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My Aching Head
What's causing your headaches and what
to do about it.
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Anyone who has suffered from a
headache knows how debilitating it can be. Though most headaches
aren’t life-threatening, the pain can make it difficult or even
impossible to work or do much of anything until your head stops
hurting. There are many types and causes of headaches, from
tension headaches due to stress to migraines triggered by
certain foods. How do you determine what kind of headache you
have, and what’s causing it? And how do you help prevent
headaches or reduce their frequency?
Tension headache
“There are several types of headaches, the most common being
tension headaches,” says
Everett Heinze, M.D., a
neurologist with The Austin Diagnostic Clinic (ADC). “Almost 80
percent of people have had a tension headache before.
Over-the-counter medications like aspirin and ibuprofen can be
effective for tension headaches.” |
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Tension headaches are usually divided into two categories,
episodic and chronic. Episodic means you have a headache less
than 15 days out of the month. Episodic headaches most commonly
occur around two times a month. Chronic means your headaches
occur more than 15 days out of the month. Chronic headaches can
be daily, or can be constant.
Often, chronic tension headaches can be caused by stress or
anxiety. Sometimes depression is the culprit. Chronic tension
headaches can be accompanied by weight loss, sleep problems, or
dizziness, and sufferers often wake up in the morning with a
headache. Because the causes of tension headaches can be
complicated, it’s best to see your doctor if you have these
symptoms.
Preventative treatment for chronic tension headaches is
important. Doctors will often prescribe antidepressant drugs to
patients who have this type of headache because the drugs also
have painkilling properties. Biofeedback, acupuncture, and
stress management may also help some patients.
Cluster headache
Cluster headaches are the least common type of headache. Men are
more likely to have cluster headaches. Cluster headaches are
grouped together, or are “clustered.” The pain is usually on one
side of the head, and is frequently behind the eye. The eyelid
may droop, the eye may water, and there may be nasal congestion
and drainage. Most cluster headaches don’t last long, but they
recur later, sometimes up to five or more times in a day.
Doctors are unsure what causes cluster headaches.
“Cluster headaches are cyclical, which means they might occur at
the same time every day,” explains Dr. Heinze. “These headaches
can be difficult to treat, especially when they are chronic.
They occur in cycles throughout the year. The cycle may last
weeks or months and then disappear, only to reappear at the same
time the following year. Sometimes sufferers mistakenly believe
they’re caused by allergies because the cluster headache cycles
may seem seasonal the way that allergy symptoms often are.”
A doctor can prescribe drugs to treat the pain, but
over-the-counter medications usually aren’t effective because
the headache is gone before the medications begin to work.
Usually cluster headaches are treated preventatively. Alcohol is
a trigger for cluster headaches, so sufferers are advised to
avoid drinking during a cluster cycle. Tobacco products and
nitrates—found in some foods and medications—are also thought to
be triggers. Talk with your doctor about treatment options. A
doctor can prescribe oxygen treatment or drugs to treat the
pain.
Migraines
Almost 30 million Americans report suffering from migraines,
according to the National Headache Foundation. Women are more
likely to suffer from migraines. Migraine pain can last for
several hours to several days, and is often described as severe
pounding or throbbing pain. Symptoms associated with migraines
include light sensitivity, nausea or vomiting, and abdominal
pain. Some migraines are accompanied by visual
disturbances—called an “aura.” The causes for migraines are also
unknown, but doctors are starting to understand what happens
when they occur. It’s believed that migraines begin inside the
brain, resulting in inflammation affecting nerves and blood
vessels in the brain. They can be hereditary, and can be linked
to hormonal changes or menstrual cycles.
“There are many different triggers for migraines,” says Dr.
Heinze. “The triggers can vary for each person, so discovering
what your triggers are can help you manage migraine pain.
Triggers can be dietary, exercise or activity related, or due to
medications. Pay attention to what you were doing before the
migraine started to help determine what your triggers might be.”
Migraines are often managed with preventative medications and
medications such as triptans to treat symptoms when the migraine
attack has already begun. For some patients, biofeedback and
acupuncture can be effective. Managing your diet, exercise, and
getting enough sleep can help as well.
“It’s important to have your headache symptoms evaluated by a
doctor,” advises Dr. Heinze, “since headaches can also be a
symptom of other health problems such as inflammation of the
arteries, blood clots, or tumors. It is important to rule these
out when determining what type of headache you have. If your
headache is accompanied by loss of consciousness, numbness,
weakness, or fever, or if it’s very severe, you should see a
doctor right away.” |
Everett Heinze, M.D., is a board
certified neurologist at The Austin Diagnostic Clinic, a
multi-specialty clinic with more than 120 physicians
representing 24 medical specialties at six locations throughout
Austin and Central Texas. Visit
www.adclinic.com or call
512-901-1111.
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