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Headache / Migraine Pain

What are Headaches?

Pain in any region of the head is called a headache. It may involve one or both sides of the head and may radiate to the neck and shoulders. You may experience dull pressure, a throbbing sensation or sharp pain that may last anywhere between an hour to days. In some cases, it may indicate a serious underlying disease.

Headaches are broadly classified into 2 types:

  • Primary headaches are caused by stress, anxiety or certain triggers. They occur due to an overactive pain-sensitive region in the head and are not associated with any other condition. Common primary headaches can include tension headaches (result from tight muscles in the neck, scalp and shoulders), migraine (throbbing pain in one side of the head) and cluster headache (occurs in patterns or clusters).
  • Secondary headaches may be described as a symptom of another condition such as ear infections, sinusitis, dehydration, panic attacks, meningitis (inflammation of the membranes covering the brain and spinal cord) and concussion (brain injury), which may trigger the pain-sensitive region in the head.

What is Migraine?

A migraine is a type of headache characterized by severe throbbing pain on one side of the head accompanied by secondary symptoms such as nausea, vomiting and sensitivity to light, sound or smell. Other symptoms may include lightheadedness and blurry vision. A migraine may be preceded by an aura, a neurological warning sign, which may occur 10 to 15 minutes before an attack. These include flashes of light, tingling sensations, or speech problems. Sometimes, you may have migraines without an aura. A migraine may last from a few hours to 3 days.

Causes of Migraine

The exact cause of migraines is unknown, but they are thought to be due to dilation and constriction of blood vessels as a result of abnormal nerve communication. It may have a genetic or environmental cause, triggered by missing meals, hormone changes during menstruation, use of birth control pills, stress, poor sleep habits, alcohol and high levels of caffeine, bright lights, loud sounds, unusual smells (paint thinner) and certain foods such as dairy, chocolate and peanuts.

Diagnosis of Headache/Migraine

If your headaches are severe and occur frequently, it is necessary to contact your doctor, who will perform a detailed examination, and question you about your symptoms and lifestyle to identify any triggers or underlying disease. A CT or MRI scan and blood tests may be ordered.

Treatment of Headache/Migraine

To treat tension headaches, your doctor may prescribe medications to help reduce the frequency and severity of headaches. Medication may be provided for other symptoms such as nausea. For secondary headaches, treatment is focused on the associated condition. Your doctor may also recommend other ways of managing headaches, such as massage, relaxation therapy and avoiding triggers.

To treat migraine, your doctor may prescribe medications that prevent migraine, to be taken on a regular basis, or abortive medications that are taken when a migraine occurs. Certain medications used for other purposes such as anti-nausea medication, blood pressure medications, anti-seizure medications, or antidepressants are also effective in treating symptoms of migraine.

Several interventions have been successful in treating headaches, including: Botox therapy, Trigger point injections, Pericranial nerve blocks, Sphenopalantine ganglion nerve blocks, Third occipital nerve blocks, and many more options exist.