty acids found in fish, flaxseeds, and walnuts

Remember, dietary triggers and beneficial foods can vary from person to person. It’s important to pay attention to your own body’s responses and consult with a healthcare professional or registered dietitian for personalized advice.

The Impact of Hormones on Headaches

Hormonal changes can significantly influence headache patterns, particularly in women. How do hormones affect headaches?

Many women experience headaches related to their menstrual cycle, pregnancy, or menopause. These are often referred to as hormonal headaches and are typically related to fluctuations in estrogen levels.

Menstrual Migraines

Some women experience migraines that occur regularly around their menstrual period. These are often more severe and less responsive to typical migraine treatments.

Pregnancy and Headaches

Pregnancy can affect headache patterns in various ways:

• Some women experience a reduction in migraines during pregnancy, especially in the second and third trimesters
• Others may experience an increase in headaches, particularly in the first trimester
• New onset of headaches during pregnancy should always be evaluated by a healthcare provider

Menopause and Headaches

The hormonal changes associated with menopause can also impact headache patterns. Some women experience an increase in headaches during perimenopause, while others find relief post-menopause.

For those experiencing hormonal headaches, treatment options may include:

• Hormonal birth control methods (for some women)
• Hormone replacement therapy (in certain cases)
• Non-hormonal preventive medications
• Lifestyle modifications

It’s crucial to discuss hormonal headaches with a healthcare provider to develop an appropriate management plan.

The Connection Between Stress and Headaches

Stress is a well-known trigger for various types of headaches, particularly tension headaches. How does stress contribute to headaches, and what can be done to manage stress-related headaches?

Stress can lead to headaches through several mechanisms:

• Muscle tension, especially in the neck and shoulders
• Changes in sleep patterns
• Alteration of neurotransmitter levels in the brain
• Increased sensitivity to pain

Effective stress management techniques can help reduce the frequency and severity of stress-related headaches. These may include:

• Regular exercise
• Mindfulness meditation
• Deep breathing exercises
• Progressive muscle relaxation
• Cognitive-behavioral therapy
• Time management and prioritization strategies

In addition to these techniques, maintaining a consistent sleep schedule, eating a balanced diet, and staying hydrated can also help manage stress and reduce headache occurrences.

For individuals experiencing chronic stress-related headaches, it may be beneficial to consult with a healthcare provider or mental health professional to develop a comprehensive management plan.

Innovative Treatments and Future Directions in Headache Management

As our understanding of headache mechanisms continues to evolve, new and innovative treatments are emerging. What are some of the latest developments in headache management?

Neuromodulation Devices

Several non-invasive neuromodulation devices have been FDA-approved for migraine treatment and prevention. These include:

• Transcutaneous supraorbital neurostimulation devices
• Single-pulse transcranial magnetic stimulation devices
• Non-invasive vagus nerve stimulation devices

These devices work by modulating neural activity and can be particularly useful for patients who prefer non-pharmacological approaches or have not responded well to traditional treatments.

CGRP Antagonists

Calcitonin gene-related peptide (CGRP) antagonists represent a new class of drugs specifically designed for migraine prevention and treatment. These medications work by blocking the action of CGRP, a protein involved in pain transmission and inflammation associated with migraines.

Personalized Medicine Approaches

Advances in genetic research and biomarker identification are paving the way for more personalized headache treatments. In the future, it may be possible to tailor treatments based on an individual’s genetic profile or specific biomarkers, potentially improving treatment efficacy and reducing side effects.

Digital Health Solutions

The rise of digital health technologies is also impacting headache management. Smartphone apps for headache tracking, wearable devices for monitoring physiological parameters, and telemedicine platforms for remote consultations are becoming increasingly popular and may play a significant role in future headache care.

While these innovative approaches show promise, it’s important to note that their effectiveness can vary among individuals. Always consult with a healthcare provider before trying new treatments or technologies for headache management.

As research in this field continues, we can expect to see further advancements in our understanding and treatment of headaches, potentially offering new hope for those who suffer from chronic or severe headache disorders.

Headaches: What to know, when to worry

Everyone gets the occasional when-will-this-day-end headache. These headaches may even follow a certain pattern. (Mine usually strike like clockwork if I miss my morning cup of French press coffee.)

But when is a headache cause for concern?

“Most bouts of regular headaches are not serious and can be treated on their own,” says Dr. Elizabeth Loder, chief of the division of headache in the department of neurology at Harvard-affiliated Brigham and Women’s Hospital. “However, being aware of the features of the different types of headaches can help you determine if your headaches are something more serious that requires medical attention.”

Headache know-how

There are three main types of headache: tension, migraine, and cluster. Here is a look at each one.

Tension. This is the most common type of headache. A typical attack produces a dull, squeezing pain on both sides of the head like it’s in a vise. The shoulders and neck can also ache. Episodes can last 30 minutes to seven days.

Although the cause of tension headaches is unknown, triggers include stress, fatigue, and lack of sleep.

The good news is that you can treat most tension headaches with over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatories, such as aspirin, naproxen (Aleve), or ibuprofen (Advil, Motrin). You could also try a warm shower, a nap, or a light snack.

Migraine. Migraines are more severe and can be quite debilitating. The pain often is centered on one side of the head, beginning around the eye and temple and spreading to the back of the head. Episodes can last from four to 72 hours.

According to Dr. Loder, one way to remember the features of a migraine is the acronym POUND:

P: pulsating pain
O: one-day duration of severe untreated attacks
U: unilateral (one-sided) pain
N: nausea and vomiting
D: disabling intensity.

Although migraines can strike without warning, they may be set off or worsened by specific triggers or aggravating factors, such as loud noises, a bright light, or strong smells. In some people, attacks are preceded by several hours of fatigue, depression, and irritability.

Almost a quarter of people with migraines often have an aura beforehand and experience halos, sparkles or flashing lights, and wavy lines. Numbness or tingling is also common. This often appears on one side of the body, usually in the face or hand.

If you catch a migraine early, you may be able to control it with an OTC pain reliever. If this doesn’t help, or if your migraines become more frequent or severe, ask your doctor about a stronger prescription drug. Common options include triptans, such as rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig). These are available as tablets, nasal sprays, or injections that patients can give to themselves. Triptans often provide complete relief within two hours.  Other medicines — and even botulism injections — may help, too.

Cluster. Cluster headaches strike five times more often in men than in women. This type of headache gets its name because they come in clusters; for example, one to eight headaches a day over a one-to-three-month period that may reoccur every few years.

The pain is quite severe and always strikes one side of the head. The headache begins abruptly and lasts for 30 minutes to an hour, on average. Also, the eye on the painful side tends to become red and watery, the eyelid often droops, and the nose gets runny. Most people become restless and agitated during an attack, and nausea and sensitivity to light and sound is common.

Unfortunately, OTC drugs usually don’t offer much, if any, relief. High-dose oxygen can be effective if taken during the onset of pain. Several medications can help shorten the duration of attacks. For example, sumatriptan can often provide quick relief, especially when given by injection, but a nasal or oral triptan also may help. And an injectable medicine called galcanezumab (Emgality), used for migraine prevention, is now FDA-approved to reduce episodes of cluster headaches.

Other types of headaches

Headaches also can be caused by other conditions or situations. These are often short-lived and easily treated. For example:

Sinus headaches. A sinus infection can cause pain over the forehead, around the nose and eyes, over the cheeks, or in the upper teeth. When the infection resolves, the pain disappears.

Brain freezes. Some people develop a sharp, sudden headache when they eat or drink something cold. The pain usually goes away within a few minutes. If this is a common problem, try to warm the cold food at the front of your mouth before swallowing.

Exercise headaches. Strenuous exercise can sometimes trigger a headache. Make sure you are well hydrated before and after exercise. Taking an OTC anti-inflammatory beforehand also may help.

When to worry about a headache

Most headaches respond to self-care, OTC pain relievers, or medication your doctor prescribes. For some headaches, though, it’s best to promptly seek medical advice. Warning signs include a headache that:

• is unusually severe or steadily worsens
• follows a blow to the head
• is accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures.

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What Causes Migraines? – Migraine Symptoms

What is a migraine headache?

A migraine is usually an intense pounding headache that can last for hours or even days. The pounding or pulsing pain usually begins in the forehead, the side of the head, or around the eyes. The headache gradually gets worse. Just about any movement, activity, bright light, or loud noise seems to make it hurt more. Nausea and vomiting are common during a migraine.

Migraines may happen only once or twice a year, or as often as daily. Women are more likely to have migraines than men.

There are different types of migraine headaches. The most common types of migraines are classic migraines and common migraines.

Classic migraines (also called complicated migraines) start with a warning sign called an aura. These types of migraines are sometimes also called “migraines with aura.” The aura often involves changes in the way you see. You may see flashing lights, colors, a pattern of lines, or shadows. You may temporarily lose some of your vision, such as your side vision.

You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable, and restless.

Auras last about 15 to 30 minutes. Auras may occur before or after your head pain. Sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.

Common migraines don’t start with an aura. For this reason, these types of migraines are also called “migraines without aura.” Common migraines may start more slowly than classic migraines, last longer, and interfere more with daily activities. The pain of common migraines may be on only one side of your head. Most people who have migraines have common migraines (they don’t have an aura).

Migraines without head pain, sometimes called “silent migraines,” may cause you to feel other migraine symptoms, but not pain. At least not the usual migraine pain around your eyes and temples. This type of migraine may even include an aura phase. You may also feel the same sensitivity to light and sound as with a typical migraine.

Hemiplegic migraines cause one side of your body to become weak, similar to having a stroke. These symptoms are only temporary. They are a part of the migraine attack. Areas of the body affected by the weakness may include your face, arm, or leg. The weakness may last from an hour to even days. It most often goes away within 24 hours. For this type of migraine, the head pain can come before or after the weakness. This type of migraine is rare.

