On the other hand, below are tips/ advice from a doctor which I saved on my files last March. Hope this article helps.
Is your headache giving you a headache?
Tuesday, March 11, 2008
If you have an occasional headache, you’re far from alone. During the past year, nearly 90 percent of men and 95 percent of women have had at least one headache, according to the American Council for Headache Education.
Headaches come in several varieties. “The types of headache include tension headache, sinus headache, migraine headache, and cluster headache,” says Camelia Davtyan, MD, associate professor and internist at
Here’s an overview of causes, symptoms, and treatment options for different types of headache.
• Tension headache. The most common headache is a tension headache, which often results from muscle tension and stress in the neck and shoulders, and may last for several hours. The dull, constant pain is sometimes described as feeling like a tight band being squeezed around the head. Noise, glare or fatigue can intensify the pain. “Eye strain can cause a variant of tension headache, which resolves if the eye problem is corrected,” notes Dr. Davtyan.
Many get complete relief from over-the-counter medications, such as acetaminophen and ibuprofen. Dr. Davtyan suggests applying moist heat and/or massaging tense neck and shoulder muscles, as well as utilizing relaxation and deep-breathing exercises, getting adequate sleep, and engaging in regular physical exercise to reduce the pain and prevent recurrence of a tension headache. For some, physical therapy or acupuncture can bring relief.
• Sinus headache. A sinus headache occurs when the sinuses are inflamed or congested. Pain or pressure is felt in the forehead or around the eyes and cheeks, and may be accompanied by tender skin and bones near the eyes.
“Sinus headaches are usually associated with infections and allergies, so the patient’s physician should decide if an antibiotic is needed,” says Dr. Davtyan. “Antihistamines and nasal corticosteroid sprays can help with an allergic cause.”
• Cluster headache. Pain from a cluster headache is severe, localized around one eye, and can last from minutes to hours. They occur at the same time each day for a period of days or weeks, until the “cluster” ends. Treatment with prescription medicine is often necessary. The cause of cluster headaches has not yet been identified.
• Migraine headache. Migraine affects up to 17 percent of women and six percent of men. For some, migraines are infrequent. For others, they recur frequently and become debilitating. Fortunately, progress is being made in migraine management. Although an individualized treatment approach is often necessary, most people can be helped.
During a migraine attack, throbbing (pulse) pain may occur on one side of the head and gradually spread, but it’s not uncommon to have pain on both sides of the head. Nausea with or without vomiting may occur. A migraine may last anywhere from a few hours to several days. The pain of a migraine may be aggravated by light, sounds, odors, exercise, and even routine physical activities. Some people experience a visual distortion (aura) — such as blurred vision, sparkling flashes or jagged lines — or localized numbness just before migraine pain. Sometimes, an aura occurs during a migraine, and occasionally, auras may occur without headache pain.
The cause of migraines isn’t fully understood. However, migraines often run in families, so it’s generally thought that genetic predisposition likely plays a big role. Women are three times more likely to have migraines than are men.
Determining a treatment route depends on the characteristics and frequency of your migraines. Medications for migraine generally fall into two classes. There are drugs to prevent migraines and drugs for pain relief (acute treatment). Your doctor may recommend preventive medications if you have two or more debilitating attacks in a month, if you use pain-relieving medications more than twice a week, if those medications aren’t helping, or if you have uncommon migraine attacks that include prolonged aura or numbness on one side of the body. Preventive medications typically are taken at regular intervals, often daily, whether you have a headache or not. Among the medications that may be considered for preventive use are:
• Cardiovascular drugs. Beta blockers, such as propanolol (Inderal) and metoprolol (Betaloc and others), are commonly used. The calcium channel blocker verapamil (Verelan, Isoptin) may help. And one study has suggested an angiotension receptor blocker (ARB) — candesartan (Blopress) — may be beneficial in preventing migraine.
• Antidepressants. Tricyclic antidepressants such as amitriptyline, nortriptyline, and protriptyline may be particularly helpful.
• Anti-seizure drugs. Some of these — divalproex sodium (Depakote), gabapentin (Neurontin), and topiramate (Topamax) — seem to prevent migraine, although the reason is unclear.
Infrequently, nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen or naproxen — may be tried as migraine preventive, and are also used to treat migraines when they occur.
Pain relief drugs for migraines are to be taken as soon as you experience signs and symptoms of a migraine. However, the overuse of pain relief drugs may interfere with migraine therapy. A good rule of thumb is to limit their use to no more than two days a week. Your doctor can help tailor a treatment plan to your situation and may recommend one or a combination of the following drugs to treat your acute migraine:
• NSAIDs. A mild migraine may respond to ibuprofen or aspirin. A moderate migraine may respond better to nonprescription combination drug containing acetaminophen, aspirin, and caffeine. Your doctor may prescribe stronger NSAIDs at times, if needed.
• Triptans. Sumatriptans (Imigran) was the first drug specifically developed to treat migraine by mimicking the action of a brain chemical called serotonin. Relief with this drug usually occurs within two hours of taking it. Some triptans are available as nasal sprays, orally disintegrating tablets, or injection and may work faster.
Triptans generally aren’t an option if you have cardiovascular problems or known cardiovascular risks. Side effects may include nausea, dizziness, and muscle weakness. A recent study has found that combining a single dose of sumatriptan with naproxen helped relieve migraine symptoms more effectively than did either medication taken alone.
• Anti-nausea (anti-emetics) and related drugs. If your migraine attacks typically include nausea and vomiting, anti-emetics taken early on with your headache medication may be helpful. Metoclopramide (Plasil, Reglan, and others) can help nausea and vomiting.
• Ergots. Ergotamine was used for decades before the release of triptans. Today, an ergot may be used if triptans aren’t helpful. Side effects may include anxiety, nausea, and vomiting. As with triptans, ergots generally aren’t prescribed if you have known cardiovascular risks or problems.
In addition to medical treatments, you may find relief from alternative therapies, such as acupuncture, massage, and biofeedback. The National Institutes of Health concluded that acupuncture can play a role in containing headaches. Biofeedback may also be useful in helping you to understand how your body reacts during times of stress and then how to mentally “dial down” that stress.
Some have found meditation and yoga helpful. A study in the May 2007 issue of the journal Headache showed that a combination of yoga, breathing exercises, and relaxation reduced migraine frequency and pain among adults with migraine. Some find benefit from herbal remedies, such as butterbur, which appears relatively safe if taken for a short period of time. In addition, the supplement coenzyme Q10 appears to reduce migraine frequency for some.
Certain vitamins and minerals may also have a place in migraine treatment. Taken over time, riboflavin — vitamin B2 — may help prevent migraine. Studies suggest maintaining an adequate amount of magnesium levels may also prevent migraines. When considering these and other alternative migraine remedies, consult your doctor first about the pros and cons, and how to prevent possible drug interactions.
There is help available for headaches!