Why Am I Getting Frequent Headaches?

To say, “I have a headache,” is one thing. To say, “I always have headaches,” is another. The latter is often more concerning.

Most people get headaches from time to time. They usually go away with or without any treatment. Frequent headaches are much less common and much more serious. They can disrupt your work or personal life. They can also be a sign of an illness or injury.

“Unfortunately, many people don’t seek help because they think they can cope on their own,” says Christy Jackson, MD, a neurologist and director of the Donald J. Dalessio Headache Center at Scripps Clinic. “They may rely on over-the-counter pain relievers instead of getting medical help. In some cases, headaches are not properly diagnosed.”

Consult with your primary care doctor if your headache symptoms get worse or occur more often despite treatment at home. Your doctor may refer you to a headache specialist.

“No one should go through life suffering from chronic headaches,” Dr. Jackson says. “Not when they are treatable.”

Headache specialists at Scripps help people who suffer from recurring, chronic headaches through a combination of traditional and complementary care with a focus on prevention and lifestyle changes.

“We evaluate your symptoms and design a treatment plan that targets the underlying physical, psychological and environmental causes of your headaches,” Dr. Jackson says.

“There are many effective treatments to relieve symptoms and prevent future attacks,” adds Robert Bonakdar, MD, a pain specialist at the Scripps Center for Integrative Medicine. Treatments may include medication, biofeedback and other therapies.

Dr. Bonakdar stresses the importance of clear and open communication between doctor and patient. “Correct diagnosis depends largely on the information you share with your health care provider.”

It’s important to understand your diagnosis as much as possible, including what type of headache you have and what is causing it. There are many types of headaches, levels of frequency and severity.

Headache pain can range from mild to disabling. Headaches can be episodic or chronic. Episodic headaches occur occasionally. Chronic headaches are more consistent. They can strike for 15 days or more in a month.

Headaches are divided into two main types: primary and secondary. Primary headaches are those not caused by another medical condition. Migraine and tension headaches are the most common.

Secondary headaches are symptoms of another health problem, such as a fever, infection, stress or a head injury.

Tension headaches, which are the most common type of headache, cause mild to moderate pain. They often present as a dull, constant pain felt on both sides of the head, and have no other symptoms.

These type of headaches are caused by tightening or tension in the muscles in the head, neck and scalp. They can be brought on by stress, noise, fumes and even long periods of watching TV or computer screens. They’re easier to handle than other types of headaches because they usually just come and go. Chronic tension headaches are much less common.

Migraine is the most disruptive type of primary headache. It is often marked by a throbbing pain that is moderate to severe. It can last four to 72 hours and happen one to four times a month.

Migraines often include other symptoms. Someone with a migraine may be sensitive to light and sound. They may prefer to be in a dark, quiet space. They may also experience nausea and vomiting and visual disturbances (aura).

Women are more likely than men to get migraines. Migraine attacks may also run in a family and begin at an early age.

Certain environmental factors are common triggers, such as sleep disruption, dehydration, skipped meals, some foods, hormone fluctuations and exposure to chemicals.

“The goal is to treat migraine symptoms right away and to prevent symptoms by avoiding or changing triggers,” Dr. Jackson says.

Cluster headaches are more severe but less common. They often begin on one side of the head and recur for days or weeks. Attacks can last between 15 minutes to three hours and occur every day.

They tend to affect men between the ages of 20 and 50, and smokers. People who experience these types of headaches are often restless, agitated and sweat profusely. Alcohol can trigger an attack.

Also known as rebound headaches, they are caused by an overuse of pain medications, such as aspirin, acetaminophen and ibuprofen. Women are affected more often than men.

When over-the-counter medicine fails to work and headaches become more frequent, medication and other therapies may be prescribed.

Medications to prevent frequent migraines include antidepressants and Botox injections and newer medications.

In 2018, the Food and Drug Administration (FDA) approved a new class of medications that modulate a neuropeptide known as calcitonin gene-related peptide (CGRP) that is believed to play a key role in migraine. Neuropeptides are small protein-like molecules used by neurons to communicate with each other.

For treatment of migraines as they occur, your doctor may prescribe triptans for relief.

Medication for frequent headaches may be combined with non-medication options, such as biofeedback, relaxation, bio stimulation and diet therapy.

Biofeedback uses electronic monitoring to help teach individuals how to control certain physical responses, such as muscle tension.