Retinal migraines (also called ocular migraines) cause changes in vision that are not related to aura vision changes. For retinal migraines, symptoms involve diminished vision or even blindness in one eye. These symptoms do not last long. They can occur before or after head pain. If you experience this type of migraine, it is important to contact your doctor.

Icepick headaches are not migraine headaches. They produce a stabbing pain around your eyes and temples. These stabbing pains may occur repeatedly in the same place or jump around to different areas each time. This type of headache can occur at any time and without warning. If you are a person who has migraine headaches, you are more likely to than others to get icepick headaches, too.

Cluster headaches are not migraine headaches. They are rare headaches that occur in patterns, known as cluster periods. These periods can mean having a headache at the same time every day for a week or even a month. Cluster headaches can be extremely painful. They usually cause pain on one side of your head. This pain can be so severe that it makes your eyelid droop and your nose to get stuffy.

Cervicogenic headaches are not migraine headaches. They are headaches caused by another illness or physical condition, usually a problem in your neck. Many times, this type of headache can be brought on by a sudden movement of your neck. You might also get a cervicogenic headache after keeping your neck in the same position for too long. The pain can last for hours or days. It may be limited to one side of your head or face.

What does a migraine feel like?

The pain of a migraine headache can be intense. It can get in the way of your daily activities. Migraines aren’t the same for all people. Possible symptoms of migraines are listed below. You may have a “premonition” several hours to a day before your headache starts. Premonitions are feelings you get that can signal a migraine is coming. These feelings can include intense energy, fatigue, food cravings, thirst, and mood changes.

15 Ways To Get Rid Of A Headache Naturally, According To A Doctor

You’re at your desk doing work, or sitting on the couch reading a book, or playing with your kids in the backyard, when it strikes: that nasty headache. Forget what you were trying to do—that throbbing pain in your noggin’ has other ideas.

Headaches, especially when experienced regularly and severely, aren’t just distracting—they can be downright debilitating. And if it feels like you suffer from them more often than, say, your BF or husband, it’s not your imagination: Women experience headaches (specifically migraines—those terrible headaches often accompanied by sensitivity to light, nausea, and fatigue) at a rate three times higher than men, according to the American Migraine Foundation. Doctors aren’t entirely sure why this is the case, but they do think our hormones have something to do with it.

For migraine sufferers, there are two types of medicinal therapies, according to Dr. Lawrence Newman, MD, professor of neurology and director of the Headache Division at NYU Langone Health. “We divide them into the preventative agents, things that are given on a daily basis to prevent future headaches, and acute medications, things that you take when you’re actually in the midst of a migraine to short circuit the attack,” he says.

Frequent migraine sufferers are often on a regimen of both preventive and acute medications.

Acute medications for mild headaches include over-the-counter drugs like ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol). For more severe headaches and migraines, a prescription drug from the triptan family (something like Imitrex, for example) is usually needed to help relieve co-symptoms like light sensitivity and nausea. (According to Dr. Newman, while ibuprofen and naproxen may help relieve a migraine, acetaminophen will not.)

Whether you’re suffering from a mild headache and looking for relief sans medication, or are wrestling with a particularly potent migraine and want to give your prescription a boost, there are plenty of DIY remedies to try.

Ahead, a handful of tactics to help relieve the pain and discomfort of a headache.

1. Log regular sleep.

When treating his patients, Dr. Newman recommends the S. E.E.D.S. approach—an acronym that stands for Sleep, Eat, Exercise, Drink, and Stress. Preventing migraines is all about maintaining a consistent routine, which *starts* with maintaining a regular sleep schedule. “That means on the weekends, you can’t sleep until 3 o’clock in the afternoon,” says Dr. Newman. Too little or too much sleep can also be a trigger. Most people should aim for between seven and eight hours of sleep a night, he says.

2. Eat well.

Your diet also plays a big role in headache hygiene. Dr. Newman recommends avoiding foods that trigger your headaches—things like sugar substitutes or aged cheeses, for example. “We also want them to eat regular meals,” he says. “It’s best if you eat three nice protein-based meals per day.” And be sure to keep healthy snacks, like almonds and raisins, on hand to ensure you’re getting plenty of fuel throughout the day.

3. Get adequate exercise.

“We want people with migraine to get aerobic exercise, at least three days a week, for at least 30 minutes at a time,” says Dr. Newman. The research bears this out: One study found that exercise’s ability to prevent migraines was on par with relaxation techniques and daily use of the drug topiramate. And, of course, exercise also releases endorphins, which is the body’s natural painkiller.

4. Watch what you drink.

Much like your diet, this point is two-fold, says Dr. Newman: First, avoid or limit drinking alcohol, and keep caffeinated beverages to no more than two cups a day to stave off headaches. Second, be sure to stay hydrated by gulping five to seven cups of water each day. (Dehydration is also a known migraine trigger.)

5. Reduce your stress levels.

This one’s probably no surprise, but stress can bring on headaches, so Dr. Newman prescribes some “me time” to all of his patients. “I tell them, man or woman, some time has to be for yourself,” he says. “Whether it’s going to the gym, walking around the block, reading a book, or talking to friends.” Whatever gives you that “ahhhhhh” feeling is all right for stress reduction.

6. Load up on vitamin B2.

“There are some good studies suggesting that relatively high doses of vitamin B2, which is riboflavin, can work as a prevention of migraine,” says Dr. Newman. “If you take a standard multivitamin, there’s about 16 milligrams of vitamin B2 in there. For migraine prevention, patients need anywhere from 200 to 400 milligrams per day of vitamin B2.” But before you gobble down extra B2, be sure to talk to your physician.

7. Or give magnesium a try.

Magnesium, in a 200 to 300 milligrams per day dose, is another supplement used as a migraine preventative. Magnesium can have side effects, however, like diarrhea, and Dr. Newman says those with heart conditions also need to be careful. Once again, check in with your doc.

8. If not, there’s always CoQ10.

One more supplement worth investigating is Coenzyme Q10, says Dr. Newman. “It’s a supplement that’s been shown to work around the 300 milligrams a day mark. ”

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9. Grab some ginger.

Ginger is another natural remedy effective in headache treatment. A 2014 study found that migraine patients who took ginger powder got the same level of relief as those who took the drug sumatriptan. And, as you may already know, ginger is also great for upset stomachs (hence all that ginger ale your mom gave you when you were sick as a kid), so it may also relieve some of the co-symptoms of migraine, like nausea and vomiting.

10. Consider acupuncture.

Acupuncture, the ancient Chinese alternative medicine involving the insertion of needles into specific parts of the body, has had a mixed reputation in the medical community. But a 2016 review of 22 clinical trials turned up promising findings.

According to the study’s authors, “If people have six days with migraine per month on average before starting treatment, this would be reduced to five days in people receiving only usual care, to four days in those receiving fake acupuncture or a prophylactic drug, and to three and a half days in those receiving true acupuncture. ” In short, pokes aren’t necessarily just for creeps on Facebook!

11. Master biofeedback.

It may sound like something out of science fiction, but biofeedback—a technique that enables you to control some of your body’s responses—has been shown to reduce headache severity and frequency, according to the American Migraine Foundation.

“Biofeedback is a biggie,” says Dr. Newman. “There are exercises you can do to prevent the headache, as well as exercises you learn to do when a headache comes on to try and lessen the severity of headaches and hopefully avoid some medications or allow you to take fewer medications.” There are a number of different techniques that fall under this umbrella—everything from personal monitoring devices to yoga. Your doctor can help you figure out which one is right for you.

12. Get a rub down.

Massage is another non-pharmacological therapy that may ease headaches, says Dr. Newman. Rubbing the shoulders and neck could be beneficial, but definitely don’t get a scalp or head massage during the throes of a migraine—that will hurt, not help!

13.

Pack on the heat or ice.

Depending on your preference, a cold compress or warm washcloth can lessen the ache. “Ice packs kind of numb the nerves,” says Dr. Newman, while cautioning that it probably won’t alleviate your pain completely.

14. Smell it later.

Verging into more woo-woo territory for headache relief is aromatherapy. While essential oils may not be for everybody, a 2016 study did find that peppermint oil had some positive effect on tension headaches. (Plus it will leave you smelling minty fresh—a bonus!).

15. Go easy on the perfume.

Conversely, some smells can actually trigger a migraine, so be careful about using heavily scented soaps or cleaning products and ask your partner to go light on the fragrance.

Bottomline, says Dr. Newman: “Just because [therapies are] not pharmacologic doesn’t mean they’re not capable of working. On the flip side, if the nonpharmacologic therapies are not working, it doesn’t mean that there are not other options. Things are always changing, meaning don’t give up if you haven’t found something that’s working. There are doctors who specialize in headache, and they are willing to try whatever it takes to help a patient with migraine.”

Amy Wilkinson
Amy Wilkinson is an entertainment editor who also specializes in health and wellness.

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Treating Severe Migraine Headaches in the Emergency Room – Comparative Effectiveness Review Summary Guides for Consumers

A Review of the Research for Adults

John M. Eisenberg Center for Clinical Decisions and Communications Science.

Author Information

Created: September 19, 2013.

Is This Information Right for Me?

Yes, this information is right for you if

What will this summary cover?

This summary will cover:

• What migraine headaches are

• Medicines to treat severe migraines in the ER

• What researchers have found about how well the medicines work

• Possible side effects of the medicines

• Things to talk about with the ER doctor

Note: This summary does not cover what researchers found about treating migraines at home or ways to prevent migraines. It only covers what researchers found about treating migraines in the ER.

Where does the information come from?

Researchers reviewed studies on medicines to treat migraines in the ER. These studies were published through January 2012. The researchers were funded by the Agency for Healthcare Research and Quality (AHRQ), a Federal Government research agency.

The researchers wrote a report on what they found, and this summary is based on that report. The report was reviewed by doctors, researchers, other experts, and the public. You can read the report at www.effectivehealthcare.ahrq.gov/migraine-emergency.cfm.

