What you need to know about headaches

A headache is a broad term used to refer to pain that occurs in any region of the head. (Photo: Shutterstock)
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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