When Headaches Strike

"When I do routine physicals, I'll ask about headaches."
"[Headache sufferers should seek out the advice of a doctor at] More than two headaches a week for more than two weeks."
"[Tension headaches derive from muscle tension and] start at the back of the head, then radiate up and over the crown."
Dr. Michael Munger, Overland Park, Kansas

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  Woman with migraine iStockphoto

And the reason that Dr. Munger asks that question of his patients? Because he has found that during visits to the doctor the common headache experience doesn't come up generally speaking because it doesn't occur to the patient to even mention their occurrence. Conversely, when he makes it a point to ask, many of his patients will report experiencing frequent headaches. So as a conscientious doctor, he takes the initiative with the thought that he can help those of his patients who do suffer headaches.

According to Nauman Tariq, director of the Headache Center, Johns Hopkins Medicine, Baltimore, tension headaches affect the lives of between 30 to 70 percent of the population; presumably any population, anywhere. These are headaches that are usually mild, responding to non-prescription pain relievers. But there are different types of headaches, not only of that variety. People suffer migraine and sinus headaches as well, rating among the most common of headache variations.

Migraine headaches tend to affect between 12 to 27 percent of people, says Dr. Tariq. He explains their range in severity and frequency, as "from two headaches a year to daily headaches". And while over-the-counter drugs are used to counteract migraines, so are prescription drugs when required. Sinus headaches on the other hand, result from excess mucus in nasal passages, typified through their association with allergies, colds or flu, and for that type, antihistamines or decongestants may relieve pressure and pain.

Whether experiencing such headaches requires consultation with a medical practitioner can depend on their frequency and severity; basically a measurement of interference with one's life, and whether a headache sufferer has through experience managed a protocol of their own devising that answers to their need to reduce their headache pain at any given time. Headaches that tend to be responsive to analgesics such as aspirin, ibuprofen, acetaminophen or naproxen.

All of which, though readily available over-the-counter have risks of their own. Gastrointestinal bleeding, the creation of ulcers and kidney problems are attached to aspirin and ibuprofen, while long-term use of high-dose Tylenol can cause liver damage. A doctor tends to ask probing questions of patients and their headaches; onset, warning symptoms, pain location on the head all of which clue the doctor in to the type of headache involved and consequently available treatments.

And while tension headaches result from muscle tension, sinus headaches tend to affect people on the face above or below the eyes. Migraine or vascular headaches are often localized to one side of the head, occasionally twinned with nausea and visual peculiarities like flashes and blind spots. Doctors ask, attempting to get a rounded picture of the headaches and their causes -- whether the headaches are accompanied with other physical manifestations such as numbness or tingling, nausea, speech disturbances or memory problems; such symptoms possibly pointing to an underlying condition.

Steroid or antihistamine nasal sprays may be recommended for simple sinus headaches, and a prescription drug like a muscle relaxant for tension headaches.

Rebound headaches
Much like overuse of nasal decongestants can lead to a perpetually stuffy nose, rebound headaches are chronic headaches caused by medication overuse.
How often is too often? Regularly taking any pain reliever like acetaminophen (Tylenol), aspirin, or ibuprofen (Advil, Motrin) more than twice a week, or taking triptans (migraine drugs) for more than 10 days a month, can put you at risk for rebound headaches in just a few months.
Don't try to treat these on your own. A doctor can help you stop the culprit drug, using alternatives until it's out of your system.

Ten Types of Headaches

• Primary headaches
• Tension headaches
• Cluster headaches
• Migraines
• Secondary headaches
• Allergy or sinus headaches
• Hormone headaches
• Caffeine headaches
• Exertion headaches
• Hypertension headaches
• Rebound headaches
• Post-traumatic headaches
• See your doctor

Types of headaches

Many of us are familiar with some form of the throbbing, uncomfortable, and distracting pain of a headache. The World Health Organization points out that nearly everyone experiences a headache once in a while.
Although headaches can be defined as pain “in any region of the head,” the cause, duration, and intensity of this pain can vary according to the type of headache.
In some cases, a headache may require immediate medical attention. Seek immediate medical care if you’re experiencing any of the following alongside your headache:

• stiff neck
• rash
• the worst headache you’ve ever had
• vomiting
• confusion
• slurred speech
• any fever of 100.4°F (38°C) or higher
• paralysis in any part of your body or visual loss