Headaches

A headache is any pain in the head, the discomfort of which can vary greatly. It may be dull or sharp, throbbing or constant, localized to a small area or engulfing the entire head. Some people suffer headaches only occasionally, while for others the problem is chronic. Although a headache is often the symptom of an underlying problem such as the flu, and may be temporarily debilitating, it is rarely associated with a serious condition. Nevertheless, for some 20 million Americans each year, the pain of headache is severe enough to warrant a visit to a doctor. And according to government estimates, some 64 million workdays are lost annually due to various types of headaches.

Simple tension is the leading cause of headaches, and the basis for the tension very often is stress. Other possible causes include fatigue, blocked sinuses, allergies, and irritated or inflamed blood vessels in the scalp. Overuse of alcohol and tobacco can bring on a headache, and so can adverse reactions to medications. Some women experience this symptom just before or during menstruation. Changes in the weather and other environmental factors can also trigger the affliction.

Diagnostic Studies and Procedures

Often, a doctor can tell what kind of headache you are suffering simply by asking you to describe when and how it develops. He will inquire about any triggering factors, the patterns of frequency, and the nature and duration of pain. Questions might include: Can it be controlled with non-prescription painkillers, such as aspirin or acetaminophen? Does it change when you move your head? Is there a family history of similar headaches?

The next step is a physical examination, paying special attention to the eyes and ears. The doctor will feel the head itself for bumps, tensed muscles, or an unusual throbbing of blood vessels in the temple and neck. Blood and urine tests, as well as X-rays of the skull and sinuses, may be ordered. Imaging studies of the brain, using CT scanning techniques or MRI, could be necessary to rule out a tumor or other structural abnormality. Some cases require vision and other eye tests. If meningitis or brain infection is suspected, a sample of cerebrospinal fluid will be obtained for analysis.

Medical Treatments

A doctor may recommend a decongestant to reduce swelling if blocked sinuses are responsible for a headache, or antibiotics if there is an infection. Other possible medications depend upon the type of headache involved. They include muscle relaxants for tension headaches, antihistamines for allergies, and tranquilizers or antidepressants for headaches related to psychiatric disorders.

For the vascular headaches, cluster, and migraine, a variety of treatments are available. In unusual cases in which headaches stem from tumors or brain abnormalities, surgery may be indicated. If fluid builds up in the brain, a drainage tube may be implanted to shunt the excess fluid to another area of the body.

Alternative Therapies

In recent years, headache clinics have incorporated a number of alternative therapies into their medical regimens, especially in dealing with chronic headaches that have no obvious organic cause. These therapies may include:

Acupuncture and Acupressure. A series of acupuncture treatments to stimulate points on the head, neck, hands, and feet may be recommended. Alternatively, practitioners advise applying pressure to the web between the thumb and forefinger.

Alexander Technique. Chronic headaches are often traced to poor postural habits that create muscle tension. An Alexander technique instructor observes your normal posture and movements and then teaches you ways to change any bad habits.

Aromatherapy. A facial massage using clary sage or rose oils can relax tensed muscles and thereby alleviate a headache related to tension.

Biofeedback. Patients are taught to divert some blood flow from vessels in the scalp to the hands or elsewhere. Biofeedback training can also be used to counter muscle tension.

Chiropractic. Practitioners use neck adjustments to treat simple headaches.

Herbal Medicine. Herbalists recommend numerous preparations to treat headaches, including fever capsules, mint tea, white willow bark tablets or capsules, and rosemary tea.

Homeopathy. Practitioners may prescribe nux vomica, sepia, or belladonna preparations, depending upon the nature of the headache.

Hypnosis. Self-hypnosis is taught as a way to treat various pain syndromes, including headaches. While the patient is hypnotized, a hypnotherapist implants instructions of specific actions to take in order to stop a headache. When the patient awakens, the therapist repeats these instructions and then instructs the person what to do when a headache develops.

Massage. This is an age-old technique to alleviate head pain. Massaging the back of the neck, temples, scalp, and face can relax tensed muscles, thereby relieving a simple tension headache.

Music Therapy. Listening to soothing music not only is relaxing but it also increases the brain's production of endorphins, which are natural painkillers.

Nutrition Therapy. Caffeine and alcohol trigger many headaches. Try eliminating these substances from your diet. MSG, artificial sweeteners, and other food additives also cause headaches in some people. Nutritionists recommend keeping a careful food diary, looking for links between headaches and foods, and then performing trial eliminations of suspect foods from your diet.

Osteopathy. In addition to medications recommended by other doctors, osteopaths may also use massage and manipulative methods to treat headaches.

Yoga and Meditation. These relaxation techniques are especially beneficial in treating tension headaches.

Self-Treatment

Simple self-care measures can alleviate most headaches. If the headache is related to tension or fatigue, resting in a dark, quiet room with a cool compress on your forehead may cure it. Otherwise, non-prescription painkillers, such as aspirin, acetaminophen, and ibuprofen, work for most people.

Other Causes of Headaches

Many diseases, ranging from the common cold and flu to stroke and brain tumors, can produce headaches. However, the presence of additional symptoms usually distinguishes headaches that are secondary to other ailments from primary headaches.