Most people experience a
headache at least once in their life. According to the
World Health Organization, 50–75 percent of adults aged 18–65 have experienced a headache in
the last year. Of that percentage, at least 30 percent of them reported having
migraines.
اضافة اعلان
Headaches are painful and can negatively impact the
quality of life. Although it is a relatively common experience, it is often
misunderstood in terms of definition, origin, and characteristics.
What is a headache?
A headache is a broad term
used to refer to pain that occurs in any region of the head. Due to this broad
definition, there are many different types of headaches, each with different
causes and treatments.
Headaches can also be a symptom of an underlying
condition resulting from medication, substances, or trauma. These are commonly
known as secondary headaches.
Certain types of headaches may be a primary
condition, meaning there are no underlying causes for these headaches.
Common types of primary headaches
Primary headaches can be
divided into two broad categories: episodic and chronic.
Headaches can also be a symptom of an underlying condition resulting from medication, substances, or trauma.
Episodic headaches are infrequent headaches that
occur 15 times or less per month. Typically, these headaches last anywhere from
half an hour to several hours.
On the other hand, chronic headaches are more
consistent and occur more than 15 times per month. According to WHO, it is
estimated that chronic headaches affect 1.7–4 percent of the world’s adult
population.
If you experience chronic headaches, regardless of
whether or not you can manage them with
over-the-counter (OTC) medication, you
should see your doctor. Even with episodic headaches, a diagnosis can still
help treat your condition.
Tension headaches
The most common primary
headache disorder is tension headaches. Tension headaches are typically
described as a pressure or tightness around the forehead which can sometimes
spread into or originate from the neck. This type is thought to be
stress-related or associated with the muscle in the neck. Tension headaches are
most commonly episodic (>70 percent) and tend to affect women more than men
(3:2 respectively). OTC pain reliever such as ibuprofen can help. Additionally,
since tension headaches are often related to muscles, people may find that
rubbing tense areas in the neck, shoulders, and temples can help resolve
headaches faster.
Cluster headaches
Cluster headaches are
another common type of primary headaches. They are characterized as severe
burning and piercing pain behind or around one eye. Additionally, this pain can
cause tearing or redness in the affected eye, a runny or blocked nose, or even
drooping of the eyelid. It can be episodic or chronic but can reoccur several
times on the same day.
Cluster headaches are relatively uncommon, only
affecting 1 in every 1,000 adults. Most develop cluster headaches in their 20s
and affects men 6:1 over women.
For those with cluster headaches, it is unlikely
that
OTC medications can help. If you suspect you have cluster headaches, you
will need to consult your doctor on the appropriate next steps.
Hemicrania continua
To understand Hemicrania
continua, it is best to break it down to its roots. Hemi means half, crania
means head, and continua means continuous. This type of headache is
characterized as a moderate headache on one side of the head that is continuous
for at least three months and may increase in intensity a few times per day.
It is also an uncommon condition that accounts for
roughly 1 percent of headaches but is twice as common in women. Like cluster
headaches, this type may be accompanied by tearing or redness in the eye, a
runny or blocked nose, or eyelid drooping.
However, hemicrania continua may also be associated
with miosis, which is when the pupil of the eyes becomes constricted. One of
the main defining characteristics of hemicrania continua is the complete
response to a nonsteroidal anti-inflammatory drug (
NSAID) known as indomethacin.
Ice pick headaches
Ice pick headaches, also
known as primary stabbing headaches, are short, intense stabbing pains in the
head that only last for a few seconds. These stabbing pains can occur without
warning as a single stab or multiple in succession.
These headaches commonly move around to different
areas of the head. If you notice that you are continuously feeling stabbing in
the same spot, this could indicate a serious underlying condition.
Treating ice pick headaches is difficult since their
duration is short. Medication typically aims to prevent future occurrences.
Similar to cluster headaches, it is unlikely that OTC medications will be
effective, and you will need to consult your doctor.
Thunderclap headaches
Thunderclap headaches are likely
the most severe form of headaches, both in intensity and in medical concern.
They can be a primary or secondary condition and are characterized as extremely
severe headaches with rapid onset, reaching peak intensity in under a minute.
If you experience this type of headache, you should
seek medical attention immediately. This is because secondary thunderclap
headaches are due to a serious underlying condition such as stroke, brain
injury, or vasculitis (inflammation of the blood vessels), and there is no way
for an individual to tell if it is primary or secondary.
If it is secondary, treating the underlying
condition will resolve the headache. If it is primary, you may be treated with
NSAIDs or other medications.
Common types of secondary headaches
Secondary headaches are a
symptom rather than a condition. With these types of headaches, treating the
underlying condition will bring relief. However, it is important to note that
if the underlying condition is ongoing, the headaches may become chronic.
Allergy and sinus headaches
Behind the cheekbones and
forehead are small, empty spaces known as sinuses which connect to the inside
of the nose.
Allergies and infections, such as the common cold, can result in
sinusitis, which is inflammation of the lining of the sinuses, ultimately
causing mucus to build up and create a feeling of pressure.
The most common secondary cause of headaches is rebound headaches, also known as medication overuse headaches.
As a result, headaches may be a common symptom. The
sinuses are butterfly-shaped around the nose, and tenderness in this area may
indicate sinusitis. Allergy and sinus headaches can mostly be managed by OTC
medications such as pain relievers, decongestants, and antihistamines.
Rebound headaches
The most common secondary
cause of headaches is rebound headaches, also known as medication overuse
headaches. Rebound headaches can vary in intensity from dull, tension-like
headaches, to more intense ones.
As the name might imply, rebound headaches are
headaches caused by medications that are often used to treat headaches. It is
more likely to occur if OTC medications such as paracetamol, ibuprofen,
aspirin, or naproxen are used more than 15 days a month. The only management
for this headache is slowly weaning yourself off the medication.
Other secondary forms
Many other conditions can
cause headaches, and each can cause pain in specific regions of the head.
Caffeine, hypertension (high blood pressure), and exertion headaches can all
cause headaches on the front of the face.
Menstrual/hormonal headaches are the result of
estrogen fluctuations can cause headaches that are similar to hemicrania
continua.
Spinal headaches are caused by a procedure known as a lumbar
puncture and affect the forehead, temples, upper neck, or back of the head.
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