Headache is defined as pain in the head that is located above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache is common problem in men and women.The main challenge to affording relief from various forms of “cephalgia,” or “head pain,” is categorizing a headache by type, and then proceeding with the therapy most likely to help. There are two types of headaches: primary headaches and secondary headaches. Primary headaches are not associated with (caused by) other diseases. The most common type of headache is a tension headache.Tension headaches are the most common type of primary headache. As many as 90% of adults have tension headaches. Tension headaches are more common among women than men. Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the US have migraine headaches. 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 have them. Migraine often goes undiagnosed or is misdiagnosed as tension or sinus headaches. Several areas of the head can hurt, including a network of nerves which extends over the scalp and certain nerves in the face, mouth, and throat. The meninges and the blood vessels do have pain perception. Headaches often result from traction to or irritation of the meninges and blood vessels. The muscles of the head may similarly be sensitive to pain.
Headache associated with specific symptoms may warrant urgent medical attention. Headaches are a common cause of suffering, but all headaches are not created equal. Migraine headaches are severe, recurrent headaches generally accompanied by other symptoms like visual disturbances or nausea. Cluster headaches occur daily over a period of weeks, sometimes months.Cluster headaches are the least common type of primary headaches, affecting about 0.4% of adult males in the United States and 0.08% of adult females. Cyclic vomiting also occurs in young kids and involves repeated episodes of vomiting. Some patients describe the pain as feeling like a hot poker in the eye. Tension headaches typically result from tightening of the muscles of the face, neck, and scalp as a result of emotional stress. Tension headaches are caused by stress, muscular tension, vascular dilation, postural changes, protracted coughing or sneezing, and fever. Sinus headaches cause pain in the front of your head and face.Sinus headaches are associated with a swelling of the membranes lining the sinuses (spaces adjacent to the nasal passages). They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches. Headaches associated with fever, convulsions, or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person with no previous history of headaches; and recurring headache in children.
Treatment of the headache depends on the type and severity of the headache and on other factors such as the age of the patient. Tension-type headaches can usually be soothed by using relaxation techniques, or using over-the-counter painkillers taken at the time of the headache. Codeine can be used with caution because of the increased chance of causing medicine overuse headache and addiction.Taking ibuprofen (an anti-inflammatory painkiller) is an alternative. Anti-inflammatories may be more effective than paracetamol for some people.Taking a painkiller such as paracetamol usually works well to relieve a tension-type headache. It is best to take a full dose as soon as a headache starts, a second dose can be taken after 4 hours if necessary. Headaches that are caused by brain tumors, post-injury hematomas, dental problems, or disorders affecting the spinal disks usually require surgical treatment. Surgery may also be used to treat cases of idiopathic intracranial hypertension that do not respond to treatment with steroids. Psychotherapy may be helpful to patients with chronic headaches by interrupting the “feedback loop” between emotional upset and the physical symptoms of headaches. Some psychotherapists teach relaxation techniques, biofeedback, or other approaches to stress management as well as cognitive restructuring.