When a Headache Needs Urgent Care

Saturday FAMILY HEALTH

By Bobo Bode-Kayode; lifeissuesfromwithin@yahoo.com; 08053372356

When we have any kind of pain or discomfort in the head, we call it headache. This feeling could be mild and transient, medium and heavy, and can extend to excruciating pain. Then medically, depending on the accompanying symptoms, it can be classified and graded.

Headache is one of the commonest symptoms experienced by humans. In fact, it is quite unusual not to have at least an occasional headache. Why some people never experience headache is not known.

Headaches are usually harmless but can create concern about their origin. Very occasionally headaches are a pointer to a serious disease such as brain tumour or stroke. This is why many people seek advice from their doctors and, in some cases, are referred to specialist neurologists. Normally the severity of the headache bears no relation to the gravity of the diagnosis.

It’s not just stress and nasty colds that cause headaches. Cleaning your home or sleeping late can cause them too. Nearly everyone has had headache pain, and most of us have had it many times. A minor headache is little more than a nuisance that’s relieved by an over-the-counter pain reliever, some food or coffee, or a short rest. But if your headache is severe or unusual, you might worry about stroke, a tumor, or a blood clot. Fortunately, such problems are rare. Still, you should know when a headache needs urgent care and how to control the vast majority of headaches that are not threatening to your health. Doctors don’t fully understand what causes most headaches. They do know that the brain tissue and the skull are never responsible since they don’t have nerves that register pain. But the blood vessels in the head and neck can signal pain, as can the tissues that surround the brain and some major nerves that originate in the brain. The scalp, sinuses, teeth, and muscles and joints of the neck can also cause head pain.

10 headache triggers and their remedy

1. Relaxing after stress

You put in 10-hour days from Monday to Friday and you feel fine, only to wake up after a lie-in on Saturday with a pounding headache. Why is that? It’s because as the tension of the week subsides, your levels of stress hormones drop, which causes a rapid release of neurotransmitters (the brain’s chemical messengers). These send out impulses to blood vessels to constrict and then dilate, which causes a headache.

Remedy: Avoid the temptation to sleep in at weekends. More than eight hours’ sleep at a time can bring on a headache. Introduce some relaxation time, such as a yoga class, into your working week, rather than squeezing it all into the weekend.

2. Pent-up anger

When you’re angry, muscles in the back of your neck and scalp tense up, causing a tight band-like sensation around your head. This is a sign of a tension headache.

Remedy : When you start feeling angry, breathe deeply and slowly. Breathe in through your nose and out through your mouth, This should relax your head and neck muscles.

3. Poor posture

Poor posture causes tension in your upper back, neck and shoulders, which can lead to a headache. Typically, the pain throbs in the base of the skull and sometimes flashes into the face, especially the forehead.

Remedy: Avoid sitting or standing in one position for a long period of time. Sit up straight and support your lower back. Consider using a special headset if you spend a lot of time on the phone, as holding a handset between your head and shoulder can strain muscles and cause headaches.

You could also see a physical therapist, such as an osteopath or Alexander technique practitioner. They may be able to help you identify and correct any posture problems.

4. Perfume

If you think housework is giving you a headache, you could be right. Household cleaners, along with perfumes and fragranced air fresheners, contain chemicals that can bring on headaches.

Remedy: If you’re susceptible to headaches brought on by certain smells, avoid heavy perfumes and strong-smelling soaps, shampoos and conditioners. Use fragrance-free air fresheners and household cleaners, and keep your doors and windows open as much as possible at home. If a colleague’s perfume is bothering you, put a fan on your desk at work.

5. Bad weather

If you’re prone to getting headaches, you could find that grey skies, high humidity, rising temperatures and storms can all bring on head pain. Pressure changes that cause weather changes are thought to trigger chemical and electrical changes in the brain. This irritates nerves, leading to a headache.

Remedy: There’s not much you can do to change the weather. However, by looking at the forecast, you can predict when you’re likely to have a headache and take a preventative painkiller a day or two in advance.

6. Grinding teeth

Grinding your teeth at night (the medical name is bruxism) makes your jaw muscle contract, causing a dull headache.

Remedy: Your dentist can fit you with a mouth guard to protect your teeth while you sleep.

7. Bright lights

Bright lights and glare, especially if flickering, can induce migraines. This is because bright and flickering lights boost the levels of certain chemicals in the brain, which then activate the migraine centre.

Remedy : Sunglasses are great at reducing light intensity, and you can wear them inside and outside. Polarised lenses can also help to reduce glare.

At work, adjust your computer monitor or attach a glare screen. You may be able to turn off certain lights or move them. If you can’t, change where you sit in the office. Fluorescent lighting tends to flicker, so if you’re able to, substitute it with some other form of lighting.

8. Food triggers

Your turkey and cheese sandwich and small bar of dark chocolate might be a tasty lunch, but beware of the headache that could follow it. All these foods contain chemicals that can bring on a migraine. Other culprits include aged cheeses like stilton and brie, diet fizzy drinks, and processed meats and fish.