Many different relaxation therapies are available and can be individualized.

“Manual and massage therapy can be especially helpful for those with significant muscle tension or neck stiffness related to headache,” Dr. Bonakdar says.

For those who may have significant stress and sleep issues, one of the most powerful techniques is mindfulness. “This technique helps individuals increase awareness to manage triggers and automatic responses that often lead to the next headache.”

Mindfulness is typically offered at Scripps as an 8-week stress reduction course.

Biostimulation is a broad term that encompasses therapies such as acupuncture, which involves the use of needles to stimulate specific points of the body to alleviate pain.

“With a treatment course, acupuncture has been found to be as helpful as medication in the prevention of migraines,” Dr. Bonakdar says.

Electrical stimulation and other techniques can also be used. The most recent is the Nerivio wearable device, which was one of Time magazine’s Best Inventions of 2019.

Many headache sufferers often report a diet-related trigger. “When this is the case, the solution may be as simple as identifying and avoiding these triggers or finding a diet or supplement regimen that can fill gaps created by long-term headaches,” Dr. Bonakdar says.

While many foods can cause headaches, some are more common than others. Dr. Bonakdar works closely with the center’s dietician to help patients identify and avoid individualized triggers, which typically fall into a few categories:

• Allergenic foods which may take testing to confirm, such as peanuts and foods made with gluten
• Additives, such as those found in pre-packaged and processed foods
• Artificial sweeteners, such as those found in diet foods to reduce calorie content
• Aged foods, including wine, cheese, sauerkraut and cured meats.

“Diet is just one component of headache management,” he adds. “It’s important to look at the whole person to develop a treatment plan that includes a healthy lifestyle, integrative therapies — and when appropriate — medication.”

Top 7 reasons you have a headache

When a bad headache strikes, you just want it to end. The aching, throbbing pain can be debilitating and result in missed appointments, work, or time with family and friends.

Regardless of whether you are prone to migraines, tension headaches, or cluster headaches (see “Is this your headache?”), you may be able to reduce their frequency by identifying what brings them on. Here’s a look at the most common triggers for each of these kinds of headaches.

Stress

Stress can cause tight muscles in the shoulders and neck, which often leads to tension headaches. “It’s believed to start in the muscles. When tension headaches become frequent, the pain in shoulder and neck muscles is felt by the brain as pain in the head,” says Dr. Sait Ashina, a neurologist who specializes in headache treatment at Harvard-affiliated Beth Israel Deaconess Medical Center. Stress is also a common trigger for migraines.

Diet

Hunger itself can trigger a migraine or tension headache. But eating certain foods may trigger migraines. It could be just one type of food — like beans or nuts — or many foods, such as avocados, bananas, cheese, chocolate, citrus, herring, dairy products, and onions. “Processed foods with nitrites, nitrates, yellow food dyes, or monosodium glutamate can be especially problematic,” Dr. Ashina notes.

Alcohol intake

Alcohol is a common cause of migraine and cluster headaches. For some people, a few ounces of red wine are all it takes to provoke a headache, although any kind of alcohol can be a trigger. It’s not clear if the alcohol itself is to blame or if another component in the drink causes the problem.

Environment

“Cluster headaches seem to be seasonal and often happen in the spring or fall,” Dr. Ashina says. “It’s something in the environment, but we can’t tell exactly what it is yet.” Environmental factors such as bright light, smoke, humidity, intense scents, or cold weather are associated with migraine headaches.

Hormones

Changes in estrogen levels are associated with migraines in women, and women suffer from migraines more often than men. Menstrual cycles may be tied to migraine in younger women. Varying estrogen levels during perimenopause can sometimes start migraines in women who never experienced them before. Estrogen therapy may also be a migraine trigger. Menopause does seem to end migraines in most women.

Caffeine withdrawal

If you normally consume caffeine in coffee or tea, stopping intake abruptly may trigger a migraine. This may be because caffeine causes blood vessels to constrict; without caffeine, the blood vessels widen and bulge out with each heartbeat — a chief reason for the pounding pain of migraines.

Lack of sleep

A lack of sleep is associated with migraines and tension headaches. “We don’t know why, but we do know there’s a correlation and that sleep can lead to pain relief. Sometimes people feel better after taking a nap,” Dr. Ashina says.

