Headache
What is a headache?
A headache is pain or discomfort in the head or face. Headaches vary greatly in terms of the location and intensity of the pain, and how often they occur. Almost all people have headaches during their lifetimes. According to Teresa Sokol PA-C, a physician assistant in the neurology department at PIH Health, the brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain, but other parts of the head can be responsible for a headache including:
- A network of nerves that extends over the scalp
- Certain nerves in the face, mouth, and throat
- Muscles of the head, neck, and shoulders
- Blood vessels found along the surface and at the base of the brain
Different types of headache include:
What causes a headache?
Headaches are classified as primary or secondary.
- A primary headache means the headache itself is the main health problem. but other factors such as muscle tension or exposure to certain foods may be triggers. Other things that may help cause the headache include medicines, dehydration, or hormone changes.
- A secondary headache is related to an underlying health condition. An example of this would be a headache caused by a neck injury, eye problems, or an infection in the jaw, teeth or sinus.
What are the symptoms of a headache?
Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary, too. Typical headache symptoms include:
- Slow start of the headache
- Head usually hurts on both sides
- Pain is dull or feels like a band or vice around the head
- Pain may be in the back part of the head or neck
- Pain is mild to moderate, but not severe
Tension type headaches typically don't cause nausea, vomiting, or sensitivity to light (photophobia).
The symptoms of a headache may look like other health conditions. Always see your healthcare provider for a diagnosis.
How is a headache diagnosed?
Your doctor will ask about your health history. He or she will also do a physical exam and certain tests.
Questions commonly asked during the exam may include:
- When do headaches occur?
- Do you have specific symptoms before the pain starts?
- What is the location of the headache?
- What do the headaches feel like?
- How long do the headaches last?
- Have there been changes in behavior or personality?
- Do changes in position or sitting up cause the headache?
- Do you have trouble sleeping?
- Do you have a history of stress?
- Do you have a history of head injury?
- Do you have other symptoms during a headache?
If your doctor suspects migraine or tension-type headaches and the nervous system exam is normal, you may not need any further testing. But if it's not a primary type headache, or if you have uncommon symptoms, other tests may be done to find the cause.
Tests used to find the cause of a headache may include:
- Blood tests. Various blood and other tests may be done to check for underlying conditions.
- Sinus X-rays. An imaging procedure done to look for congestion or other problems that may be treated.
- MRI. A test that uses a combination of large magnets, radio waves, and a computer to produce detailed images of organs and structures within the body.
- CT scan. An imaging test that uses X-rays and computer technology to make detailed images of the body. A CT scan shows detailed images of bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Spinal tap (lumbar puncture). This may be done to rule out inflammation, infection, or high pressure in the spinal fluid
How are headaches treated?
The goal of treatment is to stop headaches from occurring. Good headache management depends on finding what type of headache you have. Management may include:
- Staying away from your known triggers, such as certain foods and beverages, lack of sleep, and fasting
- Changing eating habits
- Exercising
- Resting in a quiet, dark environment
- Taking medicines as recommended by your healthcare provider
- Controlling stress
Migraine and cluster headaches may need specific medicines. These include:
- Abortive medicines. These are medicines prescribed by your healthcare provider. They act on certain receptors in nerves and blood vessels in the head to stop a headache in progress.
- Rescue medicines. These medicines include pain relievers bought over the counter, to stop the headache.
- Preventive medicines. These medicines are prescribed by your healthcare provider. They are taken daily to stop a headache from starting.
Some headaches may need medical attention right away. This may include a hospital stay for observation, diagnostic testing, or even surgery. Treatment depends on the condition causing the headache. Full recovery depends on the type of headache and other health problems you may have.
Can headaches be prevented?
If you know what triggers your headache, staying away from the trigger can prevent a headache. Reducing stress can ease or prevent headaches caused by stress. Migraine and cluster headaches may be prevented by taking a daily preventive medicines.
When should I call my healthcare provider?
Most headaches can be managed with over-the-counter pain relievers. But call your healthcare provider right away if you have a severe headache plus:
- Stiff neck
- Fever
- Nausea
- Vomiting
- Convulsion
- Shortness of breath
- Confusion
- Muscle weakness
- Double vision
- Change in level of consciousness.
Symptoms that may suggest a more serious headache include:
- Worst headache ever, or new type of headache
- Recurring headaches in children
- Headaches that start early in the morning
- Headache that follows a head injury
- Pain that gets worse with strain, such as a cough or a sneeze
- Vomiting without nausea
- Sudden onset of pain
- Headache that is becoming more severe or continuous
- Personality changes
- Seizures
Key points about headaches
- A headache is pain or discomfort in the head or face area.
- Types of headaches include migraine, tension, and cluster.
- Headaches can be primary or secondary. If it's secondary, it's caused by another condition.
- Staying away from your headache triggers is the best prevention.
- Mild to moderate headaches can be managed with over-the-counter medicines, but tell your healthcare provider if your headache is severe and you have other symptoms.
Learn more about neurology services at PIH Health. Call 562.967.2801 to make an appointment today.
