Headache is also called cephalalgia; cephal: means head or brain; algia: means pain; ache: means aching or dull persistent.
In 2018, cooperation between Lifting the burden (LTB) and World Health Organization (WHO), established the Global Campaign against Headache, whose motive was to reduce the burden of headache worldwide, in which headache ranks 2nd most leading cause of the year. Studies have established a high prevalence of headache disorders, including migraine, tension, and medication-overuse, and associations with impaired quality of life, substantial lost productivity, and high economic costs in every country surveyed.
Cephalalgia is the disorder caused by dilation of vessels, muscle contraction, and sometimes drug reaction which give pressure to surroundings that become a source of pain and disabling. Pain occurs in any part of the brain, maybe unilateral, bilateral, anterior, or posterior. Headache is characterized by recurrent episodes of the nervous system.
The primary headache includes vessels, nerves and muscles of the head caused by over productivity or problems with structures and functions of pain-sensitive area like migraine, tension, depression and cluster headache. It is not associated with any other organ.
Secondary headache is associated with other organs. Their symptoms stimulate pain-sensitive area of the brain, includes hangover (due to alcohol ), tumors of brain, clotting in brain, sensitivity headache like ice cream, due to flue, overuse of medication, panic attack and stroke. It can be severe, regulatory, persistent, continuous and may become long termed.
CLASSIFICATION OF HEADACHE (Cephalalgia)
Classification of headache is usually based on origin. We are discussing 6 types of headache here;
It is one of the most common types of primary headaches. It is mostly found in adults especially women after puberty because of hormonal influence. It is recurrent, pulsating, throbbing pain, and often life long. Accompanied by blurred vision, nausea, auras (sensory disturbance), severe and unilateral sometimes. According to WHO it is the 6th highest cause of the headache and lasts about 2-3 days.
TENSION BIASED HEADACHE
It is also a common primary disorder of headaches. Its ratio is 3:2, high in women than men usually in teen-age. It is mostly associated with musculoskeletal problems in cervical or stress-related. It starts slowly but gradually increases and people feel symptoms like the pressure of a tight band, and spread from or to the neck.
The episodic tension-type headache starts slowly and lasts for a few hours and occurs approximately 15 days per month and affects 70% of people, whereas chronic tension-type headache lasts more than 15 days to 2-3 months and affects 1-3% of people.
MEDICATION OVERUSE HEADACHE
It is also called rebound headache and happens secondary to overuse and long term taking medication. Its associated symptoms are dizziness, neck pain, tiredness, and feeling of nasal congestion. It affects up to 5% of the population with a ratio of 2:1, more in women. it usually persists throughout the day and may improve with medicine.
It occurs once per day up to eight times per day, for a period of weeks to months, and in breaks between the clusters, there may be no headache symptoms. It affects the same, with a ratio of 1:1 in people and occurs in 20’s or older. The pain is like unilateral, severe, sharp, or burning and located around the eyes, and also the affected areas become red, eyelids may drop and nasal passage sometimes becomes congested and runny.
The onset, severe and throbbing in nature that people say it “worst pain ever”. It is secondary to traumatic events like intracerebral hemorrhage, cerebral venous thrombosis, aneurysms, RVS, and meningitis. Pain increases its maximum intensity in just a minute and longer than hours.
INFECTION RELATED HEADACHE:
Infection-related headaches considered secondary headaches, which include toothache due to sensitivity, sinusitis due to allergy or other, meningitis, and other life-threatening conditions like encephalitis, post-concussion, and contusions, etc. Infection-related headaches are usually continuous or severe in nature.
Other types include substance abuse, headache, hangover due to alcohol intake, dehydration and in anemia cases, due to high BP or hypertension.
HOW DOCTOR WILL DIAGNOSE THE TYPE OF HEADACHE?
Doctor will ask the history to identify the the type of headache like;
- What types of pain do you feel?
- Is it unilateral, bilateral, or where it is located?
- What was the time when headaches started?
- How long does it last?
- Do headaches aggravate to other organs?
- Do you take long term medication or high dosage medication?
- Are you anemic?
- Does pain usually occur at night or day or any other time?
- How many patterns of attacks occur?
If the doctor feels unsafe about something, he will do further investigations like blood test, CT scan, X-ray, MRI etc.
HOW WILL WE TREAT HEADACHE ?
Doctors prescribe medicines accordingly;
- Antidepressant are for depressed patients, like fluvoxamine (luvox), sertraline (zoloft).
- Serotonin receptor agonist
- Antiepileptic, like levetiracetam, topiramate.
- Beta-blockers, commonly used are acebutolol (sectral), metoprolol (toprol-XL)
- Paracetamol, commonly used for fever and headache. like panadol, tylenol.
Other treatments are;
- Acupuncture, it is a medical practice in which stimulating certain points helps to release pain.
- Cognitive behavior theory, it is a psychotherapy treatment, short in term and its goal is to change the pattern of thinking or behavior to overcome the difficulty or tension.
- Herbal and nutritional oil products, like lavender oil (helps to reduce stress), rosemary oil (reduce headache) etc
- Hypnosis, it mainly treats anxiety, phobia, sexual dysfunction and headache pain.
- Meditation, it is the best method to reduce stress or tension that gives you headache.
- Pain relieving points in our body also help.
Avoiding extreme temperature, stress and healthy eating are some home methods to overcome headache.
Q. When should we stress about headache?
You should take a step to the doctor when the headache gets severe, radiated, when the headache increases your Blood pressure and when it irritates your face, eyes and numbness.
Q. Does dehydration cause a headache?
Because low and concentrated blood with low cardiac output makes it hard to bathe the brain and it will make the brain thirsty or also cause shrinkage of the brain and make pressure that causes a headache.
Q. What should we drink or do in headache?
Coffee and tea are the best kinds of caffeine that relieve your headache and make your mood better. Caffeine has vasoconstriction ability that makes your BP high and accomplish brain demand.
Q. What makes migraine worse?
Hormonal imbalance makes migraine worse and medication like contraceptive and hormonal replacement therapy, alcohol and too much caffeine also worsen the migraine.
Before you Leave!
Headache diagnosis is indeed challenging but Headache itself is a symptom not a disease and as it is commonest in the world, we should avoid extreme temperature, unhealthy food and drinks and overuse of medication because headache easily makes a person disable for the whole day. Treating symptoms means treating a disease.