Understanding Your Condition

What are migraine headaches?

Migraine headaches are severe headaches that cause intense pain. They can start suddenly and get worse quickly. A migraine headache typically lasts from 4 hours to 3 days if not treated. Migraines are thought to run in families.

Symptoms of a migraine headache can include:

• A severe headache, often with throbbing on one side of the head

• Sensitivity to light or sound

• Nausea and vomiting

• Difficulty doing physical activities like walking or climbing stairs

What are additional symptoms of a migraine?

Some people have additional symptoms before or after a migraine starts. These symptoms are called “auras” and can include:

• Numbness or a feeling of “pins and needles” in your arms, legs, fingers, or face

• Problems with your vision (such as temporary loss of vision or seeing flashes of light, spots, or zigzag lines)

• Trouble speaking

• Weakness or difficulty moving your arms, legs, or face, although this is rare

How common are migraines?

• Out of every 100 people in the United States, about 12 have migraines.

• Migraines are three times more common in women than in men.

• Each year, one in seven people who have migraines goes to the ER because of a severe migraine.

• Some people may go to the ER for a severe migraine several times a year.

What can cause a migraine?

Doctors are not sure what exactly causes migraines. But, many things can trigger a migraine. Different people have different triggers, which can include:

• Stress or anxiety

• Changes in hormones (in women)

• Bright lights, loud sounds, and strong smells

• Smoking

• Drinking alcohol

• Certain foods, such as chocolate, cheese, salty foods, or processed foods

• Food additives such as MSG (sometimes added to Chinese food) or aspartame (an artificial sweetener)

• Not getting enough to eat

• Not getting enough sleep

• Intense physical activities

• Changes in the weather

• Some medicines

How are migraines treated?

Migraines can be treated at home with over-the-counter pain medicines such as acetaminophen (Tylenol^®), ibuprofen (Advil^® or Motrin^®), or naproxen (Aleve^®) or with prescription medicines from your doctor. When a migraine hits, it may also help to lie down in a dark room and try to sleep.

To prevent migraines, try to avoid things you know can trigger your migraines and try to get regular exercise. Your doctor may also give you medicines to help prevent migraines.

How do I know if I should go to the ER?

If your migraine is too severe and the treatments listed above do not work, you may choose to go to the ER. If you decide to go to the ER, be sure to have someone else drive you there.

The symptoms of a migraine can be confused with the symptoms of a stroke. You should go to the hospital right away if:

• You have an extremely severe headache (it could be a migraine, or it could be something more serious)

• You have speech, vision, movement, or balance problems that are new or different from symptoms you have had before with your migraines

• You have a stiff neck or fever with your headache

• The headache starts suddenly, like a “thunderclap,” especially if you are over age 50

Understanding Your Options

How are migraines treated in the ER?

Many medicines are used to treat severe migraine headache pain in the ER, including those listed on the next page. The ER doctor may also give you other medicines for nausea and may treat you for dehydration (a loss of fluids from your body).

Medicines for Pain Relief

Researchers found that the medicines listed below work to lessen or stop migraine pain. Nearly all of these medicines are given as a shot or through an intravenous (IV) tube in your arm. Some NSAIDs (nonsteroidal anti-inflammatory drugs) can also be taken by mouth.

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Medicine	About the Medicine
Neuroleptics/Antiemetics Chlorpromazine (Thorazine®) Droperidol (Inapsine®) Haloperidol (Haldol®) Metoclopramide (Reglan®) Prochlorperazine (Compazine®)	Neuroleptics and antiemetics are medicines that change the way certain chemicals act in your brain. Some of these medicines may also treat nausea and vomiting.
Sumatriptan (Alsuma®, Imitrex®, Sumavel DosePro®)	Sumatriptan is a headache medicine that narrows the blood vessels in your brain. Note: People with heart problems, such as narrowing or hardening of blood vessels in the heart, should not take this medicine.
NSAIDs	NSAIDs are medicines that relieve pain.
Opioids	Opioids are medicines that relieve pain. But, these medicines are rarely used for migraines because of possible side effects and the fact that other medicines work well to relieve migraine pain. Note: Taking opioids repeatedly to relieve pain can lead to overuse. Opioids can be addictive.
Dihydroergotamine (D.H.E. 45®)	Dihydroergotamine is a headache medicine that narrows the blood vessels in your brain.

Medicines To Stop the Migraine From Coming Back

The doctor may also give you a medicine to help stop the migraine from coming back within the next day or two.

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Medicine	About the Medicine	What does research say about how well it works?
Dexamethasone (Decadron®)	Dexamethasone is a steroid medicine used to treat swelling and inflammation. It can be given along with a pain-relief medicine to help stop a migraine from coming back within the next day or two. Note: Because of possible side effects, doctors may only give dexamethasone to people who have a greater chance of their migraine coming back.	People who take dexamethasone (Decadron®) along with a medicine for pain relief are less likely to have their migraine come back than people who just take a medicine for pain relief alone.

More research is needed to know how well other medicines work to stop a migraine from coming back.

What are the possible side effects of medicines given in the ER to treat migraines?

Researchers found that the side effects from these medicines are usually minor and temporary. Some of the medicines can cause drowsiness, so you may not be able to drive right away. More information is listed below for each type of medicine when it is taken a single time in the ER for a severe migraine.

• Neuroleptics/Antiemetics: Restlessness in the legs or body is a common side effect. A possible serious side effect is uncontrollable muscle movements, such as tics and tremors.

• Sumatriptan: The most common side effect is pain or swelling at the place where the shot was given. Other side effects can include redness in the face and neck, a burning feeling, feelings of tightness (in the chest, neck, jaw, or other parts of the body)^*, and drowsiness.

• NSAIDs: Side effects are not common with these medicines.

• Opioids: Tiredness and drowsiness are common side effects.

• Dihydroergotamine: The most common side effects include pain or swelling at the place where the shot was given or where the IV needle was put in, drowsiness, stomach problems, nausea and vomiting, and an irregular heartbeat.

• Dexamethasone: Side effects were not common with this medicine in the research studies. But, possible side effects can include nausea, headache, dizziness, and trouble sleeping.

Note: There are other possible side effects of these medicines. The side effects listed here are the most common side effects when the medicines are taken a single time in the ER for a severe migraine.

Talking With the ER Doctor

You may want to talk with the ER doctor about:

• Your history of severe migraines and whether you have been to the ER for a severe migraine before

• Any medicines you have taken to treat a severe migraine in the past, how well they worked, and any side effects you experienced from them

• Which medicine might be best to treat your severe migraine

• The possible benefits and side effects of the medicine

Ask your doctor

• Which medicine do you think might work best for me?

• How fast will it start working?

• How long will it work? Will it help stop my migraine from coming back within the next day or two?

• Are there any serious side effects I should watch for? If so, what are they?

• What should I do to follow up after I leave the ER?

• What can I do to keep from having another severe migraine in the future?

Note: Ask your ER doctor to write down which medicines you were given and how much of each you received. You can take a copy of this to your primary care physician or neurologist along with a list of any side effects you had from the medicines.

It might also be helpful to keep a copy of this information with you (along with a list of any other medicines you are taking) in case you go back to the ER with another migraine in the future.

Sources

The information in this summary comes from the report Acute Migraine Treatment in Emergency Settings, November 2012. The report was produced by the University of Alberta Evidence-based Practice Center through funding by the Agency for Healthcare Research and Quality (AHRQ).

For a copy of the report or for more information about AHRQ and the Effective Health Care Program, go to www.effectivehealthcare.ahrq.gov/migraine-emergency.cfm.

Additional information came from the MedlinePlus^® Web site, a service of the National Library of Medicine and the National Institutes of Health. This site is available at www. nlm.nih.gov/medlineplus.

This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX. People who have severe migraines reviewed this summary.

*

In this summary, the term doctor refers to your health care professional, including your primary care physician, neurologist, emergency room doctor, nurse practitioner, or physician assistant.

†

There are several terms for “emergency room” such as “emergency department,” “emergency care center,” or “urgent care center.”

*

If you have feelings of tightness in your chest, neck, or jaw, contact your doctor right away. You may need to be checked for heart disease.

Stop that splitting headache – CNN

Story highlights

• 30 million Americans suffer from migraines each year
• Half of those can’t do household chores or attend social functions because of pain
• Migraines are a neurological disorder with triggers ranging from stress to certain foods

About once a month, usually around my period, I start feeling sort of. .. off. My neck gets tight and achy, and I can’t think as clearly as usual, like my mental gears are gummed up.

That slow-brain feeling, I’ve learned over the years, is not a good sign. It means I’m about to get a migraine. It’s my cue to be careful — to steer clear of red wine and sugar, two sure triggers when I’m in that sensitive state, and to get enough rest since lack of sleep can tip me over the edge, too.

Even so, if anything in my routine is out of whack — if I don’t eat often enough, or if I become overly stressed — I can count on one or two days of misery. Head-pounding, nauseated, verge-of-tears misery.

Sound bad? Compared to many of the 30 million migraine sufferers in the U.S., my experience is fairly mild. Several years ago, the massive American Migraine Prevalence and Prevention Study found that half of those who struggle with migraines can’t do household chores and a third forgo family or social activities.

That’s a whole lot of agony, and it affects three times as many women as men, largely because the ups and downs of our hormones seem to make us more susceptible, according to Andrew Charles, M. D., professor and director of the UCLA School of Medicine’s Headache Research and Treatment Program.

A migraine isn’t just a headache; it’s a neurological disorder, often inherited, in which triggers ranging from stress to certain foods to even changes in the weather set off a chain reaction in the brain that results in intense pain. Most migraine sufferers are between the ages of 20 and 50 — women in full-speed-ahead career/family/juggling mode. We’re talking about multi-taskers who definitely can’t afford a day or two (or more) of feeling cruddy.