What you can do

Understanding your headache triggers can help you avoid getting headaches in the future. But identifying triggers can be tricky, especially if you have more than one (like several kinds of food). Dr. Ashina recommends keeping a diary to note the day, time, symptoms, and circumstances surrounding a headache (what had you eaten? where did it happen?).

If avoiding triggers isn’t enough to keep headaches at bay, talk to your doctor. There are many prescription medications as well as pill-free treatments (acupuncture, meditation, biofeedback, relaxation therapy) that can help reduce headache frequency.

And you’ll need to go a step further: “Make sure you get enough sleep, exercise, eat a healthy diet, limit alcohol intake, and reduce stress,” Dr. Ashina says. “Headaches are a condition of hypersensitivity, so you need balance in your system to fight triggers. “

Image: © peterschreiber.media/Getty Images

Headache – causes, in which diseases it occurs, diagnosis and treatment methods

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Headache – the causes of the appearance, in which diseases it occurs, diagnosis and methods of treatment.
The basis of the headache is irritation of pain receptors located in:

• dura mater and brain vessels;
• periosteum of the skull, vessels of the soft tissues of the head, muscles.

The brain tissue itself does not contain pain receptors.

Types of headaches (cephalgia)

Headaches are divided into primary and secondary. Headache is considered primary if it is the main manifestation of brain disease, such as migraine and tension-type headache.

Secondary headache is a symptom of other disorders, such as head trauma, chronic cerebral ischemia, viral diseases, diseases of the cervical spine, etc.

Let’s take a look at the four most common types of headaches.

Possible causes

Tension headache

Tension headache is the most common form of primary headache. Psycho-emotional stress, depression, anxiety and various phobias, overstrain of the muscles of the shoulder girdle are the main causes of tension headaches.

Migraine headache

Migraines are about three times more common in women than in men, and about 60-70% of all migraines in women are so-called menstrual migraines. However, the causes and mechanism of development of migraine attacks are not fully understood. At any age, both in men and women, migraine attacks can be provoked by emotional and physical overload, malnutrition, drinking alcohol, changing weather conditions, harsh noise, strong odors, etc.

Headache with colds

Headache with colds is caused by hyperthermia and the damaging effect of microbial toxins on brain cells.

Headache in chronic cerebral ischemia

The cause of this pain, which is the most common secondary headache in elderly patients, is the pathology of the cerebral vessels, in which blood circulation is disturbed and the blood supply to the brain tissues deteriorates.

The result is progressive brain dysfunction.

What diseases occur

Tension headache

Tension headache is based on irritation of the structures of the central nervous system (CNS), called the nociceptive system. Myogenic, stress, psychogenic headaches are tension headaches.

Most often, tension headache occurs at a young and working age.

In cases of tension headache, the person experiences bilateral, usually mild, pressing and squeezing, monotonous and dull headaches. Attacks of such pain are accompanied by fatigue, nervousness, impaired appetite and sleep, and decreased performance. The duration of the attack is from 30 minutes to several days.

Migraine headache

Indicates only one disease – migraine, since the attacks of such cephalalgia have a peculiar character. Migraine pain is paroxysmal, throbbing, of moderate or severe intensity. It covers half of the head.

The pain may be aggravated by physical activity, tilting the head, often accompanied by nausea, vomiting.

Bright light, sharp sound, strong smell increase the pain. A migraine attack may be preceded by an aura lasting up to one hour – a collection of visual, auditory, olfactory or other neurological symptoms.
Headache with colds

Occurs with most acute and chronic diseases of the upper and lower respiratory tract caused by bacteria or viruses. In some cases, the intensity of such cephalgia correlates with the severity of fever, the strength of the cough, sore throat and other symptoms. The pain most often spreads throughout the head.

Headache in chronic cerebral ischemia

ic brain injury). In the clinical picture of chronic cerebral ischemia, dizziness, cognitive decline, emotional lability (unstable mood), motor-coordination disorders, and perception disorders (tinnitus, “flies” before the eyes) become indispensable companions of headaches. Headaches are usually mild, distributed throughout the head, and prolonged.

Diagnostics and examinations

Tension headache and migraine headache, headache with colds

Diagnosis is made by a neurologist based on the analysis mnesia and evaluation of patient complaints.

