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What is a Headache?

Headache is defined as pain in the head that is located above the eyes or the ears, behind the head, or in the back of the upper neck. Headache is one of the most common reasons for attending a general physician or a specialist doctor’s clinic. Headache affects everyone at some time of their life time and it is more commonly observed in women than in men. Some 15%-20% of the Indian adult population have migraine, and 80% have episodic headache from time to time.
Sometimes headache pain is mild and merely irritating, but often it is severe or chronic. Frequent headaches can seriously damage your quality of life, and even threaten your job. It has been seen that both social activity and work capacity are reduced in 60 percent of people who suffer from chronic headaches.

Headaches occur because areas around your head — including your scalp, blood vessels, and brain lining — contain pain-sensitive nerve endings that send impulses to your brain, telling it you’re in pain. But what triggers this pain in the first place is of far more interest, because when you identify your triggers, you can often keep headaches from occurring in the first place. Establishing the cause of the headache, arriving at effective treatment(s) for the headache, and taking measures to prevent or reduce headache episodes will require cooperation between you and your doctor. Following are suggestions on how to work with your doctor in finding out the cause and managing your headaches.

What are the types of Headaches? Headaches have numerous causes, and the International Headache Society agreed upon a classification system for headache. Because so many people suffer from headaches, and because treatment is sometimes difficult, this classification system allows your doctor to understand a specific diagnosis more completely to provide better and more effective treatment regimens.
There are three major categories of headaches:
1. primary headaches,
2. secondary headaches, and
3. cranial neuralgias, facial pain, and other headaches

What are primary headaches? Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.
Tension headaches are the most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men. The headache pain may be described as:

  • Dull, pressure-like (not throbbing)
  • A tight band or vise on the head
  • All over the head (not just in one point or one side)
  • Worse in the scalp, temples, or back of the neck, and possibly in the shoulders

The pain may occur as an isolated event, constantly, or daily. Pain may last for 30 minutes to 7 days. It may be triggered by or get worse with stress, fatigue, noise, or glare.There may be difficulty in sleeping. Tension headaches usually do not cause nausea or vomiting.People with tension headaches tend to try to relieve pain by massaging their scalp, temples, or the bottom of the neck.

Migraine headaches are the second most common type of primary headache. .Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. Vision disturbances, or aura, are considered a “warning sign” that a migraine is coming. The aura occurs in both eyes and may involve any or all of the following:

  • A temporary blind spot
  • Blurred vision
  • Eye pain
  • Seeing stars or zigzag lines
  • Tunnel vision

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many people, the headaches start on the same side each time. The headaches usually:

  • Feel throbbing, pounding, or pulsating
  • Are worse on one side of the head
  • Start as a dull ache and get worse within minutes to hours
  • Last 6 to 48 hours

Cluster headaches are a rare type of primary headache, affecting 0.1% of the population.. A cluster headache begins as a severe, sudden headache. The headache most commonly strikes 2 to 3 hours after falling asleep, usually during the dreaming phase. However, the headache may occur while you are awake. The headache tends to occur at the same time of day.
The pain occurs on one side of the head. It may be described as:

  • Burning
  • Sharp
  • Steady

The pain may occur in, behind, and around one eye. It may:

  • Involve one side of the face from neck to temples
  • Quickly gets worse, peaking within 5 to 10 minutes

The strongest pain may last 30 minutes to 2 hours.

The eye and nose on the same side of the head pain may also be affected. Symptoms can include:

  • Swelling under or around the eye (may affect both eyes)
  • Excessive tearing
  • Red eye
  • Rhinorrhea (runny nose) or one-sided stuffy nose (same side as the head pain)
  • Red, flushed face

Cluster headaches may occur daily for months, alternating with periods without headaches (episodic), or they can recur for a year or more without stopping (chronic)

What are secondary headaches?
Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.

Prevention of Headaches
The following healthy habits can lessen stress and reduce your chance of getting headaches:

  • Getting enough sleep
  • Eating a healthy diet
  • Exercising regularly
  • Learning proper posture
  • Learning to relax using meditation, deep breathing, yoga, or other techniques
  • Quitting smoking
  • Stretching your neck and upper body, especially if your work involves typing or using a computer
  • Wearing proper eyeglasses, if needed

Treatment of headaches
The treatment of headaches is generally dependant on the type of headache you are suffering with and requires the help of a number of medications from over the counter pain killers to preventive therapy with special drugs such as triptans to the use of advanced methods such as injections of botulinum toxin in the head muscles or occipital nerve stimulation.

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