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Just a Headache? Think again.

Just a Headache? Think again.

Not all headaches are the same, and some can be very serious. Instead of just working through or managing the pain, it's important to understand the different types of headaches and recognize when to seek help.

Just about everyone has experienced headache pain in their life. For many of us, it's a rare occurrence, usually easily treated, and not a harbinger of something more serious. But, a sizable number of adults suffer from headaches on a regular basis, and for many of them the pain is far beyond an annoyance. In fact, a 2022 meta-analysis of global research and headache studies reported that over half of the world's population suffers from a headache disorder, including frequent tension headaches and more debilitating migraines. Since headaches are a serious concern for so many of us, it's important to understand the different types of headaches, potential triggers, and available treatments. Armed with a little more knowledge, you're more likely to be able to prevent headaches or get the right treatment when they strike.

The most common types of headaches (aside from those caused by non-life-threatening illnesses such as sinus headaches that accompany a head cold or sinus infection) are tension (by far the most common) and migraine. Recently, headache experts have also started to use the term "mixed headache" to describe headaches that have attributes of both tension and migraine. And while doctors don’t know exactly what causes all headaches, they do know that the most common triggers are stress, hunger, dehydration, lack of sleep and caffeine withdrawal. Is it any wonder we're a nation full of headache-sufferers?


Tension Headaches

Stress, fatigue, eye-strain, hunching over a computer all day...all of these things are a recipe for tense neck, shoulder and scalp muscles. And tense muscles cause tension headaches. While the pain is usually mild to moderate, tension headaches can disrupt your day and put a halt to your activities. These headaches can last from 30 minutes to several hours. For an occasional tension headache, a short nap, light snack, or over-the-counter pain reliever is often all that's needed to treat the pain. You can also try applying a heating pad to your neck and shoulders to ease the tension there.

To help keep tension headaches at bay, you have to prioritize self-care. That means getting enough good quality sleep, eating regular and nutritious meals, exercising regularly, and taking time to de-stress and decompress. Try incorporating meditation, guided imagery, or other relaxation techniques into your daily schedule and see if it reduces the frequency and severity of your headaches. And, if you suffer from headaches weekly or more often, be sure to talk to your doctor about it. They should rule out other health issues, and may recommend alternative treatments such as biofeedback or different drug therapies.

Migraine Headaches

Migraine sufferers can be sidelined by intense headache pain lasting anywhere from four to 72 hours. This debilitating neurological disease affects more than 10% of all adults in the U.S., but migraines often start during the teen years. Genetics, chemical imbalances in the brain, hormones, stress, alcohol and some foods may all play a role in causing migraine headaches.

A migraine attack often starts with a "prodrome" which includes symptoms such as fatigue, sensitivity, or irritability. The prodrome may start hours or even days before the headache hits. About 25% of migraine sufferers also experience a temporary neurologic change called an aura, which can cause visual disturbances, numbness, weakness, or dizziness. Usually occurring on one side of the head, the headache is typically severe and associated with neck pain, nausea and vomiting, and sensitivity to light, smell, and sound. (The headache portion is only one piece of a migraine attack and could even be absent altogether.)  Lastly is the "postdrome" or the period following the headache before returning to baseline. Sometimes referred to as a "migraine hangover," this phase can include cognitive fog and fatigue.

Fortunately, there are a variety of new and effective medications that can help you manage pain or even prevent migraine if taken when symptoms first appear. Chronic or frequent migraine sufferers should work closely with their doctor to identify and eliminate potential triggers and determine the most effective treatment.

When to See a Doctor

An occasional mild headache during a stressful day is normal. An increase in frequency or severity of headaches should be discussed with your doctor as soon as possible. A single headache that comes on suddenly and is accompanied by severe pain, blurry vision, weakness or confusion could be a sign of a stroke or other serious condition that requires immediate medical attention. Any headache that follows a blow to the head, is accompanied by a fever, stiff neck, or a decline in mental function is also a medical emergency. These symptoms can be life-threatening – call 911 or visit the nearest ER immediately.

Other warning signs to be aware of include:

  • Headaches after age 50 when there were none (or minimal) prior
  • An increase in frequency, severity, or location of headache
  • Headaches that prevent normal, daily activities and routines
  • Headaches that come on suddenly, especially if they wake you up

Finally, remember that an occasional tension headache is generally nothing to be worried about. However, severe and sudden headaches – and headaches accompanied by any of the above symptoms are serious. Never ignore those symptoms, and discuss them with your doctor as soon as possible. There are treatments available, and there's no need to suffer in silence – or risk a serious medical issue going undiagnosed.


This article first appeared in the February 2023 edition of the HealthPerks newsletter.

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