How does the headache go? What causes ligament pain?
Headache is one of the most common health complaints in the community. Headache, which is observed in 48.9% of the general population, affects people of all ages, races and socioeconomic backgrounds. It is more common in women than men. Some headaches can make people tired and negatively affect their quality of life.
Studies have shown that one out of 10 people who apply to family physicians comes with a headache complaint. In addition, one out of every 3 referrals to neurology is due to headache.
What is a headache?
Headache occurring in any part of the head is a complaint that all humanity has experienced in a part of their life. Among the reasons for applying to emergency services, it covers 3%. 96% of headaches are benign, but the remaining cases of severe ligament pain are among the emergencies where early intervention is life-saving. Emergency physicians carefully analyze the cases that tend to have this type of course, take the patient’s medical history and perform a physical examination. Various laboratory techniques and radiological imaging methods are then used to gain an idea of the underlying condition.
What are the types of headaches?
The International Headache Society has classified headaches into 14 main groups and hundreds of subgroups. If headaches do not occur due to another underlying health problem and appear directly with a headache picture, it is called primary headache. The most common types are migraine, tension-type and cluster headaches.
Secondary headaches, on the other hand, are headaches that occur at a rate of 10% and occur during the course of diseases such as cerebrovascular diseases, nervous system diseases, brain tumors, eye diseases, sinusitis, and meningitis due to a certain disease.
The World Health Organization (WHO) states that almost everyone experiences a headache at some point in their life. Although headache is defined as “a feeling of pain in any part of the head”, the severity of this complaint varies from person to person. Since headaches accompanied by some symptoms are pains that require urgent intervention, care should be taken. Headache accompanied by symptoms such as neck stiffness, skin rash, vomiting, drowsiness, difficulty in speaking, fever of 38 degrees and above, paralysis of a part of the body or loss of vision makes the current situation qualify as a headache that may require urgent intervention.
Primary headaches are considered both as a symptom and as a stand-alone phenomenon. The triggering factor in these headaches is not any disease or allergic condition. Primary headaches can occur episodic (as attacks) or chronic (long course). Episodic headaches are pains that appear occasionally and then tend to disappear. The duration of episodic headaches varies from 30 minutes to several hours. Chronic headaches are constant pains. These pains, which are usually present most days of a month, can last for days. It is essential to apply pain control methods in the treatment of such headaches.
There are many different types of headaches:
Tension Type Headache
The most common type of headache is tension-type headache, which usually affects women over the age of 20. Patients state that tension-type headache feels like a tight band around the head. Tension-type headaches can occur as a result of stretching the muscles in the neck and skull. Situations such as holding the body in the wrong position for a long time or stress are among the facilitating factors for tension-type headache.
Cluster headache is characterized by non-throbbing pain but prominent burning pain on one side of the face or behind the eyes. After this type of headache occurs, symptoms such as watery eyes and a runny nose accompany the headache. In cluster headache, which tends to last for a long time, this process sometimes lasts for 6 weeks. Cluster headaches can occur any day of the week, sometimes more than once a day. Although the underlying cause is not fully understood, men between the ages of 20 and 40 are most commonly affected by this rare type of headache.
Cluster headaches occur in attacks. The duration of these attacks varies from person to person, but is between 15 minutes and 3 hours. On average, most patients experience between 1 and 4 attacks per day. These attacks usually tend to occur at the same time of day. After the end of one attack, another one forms and shows clustering.
Migraine, a severe type of headache, is a throbbing headache that usually occurs in only one half of the face. Migraine is divided into many sub-types within itself. Chronic migraine headache is one of these subtypes and occurs on at least 15 days of a one-month period. In hemiplegic migraine, another type of migraine, stroke-like complaints occur. In this type of migraine patient, symptoms such as nausea, vision problems and drowsiness occur without a headache.
In some migraine patients, various visual symptoms may accompany the headache. This condition affects approximately 1 in 5 people in this patient group, and these symptoms tend to occur before the headache occurs. During this period, which is called the aura period, people describe experiencing visual problems such as flashing lights, sparkles, diagonal lines, stars or blind spots. During the aura period, symptoms such as tingling in the face or part of the body or difficulty speaking may also be among the symptoms. However, since these migraine symptoms and stroke symptoms are similar, it is recommended that people with such complaints apply to health institutions as soon as possible.
Migraine headache may be familial, therefore it is thought to be associated with various nervous system conditions. Women are approximately 3 times more prone to migraine than men.
Thunder headache is a type of headache that comes on suddenly, has an unexpected and serious course. It starts insidiously with no warning signs and continues for about 5 minutes. This headache occurs especially due to problems involving the blood vessels in the brain and need to be intervened as soon as possible.
High Blood Pressure Headache
High blood pressure (high blood pressure) can cause headache in some people. Headache due to blood pressure is considered as one of the alarm signs indicating medical support. Hypertension headaches affect both sides of the head and characteristically tend to worsen during physical activity. Pulsatile (pulsating) pain may be accompanied by important symptoms such as loss of vision, numbness, nosebleeds, chest pain and shortness of breath.
What are the causes of headaches?
The answer to the question of what are the causes of headache varies according to the type of headache. E.g; In primary type headaches, in genetically predisposed individuals, environmental factors create an activation in the brain. This activation causes enlargement of brain vessels and chemicals are released. These cause pain by stimulating the nerves.
There may be many different causes under secondary type headaches. For example, infections (sinus, ear, meninges), damage to blood vessels (aneurysm, malformations, vascular occlusion), tumors, hypertension are just a few of the causes. For this reason, it is vital to determine the cause of secondary type headaches. In addition, women may experience headaches during menstruation. Apart from this, stress is also an important triggering factor.