Remedy: Keep a migraine trigger diary and once you suspect a certain food may be the cause of your headaches, eliminate it from your diet for a couple of months to see if you get fewer headaches.

If you’re concerned about avoiding any food-related trigger factor, see your GP or practice nurse or ask to be referred to a dietician for specialist advice. Remember to eat regularly, because skipping meals can bring on a headache.

9. Sex headaches

It’s a standing joke that headaches are used as an excuse to avoid sex, but for many men and women, coital headaches that come on at the height of passion are a real and distressing problem. Doctors think sex headaches are due to pressure building up in the head and neck muscles. The headaches can happen during foreplay or just before orgasm, and can last for a few minutes or up to an hour.

Remedy: They’re inconvenient, but these headaches are usually harmless and don’t mean you have to avoid sex. Take a painkiller a few hours beforehand to block the headache.

10. Ice cream

Do you get a sharp, stabbing pain in your forehead when you bite into an ice cream cone? Then you’re susceptible to ice cream headaches, caused by cold material moving across the roof of your mouth and the back of your throat. Ice lollies and slushy frozen drinks have the same effect.

Remedy: The good news is that ice cream headaches don’t need treatment. In fact, they’re over in a flash, rarely lasting more than a minute or two.

When to be Concerned :

When to worry about a headache. You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher ones. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

• Headaches that first develop after age 50
• A major change in the pattern of your headaches
• An unusually severe “worst headache ever”
• Pain that increases with coughing or movement
• Headaches that get steadily worse
• Changes in personality or mental function
• Headaches that are accompanied by fever, stiff neck,

confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures

• Headaches that are accompanied by a painful red eye   • Headaches that are accompanied by pain and

tenderness near the temples

• Headaches after a blow to the head
• Headaches that prevent normal daily activities
• Headaches that come on abruptly, especially if they

wake you up

• Headaches in patients with cancer or impaired immune

systems.

Types of headaches : Tension-type headaches :

Occurring in about three of every four adults, tension headaches are the most common of all headaches. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches, and some are troubled by them for three or four times a week.

The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel like their head is in a vise. The shoulders and neck can also ache. Some tension headaches are triggered by fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw. Most last for 20 minutes to two hours.

If you get occasional tension-type headaches, you can take care of them yourself. Over-the-counter pain relievers such as acetaminophen (Tylenol, other brands) and nonsteroidal anti-inflammatories) such as aspirin, naproxen (Aleve, other brands), or ibuprofen (Motrin, Advil, other brands) often do the trick, but follow the directions on the label, and never take more than you should. A heating pad or warm shower may help; some people feel better with a short nap or light snack.

Migraine: Migraines occur less often than tension-type headaches, but they are usually much more severe. They are two to three times more common in women than men, but that’s small consolation if you are among the six to eight per cent of all men who have migraines. And since a Harvard study of 20,084 men age 40 to 84 reported that having migraines boosts the risk of heart attacks by 42 per cent, men with migraines should take their headaches to heart.

Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. Genetics play a role since 70 per cent of migraine victims have at least one close relative with the problem

• Changing weather: rising humidity, heat
• Lack of sleep or oversleeping
• Fatigue
• Emotional stress
• Sensory triggers: bright or flickering lights, loud

noises, strong smells

• Dietary triggers:
• missing a meal
• alcohol, especially red wine
• chocolate
• nitrates in cured meats and fish
• aged cheese
• an increase or decrease in caffeine
• MSG (often present in Asian and prepared foods) .

 

Cluster headaches:

Cluster headaches are uncommon but very severe headaches, and they occur five times more often in men than women. Although anyone can get cluster headaches, the typical patient is a middle-aged man with a history of smoking.

The problem gets its name because the headaches tend to come in clusters, with one to eight headaches a day during a one- to three-month period every year or two, often at the same time of year. The pain always strikes one side of the head and is very severe. The eye on the painful side is red and watery, the eyelid may droop, and the nose runs or is blocked. The attack starts abruptly and lasts for 30 to 60 minutes. Most sufferers become restless and agitated during the attack; unable to sit still, they pace, jog in place, or beat their head against a wall. Nausea and sensitivity to light and sound may accompany the pain. Inhaling pure oxygen can help the attack.

Testing headaches :

Modern medicine depends on tests to diagnose many problems. For most headaches, though, a good old- fashioned history and physical will do the job. In fact, CT scans, MRIs, and EEGs (brain wave tests) look normal in tension-type headaches, migraines, and cluster headaches. Still, these tests can be vital in patients with warning signs or other worrisome headaches.

Living with headaches : For most of us, an occasional headache is nothing more than a temporary speed bump in the course of a busy day. Even so, most men can ease the problem with simple lifestyle measures and nonprescription medications. Relaxation techniques, biofeedback, yoga, and acupuncture may also help. But for some of us, headaches are a big problem. Learn to recognise warning signs that call for prompt medical care. Work with your doctor to develop a program to prevent and treat migraines and other serious headaches. And don’t fall into the trap of overusing medications; for some gents, rebound headaches are the biggest pain of all.