Headache or cephalgia is one of the most common form of pain encountered in our daily life. almost everyone suffers from headache at least once in their life. People who suffer headache once in a while usually neglect it as its considered common among general population. There are people who suffer from severe forms of frustrating headaches frequently and consult many doctors of many specialties and consume lots of over the counter and prescription medicines. Few among them know exact diagnosis of their condition and most of them get confused with different diagnosis given by different doctors. Intention of this article is to provide common knowledge about various headache disorders and give an idea about treatment modalities.
- Migraine: It is the most commonest cause of headache in the world. its estimated that 18 % of women and 6% of men suffer from one or the other forms of migraine. There are well established guidelines for diagnosis of this condition as well as the treatment. International Headache society has laid down various criteria for diagnosis of various types of migraine which is considered very reliable. If you are suffering from recurrent attacks of moderate to severe throbbing pulsatile headache which incapacitates you and is associated with nausea or vomiting then you might be suffering from migraine. Other features of migraine include intolerance to loud sound (Phonophobia), Intolerance to light (Photophobia) and symptoms of aura such as visual floaters and light flashes.Treatment of diagnosed migraine depends on its severity. Very frequent attacks of migraine require preventive therapy which includes medicines which needs to be taken daily. These medicines reduce frequency and severity of each migraine attack. Each migraine attack can be treated using routine pain killers such as paracetamol, ibuprofen etc. If patient is not responding well to such medicines then migraine specific medicines such as ergot alkaloids and triptans might be necessary. One has to understand that there is no proven cure for migraine and long term treatment is mandatory.
- Tension type of headache: This type of headache is second most common type after migraine. Its usually less severe and does not impact routine activities. Patients usually complains of mild to moderate severity of headache which usually feels like tight band around the forehead. There will not be associated vomiting sensation. Treatment is usually done using regular pain killers.
- Cluster headache: It's a rare form of headache which is very severe. Men are very commonly affected and usually comes in clusters which lasts for few days to months. Its so severe to cause depression and suicidal tendencies in patients suffering from them. It follows unique circadian rhythm and comes in particular months of each year. Treatment is difficult and requires inhalation of 100% oxygen. Injections of triptans are of great use in treating these patients.
- Cervicogenic headache: In this condition headaches are associated with neck pain. Treatment of predisposing neck problems will cure the condition.
- Sinus Headache: Its one of the most misdiagnosed and over diagnosed headache types. its estimated that more than 80% of diagnosed sinus headaches are migraine in reality. Such misdiagnosis leads to unnecessary antibiotic prescriptions, Unnecessary investigations and surgeries. Person should be extremely careful when surgery is advised for sinus headache. In clinical practice its seen that sinus surgeries rarely cure headaches. However sometimes sinus infections can cause mild heaviness of head and sometimes mild headaches. If proved as sinusitis treatment is usually medical and surgery is required only in few individuals.
- External compression Headache: Incidence of this condition is becoming increasing nowadays. Patients usually complain of headaches triggered by use of helmets and headphones. sometimes even spectacles and other head gears. Its considered as type of migraine disorder. Attacks of headaches can be treated by pain killer medicines. One has to avoid using tight head gears and head phones. There is no cure other than avoiding triggers. Sometimes soft surfacing of head gears can give some relief.
- Functional Headache: Sometimes stress and depression can cause chronic headaches. One needs to consult Psychiatrist for treatment of such condition.
- Medication overuse headaches: People who use non prescription pain killers for undiagnosed headaches can eventually end up having this problem. If a person gets headaches just by not taking his daily pain killers then this needs to be suspected. Treatment includes diagnosis of headache type and treatment using appropriate medicines for particular type of headache. Slow withdrawal from daily pain killer medicines needs to be done.
One has to be extremely careful while taking treatment for recurrent headaches. Proper diagnosis is mandatory. There are certain warning signs such as weakness of parts of your limbs, Very severe acute headache, change in speech, slurring of speech, giddiness associated with headache which may suggest underlying brain pathology such as stroke. One has to avoid self medication with pain killers which may lead to injury to many organs. Consult qualified ENT specialist, Neurologist or Physician for appropriate diagnosis of your headache and treatment.