Headache? ….but which one?
Posted by Eamonn Brady on
One of the most important steps in the successful management of migraine is in diagnosing that it is actually migraine which is the cause of the headache. Migraine is quite distinct from other headache types in how it presents and in how an episode evolves, attacks and subsides. Let’s look at the three most common “primary” types of non-migraine headache (secondary being headaches caused by other medical conditions)
Tension Headache
The most common type of headache is tension headaches and is usually caused by stress, poor posture or inadequate lighting. Often beginning in the afternoon or early evening of a stressful day and presenting as a “band like” or “pressing” sensation at the front of the head, they can last from one to six hours.
With tension headache, pain tends to be bilateral (both sides of head), constant and with no other symptoms as opposed to migraine which is usually confined to one side of the head, together with other identifiable symptoms.
For most, treatment with an analgesic (paracetamol, aspirin or ibuprofen) will usually take care of it. Engaging in self-management activities such as regular exercise, regular eye breaks from your computer at work, sensible eating habits and learning stress management techniques can all lead to a reduction in tension headaches.
Typically affects those with a history of ordinary tension headache……and whilst similar, it occurs on at least 15 days per month. Whereas tension headache is usually related to individual situations, chronic tension headache tends to be provoked by more enduring ongoing personal situations, i.e. job issues, family and relationship problems, grief, depression
This is caused by the overuse of medication, taken primarily to alleviate headache. In the main this relates to analgesics (paracetamol, codeine, aspirin or ibuprofen) although can also occur with migraine attacking drugs (triptans). Those most commonly affected are those with a history of tension headaches or migraines that have become more frequent or severe over time. They take medication to gain relief from the pain, only to find the headache returning once the drugs have worn off. Sufferers then take more medication to alleviate continued pain, pain eases, drugs wear off, pain returns etc. (a vicious circle!). Once in this spiral, the only way is to break the cycle completely is through withdrawal. This is best achieved through consultation with your doctor. Typical withdrawal side effects can be worsening headaches, nausea and anxiety for a couple of weeks.
Cluster Headache.
A cluster attack can be distinguished from a migraine attack in that with cluster headache the person is agitated during an attack or unable to sit or lie at peace or find relief though sleep.
During an attack, other symptoms may occur such as red or watery eyes, runny nose, nasal congestion, facial sweating. In addition, a sufferer’s eyes may be affected with constriction of the pupil or drooping or swelling of the eyelid. Cluster headache has been described by some medics as “the most painful event that can happen a person” which emphasises the severity of the condition.
Whilst the cause is unknown, suspected trigger factors include alcohol, tobacco, irregular sleeping patterns, and stress and decreased blood oxygen levels. The most common treatment for cluster headache is the inhalation of pure oxygen and is only successful if the mask fits perfectly without leaking. The three “primary” types of headache I’ve described are the most common non-migraine headaches. There are other types of headache, i.e. those relating to sinus problems, over exertion especially exercise. These are known as secondary headaches.
