Headaches are very common and every human being must have experienced headache once or many times in their lifetime. Often times, headaches are common manifestation of some systemic illness like viral infection, malaria, infectious disease and many similar conditions. Some brain problems like tumor or bleeding inside brain can also cause headache. However, some headaches persist for months or years together leading to disability, frustration and poor quality of life.

Types of Headache

There are many types and various causes of headache. They are classified into primary and secondary headache. Primary headache includes tension headache, migraine and cluster headache whereas secondary headaches can be secondary to brain tumor, brain hemorrhage, sinusitis, viral infection and the list is endless.

We will briefly talk about primary headaches which are very common.

Migraine Headache

Typically affects young to middle age people and initially may be one-sided headache to start with. It can alter with other side and patients may experience increased headache severity when they are exposed to sunlight, bright light or loud noise and this may be associated with nausea or vomiting and tingling sensation in hands. Sometimes, neck pain and stiffness in the neck is an associated feature.

Tension Headache

Typically feels like a band-like headache around the head, especially following stress, tension, depression, poor or lack of sleep. This can be associated with neck pain and stiffness.

Cluster Headache

This is special form of headache also known as trigeminal autonomic cephalgia where men are typically affected. This is a terrible form of headache, wakes up patients from sleep and is associated with eye redness, eye pain and nasal congestion.

Treatment

Most of the headaches respond well to medicines and pain killers. But in some cases with persistent headache, long-duration prophylactic treatment is needed.

Medical Treatment– Paracetamol and Pain killers are mainstay of treatment for acute onset headaches. Patients experiencing frequent attacks of migraine headache every month usually benefit from prophylactic medicine which is usually prescribed for 6-12 months. Remember, they are not pain killers and very safe.
Botox Treatment– Refractory migraines respond to botox treatment which is given at multiple locations over face and scalp.
Nerve blocks– We, Pain Specialists perform various nerve blocks like greater, lesser occipital nerve block, auriculotemporal block for providing much needed relief in patients not responding to medical management. They are best and safely performed under ultrasound which helps us precisely locate these nerves and perform accurately without any side effects.
Lifestyle changes– Patients have to follow a disciplined lifestyle, regular nutritious food, follow proper sleep, avoid stress, anger, acidity etc which are one of the triggers for migraine headache.

Danger forms of headache one should not ignore

First time headache in < 20 year or > 65 years’ age.
Severe and excruciating headache, not responding to traditional pain killers
Headache associated with weakness or visual disturbance or cranial nerve palsy
Headache with fever, malaise, body pain and weakness
Headache with loss of appetite or unexplained weight loss
If the headache pattern is different from previous headaches
Headache associated with certain position like getting aggravated in sitting or standing position
Headache increases in severity and progressive
Headache with loss of consciousness or imbalance

Consult a specialist doctor if one is experiencing above type symptoms which are called “Red Flags”.