Headaches are one of the most common health related conditions in Australia. Global 1-year prevalence data show that 1 in 2 people will suffer from a headache, so you all probably know what I’m talking about! But what are headaches exactly and how can we prevent them?
There are many different types of headaches and often it can be difficult to distinguish between them. Headaches can be classified into two broad categories - primary and secondary. Primary headache include migraine, cluster or tension headache. Secondary headaches are triggered by an underlying disorder, such as infection, injury or tumour and can be considered as a side effect of the main illness.
LOOKING AT PRIMARY HEADACHES IN MORE DETAIL…
A tension headache is the most common type of headache. A tension headache feels like a tight band of pressure around the head and is often associated with muscle tightness in the head, neck or jaw. It can be caused by physical or emotional stress.
A migraine is a headache on one side of the head and is usually accompanied by nausea, vomiting or sensitivity to light and noise. In addition, a migraine may be preceded or accompanied by an ‘aura’. The symptoms of an aura include seeing lights or spots, losing your vision, or suffering pins and needles, numbness or speech disturbances. Migraines are associated with a spasm of the blood vessels leading to the brain, and can be triggered by food, stress, heat/cold, emotions, fatigue or hormonal fluctuations.
A cluster headache is relatively uncommon and usually involves severe pain localised to one eye. Other symptoms include swelling and watering of the affected eye. It can be triggered by alcohol and cigarettes but the underlying cause is unknown.
PREVENTING AND TREATING HEADACHES:
Tension headaches are self-limiting and non-disabling and are best managed by massaging and stretching the head and neck muscles and if required simple pain killers such as paracetamol or ibuprofen (avoid preparations containing codeine).Tension headaches are best prevented by making lifestyle adjustments such as exercise, diet, stress management and attention to posture, as well as identifying and eliminating trigger factors (such as lack of sleep).
Migraines are usually treated initially with analgesics, such as paracetamol, ibuprofen or aspirin. These should be taken early in the migraine when absorption is less impaired by reduced gastrointestinal mobility. Soluble or rectal forms can be used. A medication called an antiemetic can be used for nausea/vomiting and for people who do not respond to an analgesic alone (they may improve absorption of analgesics by increasing gastrointestinal mobility). You can even use natural remedies such as Migrastick. If your migraines are severe or disabling, or if you find that simple painkillers don’t work, talk to your GP about trying a specific migraine medication. Several preparations are available, so you will need to work with your GP until you find the best medication and dose for you. It’s best to also retreat to bed in a quiet and darkened room.
The frequency of migraine attacks can be reduced by recognising and avoiding triggers such as stress, irregular sleep, skipping meals, smoking and some foods (such as chocolate, cheese, citrus fruits and wine). While it’s generally not possible to avoid stress completely, you may be able to manage it better by undertaking relaxation training or specialised counselling. Other techniques that may be useful include yoga, massage and exercise. If you suffer more than three severe migraines a month, your doctor may suggest taking a medicine to reduce their frequency. These medicines often cause side effects, so you and your GP will need to weigh up the benefits and side effects before making a decision whether or not to try one.
WHAT TO LOOK OUT FOR WITH YOUR HEADACHES:
If you suffer frequent or persistent headaches, it’s important that you see a doctor. Don’t be tempted to self-treat them by taking more than the recommended dosage of painkillers. Your headaches may not be ordinary headaches: they may be secondary headaches due to an underlying condition and may need specific treatment.
In addition, paradoxically, if you’re using painkillers frequently, your headaches may be caused by the painkillers, particularly if they occur on most days or every day. These medication overuse headaches can be caused by any of the painkillers used to treat headaches and migraines, but they’re more likely when using combination painkillers.