Health.com: Signs you’re having a migraine

And yet most don’t get effective treatment, even though there are plenty of options. “Many people still don’t know what migraines are or that there’s good help available,” says Stewart Tepper, M.D., a headache specialist at the Cleveland Clinic’s Center for Headache and Pain.

In fact, many women don’t even realize that they’ve got migraines in the first place. The truth is, most bad headaches — the ones that make getting through the day a chore or make you feel nauseated or sensitive to light — are the Big M.

“They’re more common than we used to think,” Charles says. “Nearly 48% of all women will have a migraine at some point in their lives.”

Although tension headaches affect more people, they’re far less debilitating and easier to deal with. Studies have found that most people who complain to their doctors about headaches have migraines — as do nearly 90% of people who think they have sinus headaches.

That’s why it’s so important to understand migraines — why we get them, what triggers them, how to prevent them, and the most effective ways to treat them at every stage.

Pre-headache: Prevent it

The best migraine defense is a good offense — stopping it before it starts.

“One of the most effective things you can do is maintain regular habits and try to keep your life on an even keel,” says Peter Goadsby, M.D., director of the University of California–San Francisco Headache Clinic.

Eat, sleep, and exercise regularly (studies have shown that both cardio and stretching are effective at reducing headaches), and try to control your stress, since that is the number-one migraine trigger.

Health.com: The top migraine triggers

Lifestyle changes. Two options proven to help: biofeedback and cognitive behavioral therapy. With biofeedback training, technicians attach electrodes to your head and neck to measure muscle tension and relaxation, so you not only learn to recognize those states but to control them. And in cognitive behavioral therapy, you learn relaxation strategies, like meditation.

“You get about a 55% reduction in headache frequency, on average, with behavioral approaches,” says Donald Penzien, Ph.D., director of the Head Pain Center at the University of Mississippi Medical Center, “so long as you make an effort to put the techniques into practice.”

Training costs between $70 and $250 a session, but it’s usually covered by insurance. And when Penzien and his colleagues studied the cost of behavioral therapies a few years ago, they found that most people learn the techniques in just a few sessions.

Supplements. Consider taking a supplement as a preventive measure if your headaches are disabling — even if you only have one or two a month. Since different options work for different people, you may need to try several before finding the one that’s most effective for you:

— Butterbur (or Petasites root) is an herb that can help reduce the frequency of attacks, possibly by reducing inflammation. Researchers at Albert Einstein College of Medicine found that people who took 75 milligrams twice a day had about half as many migraines as usual over a four-month period.

— Vitamin B2, or riboflavin, reduced headache frequency from four per month to two in a German trial — possibly because it speeds up brain metabolism, which seems to be beneficial for those with migraines. “The effective dose is 400 milligrams per day,” Goadsby says.

— Coenzyme Q10 is a vitamin-like substance found in meats and seafood. It, too, may boost the brain’s energy metabolism. Research shows a dose of 100 milligrams three times a day can decrease the frequency of headaches by about 50 percent.

— Magnesium is an element that’s involved in a variety of bodily functions, and there’s some evidence that low levels can trigger migraines. “A dose of 300 to 500 milligrams a day might help,” Charles says.

Health.com: Surprising ways to fight headache pain

Medication. “If you have several disabling attacks a month, and you can’t control the pain, talk to your doctor about using preventive medication on a daily basis,” Goadsby says. Options include:

— Beta-blockers normally used to treat high blood pressure, such as propranolol (sold as Inderal) and timolol (sold as Blocadren), help prevent headaches likely because they help improve blood flow.

— Antiseizure drugs topiramate (sold as Topamax) and valproic acid (sold as Depakote) may reduce your migraines because epilepsy and migraines are caused by similar reactions in the brain.

— Tricyclic antidepressants such as amitriptyline are used for migraine prevention because they regulate levels of the feel-good chemical serotonin in the brain, and it’s believed that serotonin may play a role in the development of migraines.

— Botox injections are approved for use in people with chronic migraines (headaches more than 15 days a month). They help people have fewer headaches and less painful headaches, possibly because Botox affects the facial nerves that play a role in migraines, according to Goadsby.

As it starts: Nip it in the bud

Sometimes, catching an attack in the pre-head-pain phase, known as prodrome, can prevent a full-blown headache. Not everyone has early-warning symptoms, but a 2004 study at the Headache Center of Atlanta found that about a third of people experienced signs like feeling tired and moody or having diarrhea and neck pain about eight hours before their migraine set in.

Lifestyle changes. Because stress is the most common migraine trigger, you might be able to stave off a headache by taking a few minutes to decompress, Penzien says.

Try five minutes of diaphragmatic breathing: Lie on your back with a pillow beneath your head and another under your knees, so your legs are slightly bent. (You can also do this sitting in a chair.) Put your right hand on your upper chest and your left just below your rib cage. Breathe in slowly through your nose so your stomach pushes up against your left hand. Then, as you exhale, blowing out through pursed lips, tighten your stomach muscles and let them fall inward. Your right hand should remain as still as possible through the inhale and exhale.

Health.com: Headache-proof your home

Medication. A pair of recent studies looked at treating migraine during the pre-headache stage and found it was at least moderately effective in heading off an attack, so it makes sense to talk to your doctor about taking a triptan, such as Imitrex. These drugs (if appropriate for you, your doc will give you an Rx and determine the best dose) reduce inflammation and constrict blood vessels in the brain. You can also try an over-the-counter pain med such as ibuprofen (400 to 600 milligrams).

During the migraine: Treat it

Though it’s better to prevent a headache than try to get rid of it, that’s not always possible. Fortunately, there are good options for managing the pain when you’re hit by a migraine.

Medication. “All medications work better when you take them early in the attack—within 30 minutes of when you feel the headache coming on, whether you’re actually feeling pain yet or not,” Tepper says. “Also, you have to be careful not to use any medications more than 10 days a month, because you run the risk of transforming your periodic headaches into a chronic condition.”

— OTC nonsteroidal anti-inflammatory drugs like naproxen and ibuprofen inhibit blood vessel inflammation, so they can reduce the pain, as can simple analgesics like aspirin or acetaminophen. Another good option: drugs (like Excedrin) that combine acetaminophen and aspirin with caffeine, which narrows blood vessels and increases the effectiveness of pain relievers.

— Triptans are the best prescription option for treating migraines, but because they constrict blood vessels, you can’t use them if you have a history of heart attack or stroke.

— Dihydroergotamine (sold as Migranal) is a new Rx nasal spray or injection that tightens blood vessels in the brain. Studies show it reduces nausea and sensitivity to light and sound as well as pain.

Health.com: Get headaches? Smart ways to deal

Lifestyle changes. Rest. If you can do it, relax in a dark, quiet room at the first sign of a headache—either during the aura phase or the second the pain hits.

Stretch your neck by tilting your head gently to one side for 10 seconds, then the other. “Neck tightness and discomfort are common symptoms, so stretching might provide a little relief,” says Charles.

Relax. Try yoga or progressive muscle relaxation (in which you tighten, then relax one group of muscles at a time, starting at your calves and working up to shoulders). Because of the connection between migraine and stress, relaxing can make a big difference.

Can an Orgasm Cure Your Headache?

We’ve all heard the old joke: “Not tonight, dear. I have a headache.” Surprisingly, for some people, there actually is a correlation between sexual activity and headache relief.

Headaches Linked to Sex

For some people, sexual activity can actually cause headaches. Such headaches may be benign exertional headaches brought on by strenuous activity, including sexual activity.

Or they may be sexual, or coital, headaches, a rare type of primary headache that occurs in the skull and neck during sexual activity, including masturbation or female or male orgasm.

Coital headaches may last up to 24 hours and are most common among men.

Although such episodes are usually benign, it is important that they be correctly diagnosed to rule out organic causes that can be very serious, even life-threatening. Tests used to confirm a diagnosis include a computerized tomography (CT) scan, magnetic resonance imaging (MRI), or magnetic resonance angiography (MRA).

Headaches, including migraines, induced by sexual activity may strike prior to, at the time of, or following orgasm. Such attacks have also been documented after masturbation. There are three patterns of occurrence for coital headache:

• Sudden onset: This pattern applies in 78% of coital headaches, and begins just before, during, or immediately after orgasm. This type of headache is severe, usually throbbing, and may build over minutes or be explosive. The average duration is several hours.
• Subacute, crescendo headache: This pattern applies in approximately 22% of cases. The onset is much earlier than an orgasm, with intensity increasing until the time of orgasm. Frequently in the back of the head, the pain is dull and aching. Rarely, nausea and vomiting may occur.
• A postural headache: This is the least common of coital headaches. The pain occurs in the lower back of the head and is greatly increased when the patient stands. This form is more likely to be accompanied by nausea and vomiting.

Treatment

Once coital headaches are diagnosed as benign, medications can be taken one to two hours before anticipated sexual activity to help avoid future coital headaches.

If the problem persists, daily preventive medications may be in order. While not extensively studied, indomethacin taken 30 to 60 minutes prior to sex may prevent a headache. Propanolol and possibly even Topamax (topiramate) may be used as a preventive medication, although the scientific data supporting its use is weak. 

Headaches Relieved by Orgasm

Research shows that, in some cases, orgasm can actually relieve a headache. In a 2013 study, 60% of people with migraine reported that sexual activity improved how they felt during a migraine attack (33% said that sexual activity made their migraine worse). Some study participants reported that they used sexual activity as a “therapeutic tool.”

The same study showed that sexual activity can sometimes relieve cluster headaches as well. Just over a third of study participants (37%) reported an improvement of cluster headache attack, while 50% reported worsening.

Sumatriptan Injection: MedlinePlus Drug Information

Sumatriptan injection comes as a solution (liquid) to inject subcutaneously (just under your skin). It is usually used at the first sign of a migraine headache. If your symptoms improve after you use sumatriptan but return after 1 hour or longer, you may use a second dose of sumatriptan. However, if your symptoms do not improve after you use sumatriptan, do not use a second injection without talking to your doctor. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use sumatriptan exactly as directed. Do not use more or less of it or take it more often than prescribed by your doctor.

