What To Do When Your Head Hurts
Posted by on March 4, 2014 - 3:21pm

Most of us get headaches from time to time. Some are mild. Others cause throbbing pain. They can last for minutes or days. There are many different types of headaches. How you treat yours depends on which kind you have.

Headaches might arise because of another medical condition, such as swollen sinuses or head injury. In these cases, treating the underlying problem usually relieves headache pain as well. But most headaches—including tension headaches and migraines—aren’t caused by a separate illness.

A headache may feel like a pain inside your brain, but it’s not. Most headaches begin in the many nerves of the muscles and blood vessels that surround your head, neck, and face. These pain-sensing nerves can be set off by stress, muscle tension, enlarged blood vessels, and other triggers. Once activated, the nerves send messages to the brain, and it can feel like the pain is coming from deep within your head.

Tension headaches are the most common type of headache. They can cause a feeling of painful pressure on the head and neck. Tension headaches occur when the muscles in your head and neck tighten, often because of stress or anxiety. Intense work, missed meals, jaw clenching, or too little sleep can bring on tension headaches.

Over-the-counter medicines such as aspirin, ibuprofen, or acetaminophen can help reduce the pain. “Lifestyle changes to relax and reduce stress might help, such as yoga, stretching, massage, and other tension relievers,” says Dr. Linda Porter, an NIH expert on pain research.

Migraines are the second-most common type of headache. They affect more than 1 in 10 people. Migraines tend to run in families and most often affect women. The pain can be severe, with pulsing and throbbing, and can last for several days. Migraine symptoms can also include blurry vision and nausea.

“Migraines are complex and can be disabling,” Porter says. Certain smells, noises, or bright flashing lights can bring on a migraine. Other triggers include lack of sleep, certain foods, skipped meals, smoking, stress, or even an approaching thunderstorm. Keeping a headache diary can help to identify the specific causes of your migraines. Avoiding those triggers or using prescription medications could help prevent or lessen the severity of future migraines.

Be careful not to overuse headache medications. Overuse can cause “rebound” headaches, making headaches more frequent and painful. People with repeating headaches, such as migraines or tension headaches, are especially at risk. Experts advise not taking certain pain-relief medicines for headaches more than 3 times a week.

A less common but more severe type of headache comes on suddenly in “clusters” at the same time of day or night for weeks. Cluster headaches may strike one side of the head, often near one eye, with a sharp or burning pain. These headaches are more common in men and in smokers.

In rare cases, a headache may warn of a serious illness. Get medical help right away if you have a headache after a blow to your head, or if you have a headache along with fever, confusion, loss of consciousness, or pain in the eye or ear.

“Know what kind of headache you have and, if you can’t manage it yourself, seek help,” Porter says. “Remember there are preventive behavioral steps and medicines that can help manage headaches. But if the pain is severe or lasting, get medical care.”

Source:  NIH News in Health

Migraines: more common in women
Posted by on April 19, 2012 - 6:13am

A migraine is the most common type of headache that propels patients to seek care from their doctors. Roughly 30 million Americans suffer from migraine headaches, with women affected almost three times more often than men, according to statistics from the National Headache Foundation in Chicago. Today's blog incorporates  an article by Jennifer Wider, MD of the Society for Women's Health Research.

"Hormonal changes are a big contributor to the higher female incidence,” said Michael A. Moskowitz, MD, Professor of Neurology at Harvard Medical School at the Massachusetts General Hospital in Boston. “There are lines of evidence that support this from lab to clinical evidence and a decrease (although not abolished) incidence in post-menopausal females.”

Migraine headaches can vary from person to person, but they typically last from four hours up to 72 hours. Some people get them several times per month, while others experience them much less frequently. Many migraine sufferers report throbbing or pulsating pain on one side of the head, blurred vision, sensitivity to light and sound, nausea, and vomiting.  Roughly one in five migraine sufferers experience an aura, or visual or sensory disturbance, before the onset of the headache. Examples of an aura include: flashes of light, loss of vision, zig-zag lines, pins and needles in an arm or leg, and speech and language problems.

