Headaches

Headaches are a very common medical problem and a common cause of disability among men and women. Headaches interfere with the ability to work and do daily tasks. Some people have frequent headaches. Other people hardly ever have them.

Causes Of Headaches

Although headaches can be painful and distressing they are rarely due to serious condition.
Primary Headache Disorders: Most headaches are not caused by another identifiable disorder. Such headaches are called primary headache disorders. They include: tension type, migraine and cluster headaches Tension-type headaches are the most common type of headache.

Secondary Headaches Disorder: Less common headaches result from another disorder. Such headaches are called secondary headache disorders. Usually, disorders that cause headaches are not serious. These disorders often affect the eyes, nose, throat, sinuses, teeth, jaws, ears, or neck and are minor or temporary. For example, a dental infection, sinus infection (sinusitis), or a problem with the joint of the jaw (temporomandibular disorder) may cause a headache.

Rarely, headaches are caused by a serious disorder, including the following; brain infections, such as abscess, meningitis, and encephalitis, other infections, such as tuberculosis, if they affect the brain, brain tumors, accumulation of blood in the tissues that cover the brain (subdural hematoma), often due to a head injury, bleeding in the brain (intracerebralhemorrhage), bleeding in the tissues that cover the brain (subarachnoid hemorrhage), often due to repture of a bulge in an artery (cerebral aneurysm) or of an abnormal connection between arteries and veins (arteriovenous malformation), intracranial hypertension, very high blood pressure (rarely).

Others may include; breathing disorders, such as emphysema and sleep apnea, giant cell (temporal) arteritis. Some of these disorders, such as brain tumors, hemorrhages, hematomas, and intracranial venous hypertension, increase pressure within the skull. In their early stages, many infections, including Lyme disease and Rocky Mountain spotted fever, can cause headaches, as can fluenza if severe. These infections can be serious. Headaches commonly result from withdrawal of caffeine, withdrawal of pain relievers (analgesics) after long-term use, and use of certain drugs that widen blood vessels (such as nitroglycerin).

Tension-Type Headaches

A tension-type headache is usually mild to moderate pain that feels like a band tightening around the head. Pain in other parts of the head and neck may trigger these headaches. Headaches may occur several or many days each month. Doctors base the diagnosis on symptoms and results of a physical examination, but sometimes imaging tests are done to rule out other disorders. Pain relievers and some drugs used to treat migraines may help, as may relaxation and stress management. Many people occasionally have tension-type headaches.

The cause is not well understood but may be related to a lower-than-normal threshold for pain. Stress may be involved. However, how stress is involved is not clearly understood, and it is not the only explanation for the symptoms. Other problems may contribute to or trigger the headaches. For example, sleep disturbances, a problem with the joint of the jaw (temporomandibular joint disorder), neck pain or eyestrain may trigger a tension-type headache.

Symptoms Of Headaches

Tension-type headaches feel like tightening of a band around the head, making the whole head ache. These headaches may be episodic or chronic. Episodic headaches occur fewer than 15 days a month. The pain is usually mild to moderate. It may last 30 minutes to several days. These headaches typically start several hours after waking and worsen as the day progresses. They rarely awaken people from sleep. Chronic headaches occur more than 15 days a month.

Severity tends to increase as more headaches occur. The pain may vary in intensity throughout the day but is almost always present. Unlike migraine headaches, tension-type headaches are not accompanied by nausea and vomiting and are not made worse by physical activity, light, sounds, or smells. Some mild migraines resemble tension-type headaches.

Diagnosis Of Headaches

Diagnosis is based on the person’s description of the headache and the results of a physical examination. Doctors ask the person about problems that may trigger the headaches. Not specific procedures can confirm the diagnosis, sometimes computed tomography (CT) or magnetic resonance imaging (MRI) of the head is done to rule out other disorders that may be causing the headache, particularly if headaches have developed recently.

Treatment Of Headaches

For most mild to moderate tension-type headaches, almost any over-the-counter pain reliever (analgesics), such as aspirin, acetaminophen, or ibuprofen, can provide relief. Massaging the affected area may help relieve the pain. Most people with mild to moderate episodic headaches do not go to a health care practitioner. Severe headaches may require stronger, prescription analgesics. Some contain opioids (narcotics), such as codeine or oxycodone. For some people, caffeine, an ingredient of some headache preparations, enhances the effect of analgesics.

However, overuse of analgesics, caffeine (in headache preparations or caffeinated beverages), or opioids can lead to daily headaches. Such headaches, called medication overuse headaches, begin or worsen when these drugs are suddenly stopped. If tension-type headaches are chronic, some drugs used to prevent migraine, particularly amitriptyline (a tricyclic antidepressant), can help.Behavioral and psychologic interventions, such as relaxation and stress management techniques, may help.

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