Sumatriptan injection comes in a pre-filled auto-injection device and in vials to be used with disposable syringes. If you are using vials of sumatriptan injection, your doctor or pharmacist will tell you what type of syringe you should use. Do not use any other type of syringe because you may not get the right amount of medication.

You can inject your sumatriptan in the outer side of your thigh or upper arm. Do not inject sumatriptan through clothing. Never inject sumatriptan into a vein or muscle.

You may use your first dose of sumatriptan injection in a doctor’s office or other medical facility where you can be monitored for serious reactions. Carefully read the instructions that come with your device, and ask your doctor or pharmacist to show you how to use it.

Call your doctor if your headaches do not get better or occur more frequently after using sumatriptan injection.

If you use sumatriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more frequently. You should not use sumatriptan injection or take any other headache medication for more than 10 days per month. Call your doctor if you need to use sumatriptan injection to treat more than four headaches in 1-month period.

Do not use prefilled injection devices or vials of sumatriptan injection more than once. Dispose of used syringes in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

90,000 How to treat severe headaches after coronavirus

The Covid-19 coronavirus pandemic has become a real challenge not only in 2020, but also in 2021. This virus leads to disorders of the human immune system and destroys body cells. One of the symptoms of the disease is severe headaches, which appear some time after the end of the acute period of the coronavirus.

Solnyshko devices will help to get rid of such a problem. How to treat headache after coronavirus?

Let’s figure it out.

Effects of Covid-19 on the brain

Scientists are still trying to figure out how the coronavirus affects the body. At the moment, it is known that Covid-19 leads to:

• brain inflammation;
• the formation of blood clots;
• Failure of the immune system.

Blood clots in the brain provoke the formation of a stroke. Guillain-Barré syndrome is no less dangerous. Failures in the immune system lead to an attack on the protective functions of the body’s own nerve cells.One of the symptoms of this malfunction is loss of smell. Such disruptions also lead to severe headaches after coronavirus.

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Please note: German scientists in the summer of 2020 identified Covid-19 virus cells in the brain and cerebrospinal fluid. Of the 32 patients whose body did not cope with the disease, 29 had blood clots in the brain. Which led to the embolism.

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There are also studies on the servers of reputable medical journals that link coronavirus with encephalitis and other brain lesions.

Causes of severe headache after Covid

There are both direct and indirect effects of covid on headaches in patients. The former include damage to nerve cells and a change in the state of the brain due to the presence of blood clots. It is believed that nerve cells do not regenerate. But this is not so, just the rate of formation of new ones is less than that of other types of cells.

The second cause of headaches in people who have had Covid-19 is the recumbent regime.Long stay in an unnatural position leads to changes in the body. They can also lead to headaches.

Associated symptoms

Headaches caused by coronavirus infection may be aggravated by the following accompanying symptoms:

• increase in body temperature;
• dry cough;
• pain and muscle aches;
• fast fatigability;
• loss of taste;
• loss of smell.

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Please note: If you experience multiple symptoms at the same time, see your doctor immediately. At risk are people who have chronic diseases, abuse alcohol, taking drugs and smoking.

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How can you get rid of a headache after a coronavirus with the help of Solnyshko devices?

Devices “Sun” help to cope with respiratory diseases.Emitters of devices destroy viruses, bacteria and other pathogenic microorganisms. Devices of this type can be used for the prevention, treatment and recovery from Covid-19. To use the device correctly, it is necessary to study its instructions and consult a doctor.

• Make sure there are no pets or children in the area.
• Put on safety goggles and plug in the appliance.
• Treat areas of pain.

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Pay attention: The design of the “Solnyshko” devices allows them to be used with maximum comfort.But do not use the device for longer than the recommended time. Treatment of headaches after Covid is possible only after consulting your therapist.

90,000 What is neuralgia?

Headache is one of the most common and at the same time unpleasant ailments. The general medical name for this condition, cephalalgia, includes several types of pain syndrome. Some of them indicate the presence of certain disorders in the body, others, such as migraine, are in themselves chronic diseases and require complex treatment.

The doctor can determine the cause of the headache by comparing factors such as the presence of somatic diseases, the state of blood vessels, the level of intracranial pressure and the neurological state of the patient. But until the visit to the doctor takes place, the main problem for the patient is to find a cure for the head that will help quickly get rid of pain and discomfort.

Causes of headaches


How many varieties of headache – the same number of reasons for its occurrence.Depending on the nature of the attack, headaches can be divided into:

• Tension pain (tension pain)
• Cluster pain
• Pain associated with high blood pressure
• Migraine

The most common type of headache is tension headaches or tension headaches.They occur infrequently and, as a rule, under the influence of external factors: stress, depression, anxiety, overexertion, as well as during prolonged position in an uncomfortable position, leading to tension in the muscles of the neck and head. Sometimes, tension pain can be caused by problems in the cervical spine.

The main symptom of tension headaches is a feeling of heaviness in the head and compression like a hoop or helmet, while the pain is bilateral.The intensity of such pain can be different – from mild to quite intense, interfering with work and leading a normal life.

A much more agonizing type of headache is cluster, or bundle, pain. They got their name due to the fact that they occur in a series of short attacks several times a day for several days, weeks or even months. During this period, the headache occurs at approximately the same time of day at regular intervals and is characterized by extraordinary severity.A “marker” of cluster headaches is a boring or burning sensation, usually one-sided and often occurring in the eye area. The exact causes and mechanisms of the occurrence of such pains are not fully understood, in addition, they are difficult to treat.

In addition to the cases described, headache can signal the presence of serious diseases. In old age, the appearance of a headache is often a sign of increased blood pressure, at a young age, on the contrary, quite often occurs when the pressure drops.After a head injury, a headache may appear delayed and indicate that the injury has not passed without consequences and it is necessary to see a doctor as soon as possible.

The main signs that pain is a marker of potentially dangerous changes in the body are additional symptoms: high fever, high blood pressure, trauma preceding the pain.

A separate article in the headaches column is migraine.Unlike, for example, tension headaches, often caused by external factors – stress, overwork, overexertion – migraine is a chronic neurological disease. It can occur due to abnormalities in the structure of the brain or be inherited. The main mechanism for the development of migraine headache is considered to be the expansion of the vessels of the brain.

The main symptom of migraine is the recurrent occurrence of one-sided headache, often accompanied by nausea, increased sensitivity to light and sound.Migraine attacks can provoke stress, overexertion, alcohol consumption, especially red wine and champagne, as well as foods high in tyramine (chocolate, cocoa, smoked meats, nuts, citrus fruits).

With repeated severe headaches, signaling a possible migraine, consultation with a doctor is imperative.

How do pain attacks occur?


The headache occurs in one half of the head and has a pulsating character, aggravated by exertion.In most cases, pain is accompanied by nausea, increased sensitivity to noise and light, facial numbness or tingling sensations, visual symptoms, and sometimes even hallucinations.

A headache attack may be preceded by an aura – the appearance of zigzag lines or stars in front of the eyes, bright flickering flashes or, conversely, narrowing of the visual fields and the appearance of dark spots, the appearance of auditory, olfactory or tactile hallucinations, dizziness, numbness.

Pain syndrome most often manifests itself in the morning or after waking up. However, it is known that many people experience pain at very different times of the day and night.

In terms of duration, a headache attack can last long enough – from 4 hours to 3 days. Therefore, it is very important to find a good and effective remedy for severe headache .

Headache tablets


Almost each of the cephalalgia syndromes has different approaches to treatment. Brief and intense cluster headfights, which are quite rare, can be treated with oxygen therapy and fairly strong medications such as ergotamine, somatostatin, and lidocaine. Therapy takes place only as directed and under the supervision of a physician.

For the complex treatment of migraine, along with simple analgesics (NSAIDs, paracetamol), triptans can be used – drugs that act on the serotonin receptors in the dilated vessels of the brain and cause their narrowing. However, due to a number of side effects, these headache medications are usually prescribed by specialists when the effectiveness of simple analgesics is insufficient.

Careful tracking of “risk factors” is essential for migraines.Sometimes the patient’s habit of avoiding provocative situations significantly reduces the frequency and severity of migraine attacks.

As for the most common types of pain, tension headaches, their attacks are often relieved in time by non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, or a central analgesic, paracetamol.

In some cases, when the pain is caused by vasospasm, antispasmodics can come to the rescue.And if the headache is a consequence of an increase or decrease in blood pressure, treatment should first of all be aimed at stabilizing it.

Modern multicomponent headache remedies help to quickly forget about discomfort and return to the usual and favorite rhythm of life. If stress, overwork and an intense rhythm of life overtake in the form of a painful attack, convenient and affordable pills from the head will always come to the rescue.

For example, the modern analgesic Next® is able to quickly * cope with pain, available in a pharmacy without a prescription.

Thanks to the combination of two components – paracetamol and ibuprofen – Next® has a targeted and rapid * effect not only on the pain focus at the site of injury, but also on the pain centers in the nervous system, which are responsible for its perception and suppression.The components of the drug complement each other’s properties: while paracetamol has a central analgesic effect, ibuprofen suppresses inflammation and pain “at the periphery” – i.e. at the site of pain.

The headache remedy is available in pill form and has a broad spectrum of action. This means that you can take Next® not only as a medicine for the head, but also for muscle pain, toothache, neuralgia, fever, bruises and sprains.

At the same time, it is worth remembering that Next® as a medicine for the head is not a treatment, but has a symptomatic effect. After getting rid of the headache quickly and getting in good shape, do not forget to analyze the headache symptoms and, if necessary, consult a doctor.


* According to the instructions for medical use of the drug Next


90,000 How to get rid of migraines? – Question-answer “Doctor OST”

For many years I have been suffering from a wild headache.Most often, a throbbing headache bothers in the left temple. Sometimes the pain is so severe that it even affects the eye. Difficulty moving the eye, it turns red. It is unbearable to be in the light, all the time you want to hide in a dark room and it is better to close your eyes completely. It even hurts to turn your head. I know that these are all signs of a migraine in a woman.