Several risk factors have been identified that increase a person’s chance of having migraines:

  • Family history: A significant majority of migraine sufferers have a family history of migraine attacks. For a person who has one or more first-degree relatives with migraine headaches, the likelihood rises substantially.
  • Age: Migraines typically affect people between the ages of 15-55. Most people have had their first attack by 40 years old.
  • Gender: Women are more likely to suffer from migraines than men.
  • Certain medical conditions: depression, anxiety, stroke, epilepsy, and high blood pressure are all associated with migraine headaches.
  • Hormonal changes: Women who suffer from migraines often find that the headaches have a pattern of recurrence just before or shortly after the onset of menstruation. The headaches may also change during pregnancy and/or menopause.

Migraines are vascular headaches but the exact cause is not fully understood. Some researchers believe that migraines occur when there are abnormal changes in the brain. When these changes occur, inflammation causes blood vessels to swell and press on nerves, which can result in pain.

Researchers have learned that certain triggers can set off migraine attacks. These triggers vary from person to person and can include: sleep disturbances, stress, weather changes, low blood sugar, dehydration, bright lights and loud noises, hormonal changes, foods that contain aspartame, foods that contain tyramine (fava beans, aged cheeses, soy products, etc.), caffeine, and alcohol.

Unfortunately, migraines have no known cure, but they can be managed effectively with the help of a health care provider. A variety of drugs can be used for pain relief and for prevention. Lifestyle changes are often recommended to identify and eliminate possible triggers that can set off an attack.

“Until recently there have been no treatments available to treat people who suffer from chronic migraines,” said Moskowitz. However, she does mention that BOTOX has been helpful in some cases as was discussed in one of our earlier blogs. Chronic migraine sufferers have also found relief in certain vitamins and other homeopathic remedies. But patients should check with their doctors for proper treatment protocols.
Jennifer Wider, MD
SWHR, Contributing Writer

Got headaches? You're not alone!
Posted by on September 22, 2011 - 6:59am

Factoids on headaches!
Headaches account for more than 3 million emergency department visits annually in the U.S., and of those, about 81,000 result in hospital stays.

In 2008, the highest rate of emergency department visits for headaches involved people ages 18 to 44. Migraines accounted for 63 percent of all headache-related hospital stays and women were nearly five times more likely than men to be admitted to the hospital for migraines.  At least, ER doctors aren't telling these women "it's all in your head" like they sometimes do for chest pain! (Click HERE to see our blog on this!)    And, while emergency visits for headaches were higher among rural and low income residents, there was little difference in hospitalization rates by location and income.

 

Source:   U.S. Agency for Healthcare Research and Quality

Botox for Chronic Migraines
Posted by on October 20, 2010 - 9:10am

On October 15, 2010, the U.S. Food and Drug Administration approved Botox injection (onabotulinumtoxinA) to prevent headaches in adult patients with chronic migraine. Chronic migraine is defined as having a history of migraine and experiencing a headache on most days of the month.   it is estimated that about 6% of men and 18% of women suffer from migraine headaches during any given year.

“Chronic migraine is one of the most disabling forms of headache,” said Russell Katz, M.D., director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “Patients with chronic migraine experience a headache more than 14 days of the month. This condition can greatly affect family, work, and social life, so it is important to have a variety of effective treatment options available.”

Migraine headaches are described as an intense pulsing or throbbing pain in one area of the head. The headaches are often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraine is three times more common in women than in men. Migraine usually begins with intermittent headache attacks 14 days or fewer each month (episodic migraine), but some patients go on to develop the more disabling chronic migraine.

To treat chronic migraines, Botox is given approximately every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. Botox has not been shown to work for the treatment of migraine headaches that occur 14 days or less per month, or for other forms of headache. It is important that patients discuss with their physician whether Botox is appropriate for them.

The most common adverse reactions reported by patients being treated for chronic migraine were neck pain and headache (NOTE from this blogger:   FDA should define what kind of headache---treat migraine headaches with a medicine that may cause headaches???).

OnabotulinumtoxinA, marketed as Botox and Botox Cosmetic, has a boxed warning that says the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism. Those symptoms include swallowing and breathing difficulties that can be life-threatening. There has not been a confirmed serious case of spread of toxin effect when Botox has been used at the recommended dose to treat chronic migraine, severe underarm sweating, blepharospasm, or strabismus, or when Botox Cosmetic has been used at the recommended dose to improve frown lines.