Headaches are one of the most reported symptoms in all of medicine. Headaches
are very non-specific, and can signify anything from a primary headache
disorder, prodrome of a viral illness, sinus congestion related to weather
changes, represent a sign of a serious life-threatening condition such
as bleeding in the brain or a brain tumor, or be a symptom of a host of
other medical, ophthalmologic, vascular, or neurologic disorders.
However, while headaches are a symptom of the above different medical conditions,
they most frequently represent a medical condition in and of themselves.
It is estimated that at some point in their lives, over half of the world’s
population will be affected by an active headache disorder.
Why come to LCMC Health Neuroscience Institute?
With so many different types of headaches, and with the ever-increasing
number of treatments for headaches, there is no “one size fits all”
approach. Here at LCMC Health, our headache specialists will work with
you to eliminate possible triggers, identify potential dietary and lifestyle
modifications, and work to tailor a treatment plan to achieve the best
headache control possible.
“I thought I had migraines, but later found out neck strain caused
these headaches!”
Primary headache disorder is a term used to represent several different
types of headache syndromes, including migraines, tension-type headaches,
and trigeminal/autonomic “cephalgias”. Other types of headache
disorders may be triggered by trauma or musculoskeletal conditions.
While the various types of headaches can present similarly, there is often
a characteristic pattern of onset or stereotypical pain characteristic
associated with specific syndromes. Even though some headache treatments
may work for multiple headache types, distinguishing between different
syndromes is important, as some triggers and treatments may be specific
to headache type.
"It felt like someone just hit me with a hammer and the pain wouldn’t
let up…”
While most headaches are benign, some severe headaches or ones accompanied
by other symptoms, require immediate medical attention. You should immediately
activate emergency medical services (EMS, or 911) if you or someone you
know are having these headaches:
New, severe, and sudden in onset, as if you were just struck by lightning
and have the worst headache you have ever felt
Headache with fever, stiff neck, or confusion
Accompanied by seizure (in a patient who was not diagnosed with Epilepsy)
New onset in a pregnant woman
New onset and frequent in a child
Headache accompanied by other symptoms, like:
Slurred speech
Difficulty coming up with words
Difficulty understanding others when they are speaking to you
Confusion
Weakness or numbness of a limb or side of the body
“Every time I smell strong perfume it's like my head starts throbbing…”
As alluded to, headaches can be triggered by numerous factors. One of the
first things your headache specialist is likely to do is review your headache
history and medications to determine if there are identifiable patterns
associated with your headaches. Some of the questions that might be asked include:
Do they occur when your sleep routine has been interrupted?
Do they occur during a certain time of day?
Are they more common after consuming a specific food or beverage?
Do they occur after certain activities?
Do you take pain medication for headaches regularly, only to have the headache
return several hours later necessitating taking additional pain medication?
In women of childbearing age, do headaches occur during a certain time
of the menstrual cycle?
Sometimes managing headaches can be as simple as avoiding a specific trigger,
modifying certain activities, or by making a dietary adjustment.
When dietary or lifestyle modification are not effective or are not an
option, medications, both over the counter and prescription, are often
used for headache management. Depending on how frequent and severe your
headaches are, this may involve recommending or prescribing an “abortive”
medication (a medication intended to treat a headache as it is occurring),
a “prophylactic” medication, (a medication intended to reduce
the frequency or severity of your headaches), or a combination of both.
In some types of chronic migraine headaches, Botox injections can be an
effective means of treatment.
For certain types of headaches, or in headaches that have not responded
to more traditional treatments, sometimes interventional approaches are
required. Physical therapy or dental evaluation might be recommended if
headaches are felt to be related to a musculoskeletal condition of the
neck or jaw. In some instances, interventions such as relaxation training,
cognitive-behavioral therapy, or massage therapy may be found to be effective
additions to headache management strategies.
