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What is a headache?

A headache is a pain that is felt anywhere in the head or neck. Frequent headaches can affect relationships and quality of life.

Our approach

The Headache Center provides headache treatment plans for migraines, cluster headaches, facial pain, sinus headaches, tension headaches and related conditions. We treat both primary headaches (the head pain itself is the problem) and secondary headaches (the head pain is a symptom of an underlying condition). The center employs a multidisciplinary team that includes physicians, nurse practitioners, psychological care providers and rehabilitation professionals who offer medical therapy as well as interventional options. We are committed to finding the cause of your headaches and creating a treatment plan that works for you.

Outpatient treatment at the Headache Center includes education about headache disorders, the identification of headache triggers and the development of a headache treatment plan for management of the headache problem. In addition, our program offers an outpatient infusion center and an inpatient program which provides a safe and comfortable environment for treatment options such as medication detoxification, as well as intravenous medication to help break severe headache cycles. The inpatient setting can also help the patient get used to complex headache treatment regimens and provide monitoring for individuals with co-existing medical problems.

Symptoms

The most common of all headache symptoms is the head pain itself. This can occur in many ways—continuously, intermittently or reactively. The pain may be dull, sharp, stabbing or throbbing, or a combination of different types of discomfort.

You may also have a range of associated headache symptoms along with the head pain, including:

  • Sensitivity to light or noise
  • Nausea and/or vomiting
  • Skin sensitivity
  • Worsening pain with movement
  • Difficulty with hearing, speaking, balance and/or coordination
  • In severe cases, mood can be affected and social interactions damaged

Causes

There are many reasons people experience headaches. They may be caused by anything from anxiety and tension to sleep deprivation, stress, certain medications, injury and illness.

If a headache is a symptom of an underlying condition, it’s called a secondary headache. The most common secondary headaches are caused by:

  • Head or neck trauma
  • Cranial or cervical vascular disorders
  • Nonvascular intracranial disorder
  • Use of a substance or withdrawal
  • Infection
  • Disorder of homeostasis
  • Psychiatric condition
  • Disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structure
  • A result of a brain tumor or abnormal blood vessel (in rare cases)

If you consistently have headaches, it is important to be evaluated in order to rule out certain serious medical issues

How is it diagnosed?

To obtain the most effective headache treatment, it’s important to have the correct diagnosis. Many people with headaches are incorrectly assessed. This can lead to inappropriate or unnecessary treatment and prolonged disability.

Being evaluated by a neurologist is important. They will take a medical and family history and ask questions to get a better understanding of the symptoms. A complete examination of the head, neck, muscles, senses, reflexes and coordination will be done. These tests are extremely important to make sure the proper diagnosis is reached.

Occasionally, the following tests may be needed to make certain there are no underlying causes of the headaches:

  • Magnetic resonance imaging (MRI)
  • CT scan
  • Transcranial and carotid dopplers (non-invasive ultrasound studies of blood vessels in the head and neck that can be assessed to determine blockages or tears that disrupt blood flow)

Types

A primary headache is when the head pain is the problem itself (it’s not caused by an underlying condition). The most common primary headaches include tension headaches, migraines and cluster headaches.

Tension headaches

The most common type of headache is a tension headache. Most adult headaches can be categorized as tension-type or stress headaches. Tension headaches are more common in women than men, with a significant number of children experiencing one by the time they’re 15. These headaches are typically mild and don’t last long.

It can be caused by anything from a particular food, an intense activity, eye strain, smoking, caffeine, poor posture, alcohol or stressful event. Symptoms include a dull head pain or pressure around the forehead. If tension headaches are infrequent, they can be treated with over-the-counter pain relievers such as aspirin or ibuprofen. For more severe or frequent headaches, it’s best to consult your doctor to determine the underlying cause(s) and appropriate treatment.

Migraines

Migraines differ from the common headache in their level of reported severity and frequency, as well as their tendency to be accompanied by additional symptoms such as nausea, vomiting, and sensitivity to light. Affecting more than 10 percent of the world’s population, migraines are three times more prevalent in women than men. In approximately one-third of cases, sufferers report an ability to detect migraines through “auras,” or visual cues, such as seeing flashing lights, geometric lines or disruptions. Many different factors can influence their severity and frequency including diet, nutrition, hormones, stress, anxiety, and certain auditory and visual stimuli, as well as a probable genetic predisposition.

Cluster headaches

Experienced more frequently by men than women, cluster headaches produce very severe pain on one side of the head or eye. Your eye may become red, swollen and teary. Sometimes, changes in heart rate and blood pressure, as well as sensitivity to sounds, smells or light may occur. These headaches come in cycles that range from one or more every day for several weeks, followed by pain-free days or months. Cluster headaches are most common between the ages of 20 and 50 and among smokers. They occur more often during the spring or fall, which is why they may be mistaken for allergies. Occasionally, people with this type of headache experience an aura, similar to the visual disturbance felt before the onset of a migraine headache. Once your doctor has diagnosed that you suffer from cluster headaches, there are pain relieving treatments, as well as things you can to do to help prevent them. In rare cases, surgery may be indicated.

Types of treatment

Treatments for headaches vary, depending on diagnosis and trigger identification. When there is no underlying medical cause, headaches are often due to lifestyle factors and are best treated by changes to those factors. A prescription of a well-balanced diet, exercise and sufficient sleep can go a long way. Most of the time, the doctor will reassure you that everything is OK, which sometimes is enough to alleviate the symptoms.

Other times, pain relievers or migraine medication can help. Simple over-the-counter medications such as ibuprofen, naproxen or Excedrin are helpful to the majority of people with headaches. In other cases where the headache is difficult to treat, we use abortive medications such sumatriptan, or preventative medicines such as amitriptyline, propralolol, topiramate or valproic acid.

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