【Major Points】
- Migraine and tension-type headaches are the most common, being chronic and recurrent.
- Learn methods and techniques to prevent and relieve headaches, and to manage chronic headaches.
- Seek medical attention immediately if a headache is accompanied by altered consciousness, blurred vision, or limb weakness.
What is headache?
Headaches are classified as primary or secondary.
- Primary headaches: The most common types are migraines and tension-type headaches.
- Secondary headaches: These are caused by other conditions, such as fever, head
injury, sinusitis, etc.(More information:
Care of Patient with Head Injury)
What are the common symptoms of headaches?
- Primary headaches: often chronic and recurring.
- Migraine:
- Unilateral and throbbing pain (a localized pain combined with a pulsing sensation) that can last for 4 to 12 hours.
- The pain may worsen with physical activity, bright lights, or noise. Sometimes symptoms like photophobia, nausea, or vomiting may occur.
- Some people experience an aura before the headache attack, such as feeling depressed, losing appetite, excessive yawning, etc.
- Tension headache:
- Usually near the temples on both sides of the head, caused by tight muscles, feeling like wearing a tight hat or headband.
- It may worsen when feeling nervous or irritated, but vomiting is less likely to occur.
- Secondary headaches:
- The underlying cause of the pain needs to be treated, and it usually cannot improve on its own.
- You should seek medical attention immediately if your headache is associated with the following symptoms:
- A headache that worsens over time or a sudden, severe headache (the worst headache ever).
- Fever combined with a stiff neck and pain.
- Sudden change in the state of consciousness, such as fainting, slurred speech, drowsiness, or incoherent speech.
- Unsteady gait, weakness or numbness in the limbs, or even loss of sensation.
- Visual impairment, such as sudden loss of vision, visual blockage, blurred vision, or double vision.
What should I pay attention to?
- How to prevent headaches?
- Avoid substances or foods that may trigger headaches, such as alcohol, chocolate, cheese, and excessive caffeine.
- Keep a headache diary to record triggers or improvements, which can help manage headaches.
- Engage in mild regular exercise, such as aerobic exercise or yoga, to prevent or reduce chronic headaches.
- Maintain good sleep habits.
- How to relieve the pain?
- Rest quietly: Find a quiet, dark place to lie down and rest, especially during a migraine attack.
- Head massage: Gently massage the scalp if there are no wounds.
- Cold/Hot compress: Apply a cold compress to your forehead, and stop if the pain worsens. Use a warm compress to relieve tension headaches.
- Practice relaxation techniques: Engage in mindfulness activities, gentle stretching, etc.
- Stay hydrated: Dehydration can easily trigger or worsen headaches.
- Medical approach: When experiencing recurrent chronic pain, it is advisable to visit a neurologist.
Provide the following information to your physician:- When did the headache start? How severe is the pain? How long does it last? How often does it occur?
- Is the headache unilateral or bilateral?
- Are there any associated symptoms?
- What worsens the headache? What relieves it?
- Is there a family history of migraines (Does anyone else in your family suffer from migraines)?
- What triggers the headaches?
- Take your medication as prescribed and do not stop abruptly or self-medicate with painkillers. The selection of medications for the prevention and treatment of headaches will be based on the symptoms, associated conditions, side effects, cost, and patient preferences.
References
- Ailani, J., Burch, R. C., Robbins, M. S., & Board of Directors of the American Headache Society. (2021). The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache: The Journal of Head and Face Pain, 61(7), 1021-1039. https://doi.org/10.1111/head.14153
- Fernández-de-Las-Peñas, C., Florencio, L. L., Plaza-Manzano, G., & Arias-Buría, J. L. (2020). Clinical reasoning behind non-pharmacological interventions for the management of headaches: A narrative literature review. International Journal of Environmental Research and Public Health, 17(11), 4126. https://doi.org/10.3390/ijerph17114126
- Giamberardino, M. A., Affaitati, G., Costantini, R., Guglielmetti, M., & Martelletti, P. (2020). Acute headache management in emergency department. A narrative review. Internal and Emergency Medicine, 15(1), 109-117. https://doi.org/10.1007/s11739-019-02266-2
- Peng, T.R., & Wu, T. W. (2020). Recent advances in
migraine treatment. Journal of Internal Medicine of Taiwan, 31(5), 325-332.
https://doi.org/10.6314/JIMT.202010_31(5).06