Headache in chronic cerebral ischemia

Radiological examination (doppler ultrasound of cerebral vessels) is the key in chronic cerebral ischemia

Duplex scanning of the brachiocephalic arteries with color Doppler flow mapping

Examination to evaluate blood flow in the vertebral and carotid arteries.

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USG recognizes only relatively large stenoses of cerebral vessels caused by atherosclerotic plaques. CT

CT of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

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and MRI

CT scan of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

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Contrast injection

The contrast agent is administered intravenously.

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MRI of the brain

Safe and informative scanning of brain structures for the diagnosis of its pathologies.

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also distinguish between extensive brain lesions due to strokes, but not finely diffuse foci characteristic of chronic cerebral ischemia. In chronic cerebral ischemia, conservative treatment is prescribed.

What should you do when you see one?

Pain is always a sign of a malfunction in the body. You can not tolerate pain or self-medicate. With regular headaches (more than five times a month), it is necessary to consult a doctor as soon as possible.

Tension headache

Stop pain attack with analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), antispasmodics. It is important to remember that many analgesics cannot be taken in the presence of chronic diseases (in particular, with lesions of the gastrointestinal tract, liver and kidneys). Indications and contraindications for the use of certain drugs should be discussed with your doctor.

Migraine headache

Patients with mild attacks are recommended to use NSAIDs and analgesics, with moderate and severe manifestations – specific anti-migraine drugs prescribed by a neurologist after a comprehensive examination.

Cold headache

The main way to deal with such pain is to treat a cold.

Headache in chronic cerebral ischemia

An important aspect of therapy is the fight against atherosclerotic changes in the vessels and cerebral ischemia. It is also necessary to monitor the manifestations of concomitant diseases, for example, arterial hypertension and diabetes mellitus.

Which doctors should I contact?

Tension headache:

• neurologist, psychotherapist;

Migraine headache:

• see a neurologist,
  therapist

Headache with colds:

• k
  therapist, ENT doctor;

Headache with chronic cerebral ischemia:

• k
  neurologist, and
  cardiologist and
  endocrinologist.

Mandatory control of diseases included in the metabolic syndrome group: type 2 diabetes mellitus (DM 2), hypertension, obesity and atherosclerosis.

Treatment

Tension-type headache

Most patients with tension-type headache require therapy prescribed by a psychotherapist and a neurologist. It is also important to pay attention to relaxation and adequate physical activity.

Migraine headache

Treatment includes relief and prevention of attacks.

Headache with colds

Therapy is aimed at treating the underlying disease.

Headache in chronic cerebral ischemia

As a rule, most patients suffer from several diseases, each of which negatively affects the state of cerebral vessels. Thus, the most reliable way to stop the progression of chronic cerebral ischemia is to prevent complications of diseases that are part of the metabolic syndrome group (arterial hypertension, diabetes mellitus, etc.), which are dangerous in terms of worsening cerebral blood flow.
It is important to give up bad habits (smoking, alcohol abuse, drug use) and follow a diet that includes a large amount of fresh fruits and vegetables and a minimum amount of trans fats.

If chronic ischemia is accompanied by hypertension or diabetes mellitus, daily monitoring of blood pressure and blood glucose levels is advisable. It is necessary to undergo laboratory and instrumental examinations with a certain frequency. You should visit a cardiologist and an endocrinologist at least once a year.

Once every three months, you should take a clinical

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

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and blood chemistry,

Blood chemistry: minimal profile

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in which attention to the level of glucose

Glucose (in the blood) (Glucose)

Research material

Serum or blood plasma. If it is not possible to centrifuge the sample 30 minutes after collection for serum/plasma separation…

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glycated hemoglobin,

Glycated hemoglobin (HbA1С, Glycated Hemoglobin)

Synonyms: Blood test for glycated hemoglobin. Glycohemoglobin; HbA1c; Hemoglobin A1c; A1c; HgbA1c; Hb1c.

Brief characteristics of the analyte Glycated hemo…

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820 RUB

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lipid metabolism indicators

Lipid profile: extended

Up to 1 business day

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and blood coagulation system,

Hemostasiogram (coagulogram), screening

Synonyms: Hemostasiogram, coagulogram.
Coagulation studies (coagulation profile, coag panel, coagulogram).
Profile Composition:
No. 2 Prothrombin (prothrombin time, prothrombin (according to Quick), INR …

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it is also necessary to undergo an electrocardiographic study (ECG),

ECG in 5 minutes

Examination of the functional capabilities of the heart – quickly, painlessly and informatively.

