A real pain in the head

We all suffer form headaches from time to time, but when they become more frequent, what we want to know is what the cause is and how to tell when it’s more serious.

Rebound
Regular consumption of pain killers (analgesics) is common in people who visit osteopaths. People suffering with conditions such as arthritis or simply with regular headaches often find complete relief by using over-the-counter pain killers. However, regularly consuming pain killers can actually be a cause of headache.
What does it feel like?

Rebound headaches generally occur every day and last all day long. They may inhibit your ability to sleep, as well as to concentrate. They have a very negative affect on your quality of life. They can often make the sufferer feel anxious and nauseous. Rebound headaches tend to be worse in the morning upon waking (as your body withdraws from the previous days painkillers).

Treatment? You need to talk to your GP about reducing the amount of medication you are taking over a safe period of time. Avoiding the original trigger for the headache is very important, whether it be due to fatigue, dehydration, etc. Regular exercise acts as natural painkiller and mood enhancer, while soothing therapies such as massage can help ease tensions and feelings of withdrawal.

Tension

These are the most common headache. They are also known as stress headaches. Like many headaches, the exact cause is not known, but they can be triggered by emotional stress, anxiety, depression. Posture is also a major contributing factor and is a result of the small muscles at the back of the neck getting over-tight. The prolonged contraction reduces the blood flow to and from the muscle and pain results. Another major cause of tension headache is eyestrain from staring at a computer screen.

How does it feel? Tension headache feels like a tight band around the head, or like you are wearing a tight cap and there is a weight on top of your head. You may feel pressure or pain around your eyes may and your neck and shoulder muscles may be tight.

Treatment? Over-the-counter (OTC) analgesics generally work well for this type of headache, but you may also find it helpful to use a cold pack / compress over your forehead and the back of your neck. If you are at work, take a few minutes away from your workstation, close your eyes and relax by taking some deep breath’s – breathing into your abdomen.

To prevent future headaches, take regular breaks from your desks (every 20 minutes). Try de-stressing therapies such as Yoga or Tai Chi. Learn to manage your stress with exercise or meditation. But about all, stay active and hydrated. Dehydration can be a major cause of many tension headaches.
If you find you are suffering with more frequent attacks, you may find it useful to visit an osteopath or Alexander technician to see if there are any postural elements to the headache.

Chronic Daily

This type of headache appears for around 15 days of each month. They are caused by any type of headache such as tension headaches. However, they can often be triggered by caffeine or caffeine withdrawal.

How does it feel? This will depend on the type of headache. If it is a cluster headache, it may be unilateral, or if a tension headache it may feel like a tight band.

Treatment? Tackling the underlying cause of the headache is the only remedy, so if it’s a migraine, learn the triggers and avoid them, and if it’s a tension headache, find ways to manage your stress.

Migraine

Around 8 million people in the UK suffer with migraine. Women are around 3 times more likely to suffer than men. There is a large prevalence of migraine in children too. The cause of migraine is still unknown however experts currently believe that they are linked to an imbalance of serotonin in the brain. Serotonin is a hormone, it acts as a mood enhancer, but it also causes blood vessels to narrow.

The fluctuating levels of serotonin are thought to cause blood vessels to become engorged and cause pain.
Common triggers include fatigue, hormone changes (menstruation), certain foods such as; cheese, chocolate and coffee as well as skipping meals. Bright lights and stress may also play a role in triggering attacks.
What does it feel like?

Migraines are much more intense than a normal headache. Migraines are normally unilateral. Classic Migraine is associated with visual changes such as tunnel vision or aura’s – flashing lights. Migraine sufferers often complain of additional symptoms such as nausea and vomiting, photophobia aversion to loud noises and strong smells, pins’s and needles or numbness in the face.

Children often complain of ‘abdominal migraine’ whereby they experience repeated attacks of abdominal pain often with vomiting and diarrhoea.

