Student Health Services
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Types of Headaches
All of us suffer from an occasional headache; in fact, 20 million Americans see their doctors each year because of headaches. Although headaches can be very uncomfortable and temporarily disabling, most are not associated with serious illness and can be relieved by resting in a quiet room or by taking a nonprescription painkiller, such as aspirin or acetaminophen. Some types of headaches, however, may require stronger prescription medications, and others are warning signs to seek immediate medical attention. These warning signs include:
- Severe, sudden headaches that seem to come on like a "bolt out of the blue."
- Headaches accompanied by loss of consciousness, alertness or sensation; confusion; visual blurring, or other neurological changes.
- Recurrent headaches affecting one particular area, such as an eye, temple, etc.
- Recurrent headaches of increasing intensity or frequency.
- Headaches accompanied by neck stiffness and fever.
- Headaches that wake you up.
- Any unexplained change in the nature or frequency of headaches.
The most common headaches are those associated with tension or muscle contractions and are directly related to stress. The pain tends to be steady and dull rather than throbbing. It is usually felt in the temples, forehead, neck or back of the head. Sometimes the pain seems to encircle the head like a tight band. Tension headaches may occur at any time, but are most commonly experienced during periods of stress or worry.
Treatment involves relieving the tension through massage, heat, a hot shower, relaxation techniques or any activity that puts aside the worries for the moment. Nonprescription painkillers, such as aspirin or acetaminophen, may also help. For severe muscle tension headaches, other slightly more potent drugs may be prescribed. These drugs may cause drowsiness and slow reflexes and should be taken with caution by people who work with machinery or drive. Most doctors also recommend that such medication be used for only short periods of time (not more than a few days).
Migraine headaches vary from person to person, but typically they are throbbing headaches affecting one side of the head. They are often accompanied by a number of other symptoms, which also vary according to individual cases. Some people have very little head pain but suffer from distorted vision and hearing or feelings of intense anxiety. Others may suffer from incapacitating pain lasting for several days. Most migraine patients fall between these two extremes.
Many people are warned of an impending migraine attack by bizarre distortions of size, position, time and place-the so-called "Alice-in-Wonderland syndrome." Others see flashing lights or bright colors in unusual shapes. Nausea; vomiting; chills; fever; dizziness; diarrhea; abdominal, arm or leg pain, and sensitivity to light are still other symptoms that may accompany a migraine.
Regardless for the differing symptoms, all migraine headaches are related to changes in the blood vessels of the head and neck. This is why they are often referred to as vascular headaches. Early warning symptoms of a migraine are thought to be caused by a narrowing of these blood vessels, while the head pain is believed to be a result of the subsequent expanding or dilating of the vessels. What causes these changes is unknown, although many researchers now believe that chemicals produced in the body that act on the blood vessels may be responsible.
Unfortunately, there is no cure for migraine headaches, although most can be controlled through avoiding triggering factors and by drugs and other therapies. Over-the-counter analgesics may help some migraine patients, especially children, but most adult sufferers require additional or alternative medication. The most successful treatments are those that either prevent an attack or stop it in its earliest stages.
Only a doctor can determine whether a particular prescription drug is indicated for individual migraine cases. If a prescription is given, it is important to use the drug only as directed.
Cluster headaches are a variant of migraines, which strike several times in rapid succession. They are most often experienced by men and are extremely painful. The drugs used to treat a migraine are often prescribed for administration early in an attack; therefore, they are often administered by injection or suppository to allow the medication to enter the bloodstream rapidly.
Sinus headaches are associated with a swelling of the membranes lining the sinuses (spaces) of the nasal passages. The pain tends to be dull and may shift if the head is moved in a certain way. Sinus headaches may be relieved by simple painkillers or, in some cases, a decongestant to relieve the swelling.
The vast majority of headaches are not medically serious. Most can be controlled by the use of simple medications and by habits or life style, as in the case of frequent tension headaches.