The causes of secondary headache can be summarized as follows:
- Brain tumor or brain aneurysms can cause severe headaches. Headache seen in such problems is caused by limited intracranial volume and a space-occupying lesion causing an increase in intracranial pressure.
- The part of the spine in the neck region is called the cervical spine. Cervicogenic headaches are caused by the degeneration of the vertebrae in this region and compression on the spinal canal. In addition to headache, people with this disorder also experience intense neck pain.
- Misuse of certain medications can also cause headaches. Excessive use or abrupt discontinuation of drugs used in pain control may result in headaches.
The meninges are membrane-shaped protective structures that surround the brain and spinal cord. Inflammation of these membranes is called meningitis. Headache may occur in people after the development of meningitis.
- Some people may experience headaches after trauma. Headache, defined as post-traumatic, occurs after traumas such as falls, traffic accidents or ski injuries in the head area.
- Breathing air is moistened and warmed by circulating through cavities called sinuses. Inflammation in these structures can cause a feeling of pressure in these cavities in the face area and lead to the development of headache.
- Spinal headaches occur due to decreased cerebrospinal fluid. This situation is most commonly encountered after epidural or spinal anesthesia procedures.
- As a result of some studies conducted other than these reasons, it has been determined that approximately 39% of women have headaches within the first week after delivery. This condition, which is defined as postpartum headache, may occur due to the change in estrogen level. Decreased postpartum estrogen levels can also result in the development of depression. In addition to the estrogen level, conditions such as stress, deterioration of sleep hygiene, weakness and dehydration are among the factors that play a role in the development of postpartum headache.
What causes constant headaches?
It should be investigated whether there is a secondary cause of persistent pain. If these pains persisted in patients with periodic pain before, the possibility that the patient might have used a large number of painkillers or that there may be underlying psychological reasons may come to mind. However, it should be kept in mind that diseases such as hematoma (blood collection), clots in the veins of the brain, meningitis and temporal arteritis may also cause persistent headaches after cerebral hemorrhage.
How does the headache go?
If there is an underlying health problem (such as sinus infection, etc.) for headache, the relevant treatment is taken from the specialist physician. Apart from this, in primary headaches, especially migraine, the neurologist starts the relevant treatment by taking your medical history and examining it.
There are many medications to try in the treatment of headaches. The goal in the treatment of migraine is to reduce the triggering factors, to suppress the sensitivity in the nervous system and the events in and around the veins that occur during pain. Basic treatment is divided into two as preventive and attack treatment. Here, the frequency of the patient’s pain is effective in the treatment decision. For example, if the patient’s pain is seen only once or twice a month, attack treatment is planned for this patient.
Simple painkillers, nonsteroidal anti-inflammatory drugs, drugs with active ergotamine or triptan group drugs can be used for pain control. Although pain relievers are generally innocent-looking drugs, they can cause irreversible damage, especially on the kidney parenchyma and other organs, when used continuously. Therefore, continuous use is not recommended. Painkillers should be taken at the beginning of the attack.
Protective-preventive treatment is preferred if the number of attacks is four or more in a month. In preventive treatment, drugs are taken every day. Heart medications, depression medications or epilepsy medications are used for this purpose. These types of drugs should not be taken without the doctor’s prescription and consultation.
Apart from all these treatments, there are some alternative treatment methods used for headaches. As an example of these;
- Biofeedback in tension-type headache (feedback – relaxation training),
- acupuncture in migraine
- Therapies such as deep tissue massage for chronic pain, breathing exercises, aromatherapy, riboflavin, magnesium, products containing ‘feverfew’ plant are among the applications that can contribute to some people.
Although Botox has been used in the treatment of headaches in recent years, it is a treatment alternative for frequent and chronic pain, but it is not a practical treatment used primarily because it is very expensive.
You can make some lifestyle changes to prevent headaches. We can list them as follows.
- Explore your headache triggers, note what time of day and what activities you usually feel a headache after doing. Reduce these activities if you can.
- Limit your alcohol consumption. Alcohol, especially red wine, causes headaches.
- Processed foods containing nitrates can cause headaches. Examples of these foods are chocolate, processed meats. Nitrates act on blood vessels throughout the body. For this reason, it is thought that it may cause headache by interacting with the vessels in the brain.
- Sleep quality and duration are not only important for a healthy life, but also an important factor in preventing migraine or headache attacks.
- After using a computer or mobile phone for a long time, some fatigue and pain can be observed in the neck muscles. In such cases, changing positions frequently can prevent pain.
- Since hunger is a headache trigger, it is important not to skip meals to prevent headaches.
- Some types of headaches are directly related to stress. Therefore, coping with stress in your life is very important in terms of both controlling your headaches and increasing your quality of life.
The answer to the question of when a patient with a headache should consult a doctor can be summarized as follows:
- If the pain is persistent and increasing in intensity
- If the age of the person experiencing pain for the first time is under 10 or over 50,
- If the severity and form of the pain that was present before has changed, if it does not respond to treatment,
- If it wakes you from sleep
- If accompanied by symptoms such as sensitivity to light, nausea and vomiting
- If you have a headache with fever or neck stiffness
- If the headache is the most severe pain he has ever faced in his life and the pain occurs during a physical activity (lifting a heavy load, sexual intercourse) or if the pain has increased, it is absolutely necessary to go to the doctor.
- If you are observing the above factors in yourself, you should definitely consult a neurologist.
Wishing you healthy and pain-free days…