Treatment? The most important thing to do is to identify the triggers. The easiest way to do this is to keep a diary. Reduce your stresses through exercise. Maintain a regular sleeping and eating pattern, avoiding sugary snacks and stay hydrated. Think about your work posture and lighting. Consider investing in a screen for your monitor and if your wear glasses, maintain regular check-up’s. There are many OTC medications to consider and you can discuss these with your GP. Alternative medications include Feverfew, which has been proven to help relieve and prevent migraine as well as ginger (for nausea). Complementary therapies such as osteopathy may help to improve the venous drainage from the head and neck and alleviate any muscular tension that may pre-dispose to the headache.

Cluster

Cluster headaches are severe in nature. They are nearly always one-sided (unilateral) and are more common in men. The headaches themselves vary from a few minutes to a few hours and occur in clusters e.g. daily headaches for a week or so and then a month without a headache. Attacks tend to occur over weeks or months and then stop as suddenly as they started, until the next attack.

Cluster headaches are thought to have some connection to the hypothalamus – an area in the brain that is involved in regulating temperature and blood pressure.

What does it feel like? Sufferers complain of excruciating pain behind the eye which spreads over one side of the head. They can be associated with a runny or blocked nose, watery eyes and increased facial sweating.

Treatment? Cluster headaches are known to be triggered by alcohol and extreme changes in temperature. Avoiding these triggers may help reduce the number of attacks.

Sinus Headache

These headaches occur when the sinuses (bony, air filled cavities within the skull that connect to the nasal cavity through small openings) become blocked, usually as a result of a cold or allergic attack.

When blocked, the sinuses can also be prone to infection, sinusitis. Sinusitis tends to occur following a cold due to the lining of the sinuses becoming infected by bacteria and viruses.

Sinus headaches can also be caused by any injury to the facial bones, or any deformity of the bones either congenital or acquired – following injury, since these may lead to poor sinus drainage.

What doe it feel like? Sinus headaches feel like there is a build up of pressure within the skull – around the eyes, cheeks and forehead. The face may feel tender to touch, especially around the eyes. There may be increased pain when bending forward or when blowing the nose.

Treatment? To alleviate the headache completely you have to tackle the sinus congestion. Your doctor may prescribe decongestants with or without antibiotics (dependant on whether there is also an infection). To decrease the pain, simple OTC pain relievers (analagesics) should be sufficient. If the sinus congestion is due to allergy, your doctor may also prescribe you with an antihistamine. In people that are prone to sinus congestion and headaches, a home humidifier may provide some relief.

Benign Sex Headache

Benign sex headaches are headaches which tend to occur before or during orgasm. They occur in both men and women and tend to persist from a few minutes to a few hours after sex. The current thinking is that they are caused by a combination of muscle contraction and blood vessel dilation in the head and neck during sex. The headaches themselves are very painful and obviously limit sexual enjoyment however, they are harmless and generally very easy to treat.

What does it feel like? There are two type major types of benign sex headache, the first is a dull bilateral ache that build up with sexual activity, becoming more intense at orgasm. The second is an explosive, intense bilateral headache, it often feels throbbing and can be associated with palpitations. This second type of headache mimics a sudden intracranial bleed (bursting of an abnormal blood vessel within or around the brain). Sudden onset, intense headaches with or without associated symptoms require medical attention.

Treatment? Once serious causes, such as brain haemorrhage have been ruled out, benign sex headaches are often easy to treat. Sometimes it can be as simple as abstaining from sex for a couple of weeks. If that fails to work then your GP can prescribe medications that can be taken an hour before sex, these include beta-blockers, non-steroidal anti-inflammatory drugs (NSAIDS) and calcium channel blockers.

Benign sex headaches tend to improve with a reduction in stress levels. The best news is that this type of headache seems to resolve on its own over time.

When should I be concerned?

The majority of headaches are benign; however, if the nature of your headache changes – duration, type of pain, additional symptoms or you develop a sudden, severe headache after a blow to the head you should seek medical help immediately. Additional symptoms include; stiff neck, vomiting (especially without warning), blurred vision, sensitivity to light, confusion or dizziness.

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