What helps against migraines? I am already quite well versed in medicines and I always have a supply of pills at hand. If you don’t start taking pills right away, it will only get worse.Seizures are often accompanied by nausea, dizziness, weakness, frequent urge to urinate, and even diarrhea.

I would like to know how to get rid of a migraine? What helps in such cases? Is there any effective treatment? Or am I doomed to constant medication?

You are right, all the described symptoms are similar to those of a migraine in a woman. But the symptoms of many serious illnesses often overlap. Dizziness and nausea against the background of a headache are not always signs of a migraine in a woman.

Therefore, it would be correct to undergo an additional examination in order to exclude such diagnoses as a brain tumor, aneurysm, etc.

How is migraine treated? What helps in such cases? – know in the MC “Doctor Ost”. For the treatment of headaches and migraines, we use a number of advanced hardware techniques that can significantly reduce and sometimes even completely cancel drug therapy. This is extremely important, since the toxic side effects of drugs can become an additional reason for the appearance of headaches.

In case of symptoms of migraine in women at the Doctor Ost MC, good results are obtained, for example, by micropolarization of the brain. The unique technology of St. Petersburg scientists has been successfully mastered by the Doctor Ost MC. The advantage of micropolarization in targeting the cause of the headache.

Micro-impulses of current, similar to natural impulses of the brain, quickly restore the disturbed activity of the nervous system, including the most serious pathologies. Note that the normal activity of the central nervous system is restored, and not just the unpleasant symptoms of the disease are drowned out.In addition, micropolarization does not have any harmful side effects.

90,000 What is migraine? | Allegro

Migraine is one of the most common types of primary headaches. The term “primary pain” means that it is an independent disease, and it is associated with impaired brain function.

A migraine attack can last from 4 hours to 3 days. The pain can be so unbearable that a person is unable to do either work or everyday activities – any activity increases suffering.

Attacks are often caused by some provoking factors (triggers). 90% of people with migraine know at least one such “provocateur” of their own migraine. Most often it is physical or emotional stress (77%) and fluctuations in hormonal levels associated with the menstrual cycle in women (72%). Taking oral contraceptives can cause seizures. Occasionally, seizures cause head or neck injuries.

External factors should be singled out as a separate category of migraine provocateurs:

• loud noises and bright lights;
• substances with a pungent odor: perfumes, paints, household chemicals, etc.;
• Excessive consumption of products containing caffeine;
• unhealthy diet and skipping main meals;
• mismatch of the daily rhythm of a person with the natural daily rhythm, frequent change of the time zone during air travel (jet lag).

How do you know if you have a migraine?

The symptoms of migraine are easy to describe. A typical migraine headache is unilateral, often in the frontotemporal region of the head, intense, pulsating, aggravated by a change in body position, physical exertion.The pain is accompanied by increased sensitivity to bright light and loud sounds. At the height of pain, nausea, vomiting, fever, or, conversely, chills may appear.

However, some attacks can be moderate in intensity, involve the entire head, or sometimes proceed without pain at all in the form of a migraine aura.

What is a migraine aura?

These are specific neurological disorders that precede a migraine attack. Aura describes about a quarter of people with migraines.

• Visual disturbances are the most common manifestations of the aura. These can be visual “special effects” when rainbow spots, stripes, luminous zigzags flash before the patient’s eyes, or areas of the visual fields fall out.
• Possible tingling and numbness auras in the hands and face.
• Less commonly, patients are faced with impaired hearing, smell, taste and coordination.

These sensations may vary in brightness, but they always disappear within a few minutes or an hour.

What is a menstrual migraine?

In women, migraines are often associated with the menstrual cycle. Such attacks occur two days before the onset of menstruation or within three days after the onset of at least two out of three cycles. So menstrual migraine is described in the III International classification of headaches. With a “clean” menstrual migraine, attacks occur at the beginning of menstruation, and no more on any other days of the cycle. With menstrual-associated migraine, attacks can occur on any day of the cycle.

What is the cause of the migraine?

It has long been thought that migraines are associated with the vessels that feed the brain and other structures in the head. It was believed that the aura arises from spasm of the arteries in the brain, and the throbbing pain is caused by compensatory vasodilation.

It is now known for sure that migraine is based on increased excitability of nerve cells in the brain (neurons). It is not known exactly how it arises, but heredity plays a significant role here.If both parents suffer from migraines, then it is very likely that the child will also have the disease. With an attack of pain, excitement from the affected brain cells spreads to neighboring neurons, then pathological pain impulses spread to large areas of the brain, including those responsible for pain. Thus, an attack of pain occurs. The hyperexcitability of neurons can be influenced by various provoking factors: certain foods (some types of cheeses, wines, coffee), physical and emotional stress, disturbed sleep and wakefulness or insufficient sleep, changes in hormonal levels during the menstrual cycle in women.

Prevention and treatment of migraine

Migraine, like any other primary headache, cannot be completely cured once and for all. Nevertheless, doctors can effectively relieve a patient from severe seizures, significantly weaken them, and make them more rare .

Treatment and prevention of migraine attacks are aimed at reducing the excitability of neurons.

The doctor prescribes treatment depending on the frequency, intensity and duration of the pain.This can be taking painkillers and other symptomatic drugs. Relief (interruption) of a migraine attack is considered effective if the headache has gone away or significantly decreased within two hours after taking the drug and did not return within the next 24 hours. The effectiveness of drugs for the relief of a migraine attack is compared precisely for this indicator.

What medications are used to treat migraine headaches?

Triptans – a group of medicines specially designed to relieve migraine attacks.Currently, three triptans are available in Russia – sumatriptan, eletriptan and zolmitriptan. Triptans are prescription drugs that a doctor selects, taking into account concomitant diseases, contraindications, and a person’s lifestyle.

Non-steroidal anti-inflammatory drugs (NSAIDs).

Before there were specific drugs for migraine – triptans – non-steroidal anti-inflammatory drugs (NSAIDs) were the main means of relieving an attack.The most commonly used drugs from this group are: ibuprofen, naproxen, indomethacin, diclofenac, aspirin. In Russia, analgin (metamizole) was often used for migraines, which is prohibited for sale in most countries of the world because of its side effects.

Treatment of a migraine attack with combined painkillers.

Combined pain relievers (analgesics) – drugs that contain two or more active substances in a tablet or capsule. However, now they are rarely recommended because of the risk of developing an abusal headache.

Abuse headache is a complication of excessive intake of pain medications.

Excessive use of painkillers can itself cause headaches. This diagnosis is made when a person has been taking regular pain relievers for 15 or more days a month for the past three months. And if we are talking about combined painkillers (drugs such as spazmalgon or citramone), then it is enough to take them only 10 days a month for three months to get an abusal headache.

To get rid of an abusal headache, it is necessary to give up the uncontrolled intake of all painkillers.

Another method of treatment is behavioral psychotherapy. The idea is that a person’s feelings, thoughts and actions directly affect the state. Stress can trigger an attack. The goal of therapy is to change a person’s behavior model, to teach him to adequately respond to stress.

How to relieve an attack yourself?

A migraine attack can be predicted and prevented by taking the medication prescribed by your doctor on time.If there is a feeling of an imminent attack, you need to quickly eliminate annoying factors: turn off the TV, telephone and other sound sources, close the curtains tightly, provide fresh air and go to bed. Massage the temporal zone with essential oils and soothing herbal teas helps to relieve suffering.

According to the international standard, the diagnosis of migraine, like most types of headache, is made based on the results of a consultation with a neurologist, no additional research is required.That is, the diagnosis of headache in most cases is made only on the basis of the story of the patient himself and the examination of the doctor.

As a patient, what can you do to make your visit to a specialist the most effective? Describe in detail the history of your headaches. It is recommended to keep a diary of seizures – to record their date, time of onset and duration. This tactic helps the doctor understand what triggered the pain and choose the right treatment.

Migraines are difficult to heal completely, but they can be controlled.If the patient wants to live a full life and actively participates in treatment, he has every chance to achieve an improvement in his condition and an increase in the quality of life.

You can consult with a specialist and make an appointment by phone or via the online form on the website of our clinic.

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90,000 Migraines can be managed: how to get rid of a throbbing headache

This autumn still pampers Muscovites with warm, comfortable weather. But the inhabitants of our city are well aware of the atmospheric drops in the capital.Here is the first month of autumn, September, according to forecasters, “will end with cool, unstable weather with precipitation and fluctuations in daytime temperatures from +23 to negative values ​​(at the end of the month -1). “Vessels can’t stand”, “head splits”, “damn migraine” – you can often hear from meteo-dependent townspeople …

What happens to the person at this time? And can this addiction be avoided?

“A banal migraine,” says our expert, neurologist Alexei Samsonov, “the result of a chronic neurological disease, which is especially common in people living in a climatic zone with an unstable climate.But an unbearable headache is more often due to violations of vasomotor regulation. What it is? We are talking about a violation of the regulation of the tone of blood vessels, about a possible decrease in vascular tone or about its increase.

In general, migraine is more of a hereditary disease, – explained Alexey Viktorovich. – The attacks are not constant, but occur periodically. But they are excruciating. A person has the feeling that blood is beating in different parts of the head, more often in the fronto-orbital-temporal region, lasting from 4 to tens of hours! And pain is accompanied in most cases by nausea, vomiting, poor tolerance to light and loud sounds.There is also drowsiness, lethargy, but after the end of the attack.

Unfortunately, most people with headaches do not seek medical help for a long time. And this leads to improper treatment, a chronic condition of the disease. But that’s not all: the wrong choice of therapy leads to the formation of the so-called drug headache of a particular person.