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Echocardiography.

Echocardiography

Examination to assess functional and organic changes in the heart, its contractility, as well as the state of the valvular apparatus.

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If abnormalities occur, you may need to take antidiabetic drugs, statins, or anticoagulants. Ultrasound should be performed at least twice a year

Duplex scanning of the brachiocephalic arteries with color Doppler flow mapping

Examination to evaluate blood flow in the vertebral and carotid arteries.

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to control the progression of atherosclerosis of cerebral and aortic vessels.

Sources:

1. Clinical guidelines “Migraine”. Developed by: All-Russian Society of Neurologists, Russian Society for the Study of Headache. – 2021.
2. Clinical guidelines “Acute respiratory viral infections (ARVI) in adults.” Developed by: National Scientific Society of Infectionists, Russian Scientific Medical Society of Therapists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories can use different research methods and units of measurement to perform the same analyzes.

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Constant headache? Take action!

Probably every person at least once in his life faced with a headache. For some, these sensations go unnoticed, and for some people, the head can hurt strongly and often. During such periods, life seems to stop: it hurts to look at a bright light, loud sounds are annoying, concentration of attention decreases, it is impossible to concentrate on anything.

There is more than one reason why a headache can occur, and before answering the question: “Why does my head hurt?”, you need to understand its types.

Contents

• 1 Types of headaches
• 2 Headaches and the spine
• 3 Why should we not tolerate headaches?
• 4 Where can I turn for help in St. Petersburg?

Types of headaches

There are several types of pain in the head, the occurrence of which depends on various factors.

Tension headache – this type is the most common and occurs from prolonged exertion, muscle strain. It can be caused by an uncomfortable body position, eye fatigue, mood swings, prolonged stress or depression. Headache in this form is constricting, pressing, can capture the entire area of ​​​​the head. Basically, such pain appears in the evening and signals the fatigue of the body.

Migraine is common among middle-aged women. Painful sensations appear more often on one side, more in the temples and frontal part of the skull. Pulsating pain, as it were, presses on the eyes, there is a fear of bright light, loud sounds and pungent odors.

Cluster headache – mainly affects the stronger sex. Unpleasant sensations arise unexpectedly and also end, but they are unbearable to endure. Localization of pain in the superciliary part or temporal region of the skull.

Headaches can be caused by:

Chronic stress – in this case, the pain is caused by constant anxiety, depression and fatigue. Pain can be different: aching, pressing, tightening, without a clear localization.

Intracranial pressure – it can decrease or increase, it occurs even in children. Accompanied by spasms, which are often accompanied by dizziness or vomiting.

These are not all causes of headaches, but are the most common.

Headache and spine

It often happens that the spine is to blame for severe headaches. This is facilitated by diseases such as osteochondrosis, intervertebral hernia, etc. Also, incorrect posture can affect the development of a headache. The most common cause is precisely osteochondrosis, since the vertebral arteries and nerve roots are squeezed, which leads to oxygen deficiency in the brain.

If pain sensations are associated with the spine, then they can be determined by the nature of the pain:

• sharp spasms appearing in the occipital part of the skull. They are aggravated by turning and tilting the head;
• Pressing sensation in the back of the head, accompanied by tinnitus, dizziness, vomiting and “flies” before the eyes.

The loads on the spine are heavy every day, so it is not surprising that the head can hurt.

Why can’t you bear a headache?

If pain sensations have become regular, then it is necessary to take measures – contact a neurologist and find out their true cause. Self-medication is not worth it, as this may be the first symptom of diseases such as:

• hypertension;
• cardiac arrhythmias;
• diseases of the cervical spine;
• disturbance of blood circulation in the brain;
• kidney or endocrine problems;
• the presence of inflammation in the body;
• malignant tumors in the brain, etc.

If you do not contact a specialist in time to prescribe treatment, you may encounter serious problems:

• problems with memory, attention and coordination;
• dizziness;
• persistent pain;
• loss of vision;
• stroke, heart attack, etc.

Where can I turn for help in St. Petersburg?

If headaches prevent you from enjoying life, Dr. Razumovsky’s Spine Clinic will help you get rid of them. It uses effective methods of diagnosis and treatment.

Klinka’s specialists use modern diagnostic equipment to determine the exact cause of headaches and prescribe treatment.