A day seldom goes by without someone around you complaining about a headache. It has become such a household name with popular phrases like, ‘I feel like someone is pounding something on my head, it feels like my head is going to explode, my head hurts, I feel pain in my head,’ being used to describe the feeling. It is either you have heard someone complaining about a headache or you have experienced one. The interesting thing about headache is that most people know what or who causes their headaches. Some people experience headaches regularly, while others experience it occasionally or rarely.
Headache is pain in any region of the head. It could be localized (felt on a particular side) or generalised (felt all over the head). It varies in severity, from mild headaches which are relieved by rest or some over-the- counter pain relieving drugs to severe headaches indicating life threatening conditions. Headaches affect people of different ages from children to the elderly. However, the causes vary.
It is not fully understood what exactly causes headaches. Certain factors associated with headaches can be stress (physical or emotional), fatigue, poor sleep, dehydration, allergies, sinus infection, changes in hormonal levels, excess caffeine, intense physical activity (exercise), excess alcohol intake (hangover), genetics, carbon monoxide poisoning, concussion and other traumatic brain injuries, glaucoma, dental problems, over use of analgesics, hypertension, stroke, infections like meningitis, encephalitis, amongst others.
There are many different types of headaches with their various causes and treatment modalities. Headaches according to the International Headache Society (IHS) is categorised as primary (when they are not caused by any other condition) or secondary, when there is a further underlying cause.
Some types of headaches include:
A) Tension headache: This is the commonest form of headache. The person experiences a dull, squeezing pain on both sides of the head. It is often triggered by stress or fatigue and may have no other symptoms.
B) Migraine headache: It is often described as pounding or throbbing and may be accompanied by other symptoms like sensitivity to light, noise and smells. Episodes may follow fatigue, irritability, restlessness and depression. Some migraine headaches begin with neurological symptoms called aura. Visual complaints like halos, flashing lights, amongst others, are usually the most common aura. However, in a lot of people with migraine there is no aura. The pain is mostly felt on one side of the head, starts around the eye and temple and then spreads to the back of the head. There may also be nausea (sensation of wanting to vomit), watery eye discharge, running nose (nasal discharge) and can be disabling to those affected. When spotted early, non-prescription pain relievers can be used but in more severe forms prescription drugs are required, hence the need to seek medical care.
C) Cluster headache: This is the least common but the most severe. It may be throbbing or constant. Cluster headaches are so called because they tend to happen in groups. It occurs more in men (especially among male smokers) than in women. The eye may get red on the affected side, it may also be watery, with drooping eyelids and nasal discharge (running) or blocked nose. It causes restlessness and anxiety in affected people and some people experiencing it may go as far as banging their heads against the wall to gain relief. This requires urgent medical attention.
Other types of headaches include:
Chronic daily headache
Medication overuse headache
One may ask, “When is the right time to worry about headache?” The thing is that many people know the cause of their headache and should know when they are experiencing a different type of headache from the one they are used to. Some situations in which people are advised to seek urgent medical attention concerning their headache include:
• When the headache is severe enough to interrupt or prevent daily activities.
• When headache develops after head trauma
• When headache is sudden and severe (worse than any previous episode)
• When headache is steadily getting worse even after treatment has started
• When there is a major change in the pattern of headache
• When the headache is accompanied by fever, neck stiffness, decreased alertness, visual disturbances, painful red eyes amongst many others.
The diagnosis of headache should be made by your doctor after thorough history taking and examination to identify type and likely cause of the headache. It has become common practice in Nigeria that people just go ahead to self-medicate when they feel a headache without seeking the doctor’s advice or only present to the hospital after all other measures that were applied have failed. That may lead to abuse or overuse of pain relievers and unwanted complications of using those medications.
It is generally advised that people seek medical treatment early in order to correctly identify which type of headache one has before using medication as not all headaches will require the use of medication. Some headaches may be relieved by rest, effective stress management techniques, eating a light snack, taking care of one’s self and keeping a headache diary (to identify likely causes and avoid them). You should also avoid taking excess alcohol or caffeine.