Introduction to Headache

Headache is an enormously common problem. It is estimated that 10-20% of the population have a migraine. It is one of the most common reasons for people visiting the doctor and can be the indication of a severe problem, or it can be chronic, annoying, and incapacitating, without any fundamental cause.

Causes of Headache

Headache is taken by some nerves that supply the head and neck. It affects the face as well as the cervical and the back of the head. It suggests that something is pressing on the brain. In migraine, there may be a generator of headache in the brain which is triggered by many factors. Some generators are more susceptible to stimuli such as light, noise, smell, and stress than others which causes more frequent headaches.

Types of Headache

People may suffer from more than one type of headache among which, migraine is most common. The analysis of headache type is important because treatment varies for each headache category. Headache patterns and symptoms may change throughout life.

Migraine Without Aura

Migraine is generally present in family history which means a person may have a genetic tendency to get headaches. It can cause mild pain with the features of dizziness and blurred vision and is still considered a migraine headache. Migraine headaches are generally:

  • Inherited
  • Moderate to severe pain
  • One-sided
  • Related with nausea and vomiting
  • Light and sound sensitivity
  • Worsenedwith activity
  • Pounding or throbbing

Migraine with Aura

Sometimes people receive alert signs of getting a headache. This is called an aura which leads the migraine headache. They are usually visible, but more symptoms can occur, including numbness or tingling of a hand or face, lightheadedness, speech difficulty, and further complicated symptoms. These symptoms arise in 15% of patients with migraine. Typical visual auras involve:

  • zig-zag lines
  • spots
  • dots
  • waves

Tension Headache

This can occur in any individual and is usually caused by fatigue, excessive recitation, or anxiety. It can occur in a chronic form. Tension headaches are generally:

  • Mild to moderate discomfort
  • Both sides of the head
  • Pressing or squeezing
  • Not provoked by activity or alcohol
  • Mild brightness or sound sensitivity (not both), and never nausea

Cluster Headache and Related Disorders

Cluster headache is a disorder commonly seen in men. It begins in the second or third decade of life. The agonizing pain is typically over one side of the head and is linked with a drooping eyelid, sweating, tearing, and nasal congestion. The pain is radiated to the eye, temple, jaw, nose, chin, or teeth. Cluster headaches occur in phases taking weeks or months. It is precipitated by alcohol, excitement, sleep, and smoking. They are cured by certain types of medication and frequently treated with oxygen.

A headache type seen in females and like cluster is Paroxysmal Hemicrania. This headache is one-sided which lasts only for a few minutes and occurs several times a day and is associated with nasal congestion, droopy eyelid, and irritation to the eye. Sometimes it becomes a chronic headache with overlaid stabbing pain known as hemicrania continua. Though it is less common, women can also have a cluster headache.

Sinus Headaches

Sinus headache usually occurs due to infection and congestion in the sinus cavities. Sinuses are situated around the eyes, nose, and cheeks. The nerve endings generate pain behind these regions. They are usually associated with a common cold and worsen with cough or changes in head position. The face is usually tender to touch. Sinus headache is unusual, in fact, migraine can occur across the face and feel like arising from the sinuses.

Management of Headache

Identify the triggers that can bring on a headache:


The diet has a greater impact on headache in some people. Some common diet causes are:

  • Beverages including caffeine, sodas, hot chocolate, energy drinks
  • Alcohol, red wine, champagne, beer
  • Dairy products which involve cheese, yoghurt, sour cream
  • Processed meats (hot dogs, sausage, smoked meats)
  • Dessert, chocolates, and other high sugar treats

The most important things to remember about diet:

  • Excessive sugar should be avoided
  • Meals should not be skipped
  • Intake of 5 servings of fruits and vegetables per day
  • Drinking plenty of water


  • Luminous light, strobes, computer, and television screens
  • Loud noises
  • Strong smells
  • Changes in weather
  • Altitude changes

Sleep Hygiene

  • Sleep at least 8 hours
  • Do not perform any other activity in bed except sleep and sex
  • Think About sleep as it helps to sleep faster
  • Prevent excessive meals before going to bed
  • Do not take nap in the daytime

Emotional Factors

  • Stress releases several chemicals in our brains that can either cause headache or get a headache worse. As the stress fades and the chemicals drop, individuals may feel headache.
  • Anxiety and fear of headaches and lack of ability to cope with the pain triggers worsening headaches

Hormonal Factors

  • Sex hormones can cause headache in some people. For example, migraines can be linked with the menstrual cycle.
  • Pregnancy can worsen the headache. Often in the following stages of gestation, headaches may get better but may resume after delivery.

Medication Management

Medication treatment is split into Prevention and Severe. Avoidance is forever the most important goal. Knowing the diagnoses, triggers, and medication is important in the management plan. The choice of medication therapy is personalized and depends on headache symptoms, frequency, intensity, and other comorbidities. Precautionary medicines are typically begun at a low dose and augmented slowly to lessen side effects and to find the lowest dose. The best medicine depends on what other comorbidities person is carrying, and what side effects individual can bear.

Treatment for Acute Headache & Rescue Medication

It is important to remember 3 principles when the headache begins:

Prevent Nausea: Medications reduces nausea that derives with migraine, improve absorption, and may help in reducing headache pain. If nausea is absent, it is important to treat the stomach

Treat Headache Pain: Triptans, Titans, and ergotamine are effective medicines to treat migraine headache

Sleep: Occasionally, sleeping assistances are used for headache treatment because good sleep refreshes your mind.

Non-Medication Medication

  • Progressive muscle easing is practised by alternately constricting
  • Ice packs, massage
  • Muscle stimulators
  • Acupuncture
  • Physical therapy body tools
  • Aerobic exercise for at least 20-30 minutes per day
  • Muscle stretching
  • Yoga, Pilates, and tai chi



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