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Headaches

Headaches - Imgflip

What's the deal with headaches?

- 96% of people get headaches at some point in their life.  The other 4% are probably just liars.

- There is an International Classification of Headache Disorders in case you ever feel like giving yourself a headache.  (It's actually a pretty nice site)

- Everyone worries that their headache is due to a brain tumor but in truth, less than 1% of brain tumors show up as headaches.  The ones that should prompt you to call me sooner than later are if you've never had one before and you're over 50, the headache is at its most painful as soon as it starts, it only comes on with exercise or straining, it wakes you up from sleeping at night, or you have anything else going on in your body - fever, stiff neck, rash, weakness, cancer, prenancy, etc.  Those are the times we worry about something else going on - it's not always the case, but those are more concerning.

- You can divide headaches up into primary (tension headaches and migraines are the most common) and secondary (headaches due to another medical or psychiatric condition or trauma).  We don't really know why people get the primary headaches, hence the name, but I'll talk mostly about them here.

- Most people get tension-type headaches.  It's the dull, vice-like sensation around your whole head that you can usually work with to get through your day.  It's typically triggered by physical or emotional stress, excessive caffeine, and a few other things.  Usually these will resolve within a few hours.  Relaxation techniques and biofeedback help a lot and the over-the-counter pain medications like Tylenol (acetaminophen), aspirin and ibuprofen or Aleve (naproxen) help some as well if used occasionally.

- There are some people who get frequent or chronic tension-type headaches, much more frequently and with more impact on their lives.  For these cases, we talk more about daily medications and/or behavioral therapies (cognitive behavioral therapy, acupuncture, physical therapy).

- Migraines are less common than tension headaches but under-diagnosed as about 10-15% of all people get them.  These are different in that they are usually one-sided, pulsating and you need to stop what you're doing because they are that intense.  Sometimes they come along with nausea or strange visual symptoms or a host of other neurologic signs.  They can last for a few hours to a few days and lots of triggers can be involved - smells, foods, stress, lights - pretty much anything.  And then sometimes they just happen for no good reason

- We kinda understand part of why migraines happen - something triggers the release of a bunch of proteins in the brain that start spreading out through the blood vessels which is why for many people it starts with a painless aura before the pain and headache set in.  Imagine a dam springing a leak and then slowly spreading out with the cracks getting bigger.  And just like that situation, the earlier you get there the better.  A few different things help in shutting down this process - caffeine, NSAID's like ibuprofen or naproxen or aspirin and prescription strength medications called Triptans (Imitrex, Amerge, Maxalt are examples).

- "Sinus headaches" in most people are actually migraines and have little or nothing to do with the sinuses or sinus infections.  This is important because these often don't receive the right treatment if you call them sinus headaches.  Lots more information on this here if you're interested or know someone who talks about this.

- There are a bunch of other rare primary headaches that have lots of acronyms and latin names, but they are best saved for Trivia Nights.  Except of course for Stimulus-Induced headache, which you have had if you've ever eaten ice cream too fast or worn a ponytail that was too tight.

- Medication-overuse headaches are another common one out there that is more of a secondary headache syndrome.  If you use any medication for stopping (not preventing) a headache for more than 15 days a month, the thought is that it starts sensitizing you to get headaches more frequently.  These are tough to treat so try not to get to that point.

- We do have some good resources to help out with headaches here if you are interested

A good podcast on headache management (and also some other podcast topics)

Guided meditation for headache management

Some ways to help avoid headache triggers

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