Although there are ways to treat migraines, stopping the attack. And there is a possibility of prevention, our expert says.And adds:

– The best way to cope with a migraine attack is to extinguish it at the very beginning, when the characteristic precursors of a headache are just beginning to appear. Many people know that at this time there is increased irritability for no particular reason, the desire to drink more water (the thirst can be very strong), sometimes you want to sleep or eat something unusual.

You need to know that when one or more of these signs appear, it is advisable to rest, lie down, try to sleep.Sometimes a hot water bottle with warm or cold water helps, depending on which works best in a particular case. It is known from practice that massage of the face, head and neck, strong sweet tea with lemon can also pause and even stop migraines.

But, knowing about your problem, it is advisable to avoid provoking factors: long travel, change of climatic zones, stress, emotional stress, heavy physical exertion. And also – do not starve, exclude some food products: coffee, white and red wine, chocolate, citrus fruits, etc.

Headache is also provoked by hormonal contraceptives, hormone replacement therapy.

What helps?

– Use relaxation techniques, the neurologist advises. – This will somewhat reduce emotional stress. Lack of sleep and excess sleep should also be avoided. And also – do not get carried away with drugs. They can lead to new spasms of blood vessels in the head.

In theory, it would be necessary to keep a diary of headaches in order to “calculate” the probable provoking factors and understand the general picture of the disease.In a diary, note the time of onset, the duration and frequency of attacks, as well as the situations that preceded them. But who does it? Unfortunately, almost no one. But in vain.

And one more simple advice: in the first minutes of an attack, to relieve symptoms, you can take simple or combined analgesics, nonsteroidal anti-inflammatory drugs. This includes regular aspirin. If it does not help, consult a doctor. Indeed, during a severe headache, other pathological processes can occur in the body, explains the neurologist Samsonov.

Well, if migraine attacks are repeated (more than 2 times a month) or severe and do not respond well to therapy with relief agents, you should consult a doctor to decide on the appointment of serious treatment and preventive ways to prevent the disease. Today there are drugs that have an anti-migraine effect – they need to be taken for a long time, and always under the supervision of a neurologist. These are beta blockers, antidepressants, and calcium channel blockers.

And of course, you need to regularly engage in special medical gymnastics, swim, spend more time in the fresh air, look for positive emotions in life.

Alas, this type of headache cannot be cured, but you can significantly improve your condition.

Published in the newspaper “Moskovsky Komsomolets” No. 28074 dated September 13, 2019

Newspaper headline:
Migraines can be managed

Headache Check-up program – complex diagnostics, identification of the causes of headaches and treatment programs, Central Clinical Hospital of the Russian Academy of Sciences in Moscow

Headache is the most common cause of pain.With frequent repetition, an increase in the intensity or changes in the nature of the headache, it is necessary to consult a doctor to exclude serious brain diseases (tumors, vascular malformations, aneurysms, etc.).

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Causes and consequences of headaches

To get rid of the headache caused by the usual overwork, it is enough to get enough sleep, adjust your lifestyle and diet.But this does not help in all cases, as does taking pills in an attempt to numb the pain. If painful sensations in the head are caused by developing pathological processes, it is necessary to identify and eliminate their causes. It can be:

• hormonal failure;
• vascular diseases;
• neurological disorders;

90,013 viral diseases;

• inflammation of ENT organs;
• cranial injuries and post-traumatic pathologies;
• tumor processes.

To find out what provokes a headache, a specially designed check-up program will help. Many diseases can develop over the years without any manifestations. The examination results in such cases come as a complete surprise to patients.

Benefits of the Check-UP program headache

• The Check-Up program is based on personal experience
• More than 80% of patients who underwent Check-Up solved the health problem on time
• Comprehensive survey in an ecologically clean park area
• Polite attitude and patient care

How is the Check-up performed in case of complaints of headache

The Check-up examination program includes the following procedures:

• daily observation;
• MRI of the brain and one part of the spine;
• duplex / triplex scanning of the extracranial sections of the brachiocephalic arteries;
• X-ray of one part of the spine with functional tests;
• 24-hour blood pressure monitoring;
• electroencephalography;
• ECG;
• blood test for 10 indicators and urinalysis.

Consultations are carried out by a neurologist and an ophthalmologist. During the final conversation, the patient is introduced to the detailed examination results and a medical report is issued with recommendations for prevention or treatment. If necessary, additional examinations are prescribed.

CheckUp Headache
The program includes:
B01.023.001	Appointment (examination, consultation) of a neurologist, primary	1,500	1	1500
B01.023.002	Appointment (examination, consultation) of a neurologist repeated	1,200	1	1200
B01.029.001	Appointment (examination, consultation) of an ophthalmologist, primary	1,700	1	1700
A05.23.009	Magnetic resonance imaging of the brain	5760	1	5760
A05.03.002	Magnetic resonance imaging of the spine (one section)	5760	1	5760
A04.12.005.005	Duplex / triplex scanning of the extracranial sections of the brachiocephalic arteries	3,000	1	3000
A06.03.019	Spine X-ray with functional tests (one section)	2,000	1	2000
A02.12.002.001	24-hour blood pressure monitoring	3,500	1	3500
A05.23.001	Electroencephalography	2,000	1	2000
A11.12.009	Taking blood from a peripheral vein	250	1	250
B03.016.002	General (clinical) blood test (hemoglobin, leukocytes, platelets, erythrocytes)	320	1	320
A09.05.010	Study of the level of total protein in the blood	190	1	190
A09.05.042	Study of the level of alanine transaminase (ALT) in the blood	190	1	190
A09.05.041	Study of the level of aspartate transaminase (AST) in the blood	190	1	190
A09.05.022.003	Study of the level of total, free and bound bilirubin in the blood	380	1	380
A09.05.020	Study of the level of creatinine in the blood	190	1	190
A09.05.017	Study of the level of urea in the blood	190	1	190
A09.05.023	Blood glucose test	220	1	220
A05.10.006.1	Registration, interpretation, description and interpretation of electrocardiographic data (ECG)	1,000	1	1000
B03.016.006	General (clinical) urine analysis	285	1	285
	TOTAL:			37075

Check-up at the Central Clinical Hospital of the Russian Academy of Sciences.Fast, efficient, inexpensive

Experienced doctors of the Central Clinical Hospital of the Russian Academy of Sciences use modern diagnostic methods and the latest medical equipment in their work. Those who wish to check their health in our clinic can independently choose the day of the examination.

Check-up “Headache” at the Central Clinical Hospital of the Russian Academy of Sciences is not only images, test results and medical reports. Each patient receives professional advice from qualified doctors, and, if necessary, can undergo outpatient or inpatient treatment in our clinic.

To register for examination at the Central Clinical Hospital of the Russian Academy of Sciences and clarify the cost of services, you can call +7 (499) 400 47 33 or use a special form on the website.

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“Headache is a subjective experience, we cannot help but believe a person” – cephalgologist Margarita Naprienko – Moskvich Mag – 03/05/2020

compared to a flash of lightning.In ancient Egypt, it was described as “a disease of half the head.” Olga Darfi talked with a cephalgologist, doctor of medical sciences, chief physician of the clinic for headaches and autonomic disorders. AM Veyna Margarita Valentinovna Naprienko on methods of headache treatment and what mistakes we make ourselves.

Our clinic was opened in 1999 during the lifetime of Academician Alexander Moiseevich Vein, it was his idea and his brainchild. He was one of the first scientists in Russia to study headache problems.This is one of the oldest known diseases. Chinese doctors five centuries BC tried to treat this symptom with acupuncture and moxibustion. Hippocrates in his work “Aphorisms” described various types of cephalalgia, was the first to define it as a disease and described the symptoms of migraine. And so on, right up to Bulgakov with his brilliant description of torment from a headache. Nevertheless, the first international classification of headaches appeared only in 1988. For example, hypertension or bronchial asthma has been studied for centuries, and only thirty years ago began an orderly study of this colossal problem.

Many people believe that a headache cannot be cured, you just have to wait for it to go away by itself.

This is a misconception based on historical background. For example, in the USSR, however, in the rest of the world too, drugs for the treatment of migraine simply did not exist. Hence, one of the reasons why the opinion has taken root that it is impossible to cure and help. In Soviet times, a patient with migraine who really suffered – he was bothered by nausea and vomiting, had to spend two or three days in bed and absolutely could not go to work – simply could not legally receive a sick leave certificate.

All my childhood I witnessed such a drama with my mother. No one believed that she had such a headache that it was impossible to work. She had problems due to absenteeism, she had to constantly change her place of work. And today you can get sick leave with migraines?

Yes, after the classification appeared in 1988 and doctors said: “Oh, there is a migraine!”Every year this problem is being studied more and more actively in the world, patient organizations are being created that try to interact with employers with the help of trade unions. True, in our country I do not see any great success in this direction, but in Europe this movement is developing actively.

Our clinic has been operating for 20 years, and, according to our modest statistics, the number of patients is not decreasing, but today we have accepted – this figure is in our database – 51 thousand people. And in Russia there are already a dozen similar clinics, although in tiny Italy there are 36 headache clinics.

How to determine that a headache is already a disease? Where is the border? Maybe this is a temporary phenomenon that is not yet considered a disease.

The classification that exists today is very simple – there are primary headaches that are not associated with any damage to the body. While we may not yet know what changes occur in the brain at the time of headaches, this topic has not yet been studied.

Primary headaches include migraine (recurrent attacks of moderate to high intensity headache).It is usually localized in one half of the head, has a pulsating character, lasts from two hours to three days. It is accompanied by nausea, vomiting, and a third of patients have short-term visual impairment. The mechanisms underlying the disease are not fully understood. Then there is a tension headache (pressing pain in the head of varying intensity), every person, probably, experienced it at least once in his life. Cluster headache (a pronounced series of attacks of pain syndrome in the areas of projection of the brain onto the walls of the cranium, lasting from several weeks to several months).The intensity of the pain is so great that there have even been cases of suicide attempts.

