Identifying And Treating The Most Common Types Of Headaches
Identify and get the right diagnosis for your brain pain
If you suffer from headaches (as per a 2018 National Journal of Community Medicine study, globally, the prevalence of headaches among adults is about 50 per cent) then you’re well acquainted with the throbbing or pulsating pain that can leave you reaching for painkillers or looking for an ice pack. Though more than 300 types of headaches exist, the most common are tension-type, migraine and cluster headaches. The good news? You can prevent and minimize them.
Chances are you’ve experienced tension-type headaches, which affect 29 per cent of the global population. The most common type, they’re characterized by dull pain and pressure around the forehead and scalp, as well as throbbing on one or both sides of the skull. Tension-type headaches are caused by stress, tight neck muscles, sitting in one position for too long or by cold weather, and usually last for about 30 minutes. “In the absence of any biomarker to establish the diagnosis, this is regarded as a mild, bearable, featureless headache without any accompaniments. People who have tension-type headaches usually self-medicate,” says Dr K. Ravishankar, MD, consultant-in-charge, The Headache and Migraine Clinic, Jaslok and Lilavati Hospitals, Mumbai.
Migraines can last for hours or even days, with symptoms that precede and follow the attack. Often running in families and triggered by stress, lack of sleep or changes in barometric pressure, these neurological disturbances can lead to throbbing on one side of the head, nausea and vomiting, as well as sensitivity to light, sounds and smells. Because sufferers miss a lot of work, “Migraines lead to more lost productivity than having cancer,” says Dr William Kingston, a neurologist and headache specialist at Toronto’s Sunnybrook Hospital. According to the Global Burden of Disease Study, by the World Health Organization, migraine on its own was found to be the sixth highest cause, worldwide, of years lost due to disability (YLD).
“Most of the time, patients resort to household remedies like tying the head with a scarf, turning off lights and taking rest, applying balm or popping over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs),” says Dr Colonel Prahlad Kumar Sethi, president, Brain Care Foundation, and emeritus consultant, Department of Neurology, Sir Ganga Ram Hospital, Delhi.
“While triptans are prescribed as a quick fix for moderate to severe migraine attacks in many patients, analgesics such as paracetamol or aspirin and also NSAIDs such as naproxen or ibuprofen, help combat acute migraine. These work well along with an anti-emetic like Domperidone,” says Ravishankar. Practising good migraine hygiene—getting rest, exercising, eating regular meals and skipping alcohol and caffeine—can also help, says Kingston.
These painful bouts have been called suicide headaches—and not without reason. They’re characterized by extreme discomfort that starts around the same time every day—usually in the morning—and typically increases for five to 10 minutes, lasting up to an hour and a half. Attacks can recur multiple times a day. “Treatment includes background preventive drugs such as verapamil and lithium for severe cluster headaches. For an acute attack, sumatriptan nasal spray or injection, or zolmitriptan nasal spray work well, along with the patients inhaling oxygen through a mask,” says Ravishankar.
When to call the doctor
Unusual headaches—ones that you’ve never experienced before that become worse or more frequent—warrant further investigation, says Kingston. If you notice unexplained weight loss, chills, fever, vision changes or mobility or balance issues, ask your doctor to rule out an aneurysm (a weakening of an artery in the brain) or a brain tumour. “It’s important to get the right diagnosis,” Ravishankar adds.