And there is the concept of “secondary headache”. For example, we have the flu, we may have a headache, we have recovered, and the headache is gone. That is, a headache that is clearly associated with some kind of condition. With the worsening of the underlying disease, the headache increases, with improvement, it decreases.

Among our patients there are “champions” who took 20-30 tablets a day!

There was a breakthrough when the international neurological community gave an official definition of the state of pain – this is a subjective experience, we cannot help but believe a person.If a person says that he is in pain, we must believe him. Today we cannot tell a patient: “Well, you know, those who don’t have a headache, go and work!” The doctor is obliged to react very clearly.

What doctor? Therapist or neurologist?

Generally, all over the world, general practitioners are engaged in this, it has historically developed in our country that neurologists are engaged in this. But in terms of appealability, general practitioners and therapists are still in the lead.

That is, if I am worried about a headache, I have to go to a therapist at the district clinic?

Yes.And he must figure it out, if a difficult case and he does not have enough qualifications to understand what is happening, he must send you to a narrow profile specialist, they are called “cephalgologists”. Such doctors work in our clinic.

You have a private paid clinic. Are there such doctors in district polyclinics? I have never heard of it.

In Moscow, not all polyclinics, but in the districts there are several offices. I know for sure that in the Southern Administrative District there is such a headache office, it is state-owned, it functions on the basis of a district polyclinic.And if a person does not have the financial ability to go to a private clinic, he can ask for a referral to such offices. There are also pain departments at the Sklifosovsky Institute, at the Petrovsky All-Russian Surgery Center and at the First Honey on Pirogovka. These are all federal institutions where people can be treated on a referral from the district polyclinic.

Good. Here comes a man with a headache. How do you treat him?

To begin with, we determine whether it is the primary headache or not.It is most important. If the pain has arisen as a result of something, then it is necessary to remove this “something” and treat the underlying disease. Headache is treated taking into account what the main diagnosis is, today the classification is very large and describes more than 160 types of headaches. It is clear that primary care specialists in the district polyclinic cannot and should not understand all this diversity, their task is to provide first aid, and if the situation worsens, then narrow-profile people should be involved.Treatment of any type of headache, secondary or primary, always consists of two blocks. The first is the treatment of the attack itself, the second is prevention.

Legally, this issue is interpreted as follows: if a person has more attacks than twice a week, he can be prescribed preventive therapy. But people are all different, with different pain thresholds, and pain, as I said, is a subjective phenomenon. There are people who have headaches every day. Then the doctor puts the highest score in the questionnaire – 10 (questionnaires with points are used to classify the strength of the headache).In this case, a person to the question “Can you work?” replies: “Well, of course, I have to do it.” Another person with 2–3 points pain cannot do anything, because this is how he assesses his pain. And, for example, if they have a migraine attack, they can collapse completely with a severe attack. They rate their pain at 3 points, and a severe attack is 10 points, when it is impossible to tear off the head completely from the pillow. Of course, it is very important to choose the right treatment regimen, it is individual, as well as the right drugs for stopping seizures.

For relief of migraine attacks, there are narrowly targeted drugs. By the way, we have a colossal problem – almost all painkillers are sold in the public domain at the pharmacy. As a result, we got another type of headache – drug-induced. People take painkillers uncontrollably, and there comes a time when they develop addiction, and their head hurts from taking the pills. This is a problem that, from my point of view, should be actively covered, because self-medication is a dangerous thing, you will not even notice how you move from one category to another.People who have episodic headaches rush into the pharmacy, buy pills, then lose control and no longer understand where the borderline is, when the head hurt six times a month, then sixteen, and then twenty-six. There are “champions” among our patients who took 20-30 tablets a day! And from year to year there are more such people. It is clear that it is difficult to take time off from work, the level of stress is very high, people hold on to their jobs and at the same time are not sure about medical care, they think that they themselves know what helps them.But this circle is closing very quickly, and it is already very difficult, almost impossible for primary care physicians to help such patients. The doctors in the polyclinic also have an appointment that lasts only 12 minutes; there is no way to question such a patient and understand the cause-and-effect relationship in such a short time.

What diagnostics exist besides the stories of the person himself?

There is a certain percentage of headaches associated with neoplasms. By the way, it is very small, only 2% per year, but it is still someone’s life, and everything is very clear here.The doctor interviews and examines the patient, it can be both a neurologist and a therapist, and if they do not see any neurological signs, then they may not prescribe any diagnostics. There is such a conditional corridor – 30 days. If we treat a patient for 30 days and do not get any effect, the symptoms do not go away or even increase, this is a direct indication to send the patient for a tomography.

Sometimes it is enough to remove the pillow and nothing needs to be treated.

Now overdiagnostics (today anyone can do an MRI without any direction or indication), which we plunged into, sometimes does not help us, but creates additional problems.For example, we do an MRI for a person, we find some foci in the brain. A sensitive patient immediately panics: “Ah, my brain is collapsing.” His mood deteriorates, he begins to look for the cause, and very often such foci can be genetic, the same foci were in his mother, father, grandmother. Of course, this is an important study, but often it does not provide a causal link to the headache, and this information created the problem. In the West, the Nostress movement is now popular! That is, we do not do additional surveys so as not to have unnecessary information.And then the patient is doing a study of the vessels, they find that one vessel is a little narrower than the other, and that’s all – already a million questions: “Here I have one vessel already, and therefore my head hurts.” And this is not at all true, there is no such connection. A person for 50 years lives normally with this vessel, all vessels cannot be the same. Sometimes such facts also confuse specialists, which leads to an incorrect diagnosis. Accordingly, the correct treatment is not prescribed. Therefore, sometimes the doctor does not prescribe an MRI, not because he is sorry, but he does not see much sense in it.Although psychologically and humanly I understand this, after a number of famous people died from a brain tumor, we have a total fear of neoplasms, it is very difficult to calm people down. Until the patient himself goes for an MRI and makes sure that he does not have a tumor, it is almost impossible to interact with him further. Although MRI also has errors.

And I went and did it, uneven and narrow vessels were found. I correctly understood that all diagnostics are based on examination and the patient’s story, right? But then we get into the viscous area of ​​the patient’s adequacy.There are psychoses, phantom pains. There are hypochondriacs who invent half of the symptoms. How do you identify and separate all this? How do you understand how the patient adequately tells you?

Let’s go back to where I started. Complaints are subjective. There are types of headaches associated with mental disorders. In general, it’s okay to worry about your health. The only thing is that our anxiety, which should have protective functions, can one day break down all barriers, become a disease and destroy our brain with fears.Then a specific treatment is prescribed – psychotherapy sessions. Of course, if a person does not have money or relatives are ill, there are problems all around, it is wrong to recommend a psychotherapist to him when he would only survive. It is necessary to select the appropriate therapy so that a person can be in society and adequately solve their problems. And so I would recommend visiting a psychotherapist to all residents of the metropolis.

Is the treatment of headaches based on painkillers?

Not only.Migraine, for example, a genetic disease (by 70%), we cannot do anything with genetics yet. In our clinic, we are already seeing the third generation of patients in several families. Our grandmothers were treated, then mothers, now the girls have come (in most cases, women suffer from migraines), and the medical history is right under the blueprint. We must influence what we can – remove provoking factors. We will not, of course, give a person stupid advice not to be nervous, but we can say that if he was nervous, then let him take valerian so as not to further make the stress deep.Or if you know that you are going to be experiencing, take something proactively so as not to bring the situation to high drama. You need to pay attention to neck pain, sleep and appetite disturbances, and so on. Accordingly, if a person has a headache and sleep disturbance, then until we improve the quality of his sleep, we will not be able to move forward in treatment.

Headaches have triggers such as alcohol, cheese, citrus fruits, chocolate and other foods. It is necessary to monitor this and remove them.And then there are funny cases when a person comes, complains of a terrible headache, you ask him if he connects this pain with some factors, he says: “Yes, my head hurts after drinking red wine.” The conclusion is obvious. You explain to him how red wine affects the vessels, you advise him to exclude it. To which he replies: “This is impossible. I love him, ”and here I cannot do anything, this is the patient’s choice. People often know what is causing them headaches. So first we remove the provocateurs.

If a person develops a headache, say, at work, you need to look: maybe the ergonomics of the workplace are not good? Maybe you need to move the computer, unfold the monitor to make it convenient, change the chair, add lighting, and – oh, a miracle! – the headache has passed or has become much less disturbing. Often the head hurts from incorrectly fitted glasses or lenses. Go to the optometrist, change glasses – these are simple things that do not occur to you to check.

Often headaches from sports.It’s not doctors who work in the gym, they look – young, healthy, come on! And a person cannot “give”, he has such physiological characteristics. And if he attends group classes, and the coach urges him on: “Do not lag behind, a little more, be patient!” – a person tries, but he gets worse and worse … Listen, obviously – something is going wrong. One hobby is still fashionable – orthopedic pillows. They must be selected very carefully, taking into account the individual characteristics of the structure of the neck and head. But often, after all, the first ones who come across buy it or friends will give it as a birthday present.A person begins to sleep on such a pillow, and soon it becomes a source of headache. A person often does not see such simple connections. Sometimes it is enough to remove the pillow, and nothing needs to be treated. So before you go to the doctor, look around carefully to see if anything needs to be changed.

Well, what about serious migraines? By the way, can you die from migraines?

No, this is not a fatal disease, no such cases have been recorded. But migraine disrupts the quality of life, so you need to be treated.To stop seizures, specific pain relievers are prescribed. This is not analgin, of course, combined analgesics are generally not good, addiction develops to them very quickly. They can effectively reduce the seizure, we try to prescribe one-component drugs so that addiction develops slowly or does not develop at all, and for each type of pain there is a drug and dosage. And preventive measures already consist of numerous factors and a combination of symptoms.It can be antidepressants, antiepileptic drugs, and drugs that relax muscles.

When should a person with a headache see a doctor? When does he have a headache how many times a month?

This is also very subjective. I have had patients who have had a headache once a year.