Health
4 Types of Headaches & How To Treat Them
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Health
4 Types of Headaches & How To Treat Them
Headaches can range from passing discomfort to a disabling disease that can take days to overcome.
Here’s a look at the four main types of headaches and ways to relieve them.
1. Tension Headaches
Although this is the most common type of headache, the exact cause remains a bit of a mystery. Since few people seek medical attention for this type of headache, there are few studies on the subject. Dr. Michel Aubé, a neurologist specializing in migraines, explains that tension headaches are caused by a contraction of the muscles in the neck region and the back of the skull or the jaw muscles following stress. This tension would lead to irritation of the nerves in the head and neck and trigger a headache.
Symptoms
“The pain feels like a helmet, a headband or a vice, like a tightening of the head,” says Élizabeth Leroux, a neurologist specializing in headache medicine and founder of the organization Migraine Québec. “The intensity of the pain is mild or moderate, and the headache is generally not accompanied by other symptoms such as nausea or vomiting.” It is not a pain that forces us to go to bed. “Usually, we can continue to work and do our activities,” says Dr. Aubé. This headache can last from 30 minutes to a week.
Triggers
Stress is the main trigger for tension headaches. Prolonged poor posture can also cause tension in the neck and head area, which can trigger it. “Fluctuating hormones during menstruation, heat and dehydration are other things that can trigger a tension headache,” says Dr. Leroux.
Treatment
When you get a tension headache, the pain can usually be relieved with over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).
But to get rid of this type of headache in the long term, you have to eliminate the tensions that cause them, often by doing relaxation exercises, breathing, gentle yoga or meditation. It’s also a good time to look at your sleep hygiene. "Adequate sleep ensures relaxation of all the muscles around the neck and skull," says Dr. Aubé, "and this often helps improve the situation."
Dr. Aubé adds that treatments offered by a recognized osteopath can help eliminate certain postural tensions. Exercising and stretching also provide good relief. "Regular physical activity reduces tension, improves posture, promotes sleep and reduces anxiety," says Dr. Leroux. "That's often enough to get rid of these headaches.”
2. Migraines
A migraine is a complex neurological disease that is difficult to endure and relieve and can prevent us from functioning in our daily life. It is not easy to identify the precise cause of migraines, "but we can say that people with migraines have a predisposition, partly genetic, which causes their brain to react more strongly than average to certain triggers and certain situations," explains Dr. Leroux.
The brains of migraine sufferers are marked by a deficiency in the activity of serotonin, a hormone that acts in particular to calm our nervous system. "This places the migraine sufferer's brain in a state of constant hyperexcitability," adds Dr. Aubé. "At a certain point, the brain becomes so overexcited that it can no longer function properly." This triggers an inflammation reaction in the nerves of the head and leads to migraines.
Symptoms
A migraine is a moderate to severe painful headache that is felt in a specific area of the head mainly in the forehead, temple or eye level) and often prevents you from concentrating or being able to work. “Migraines are also accompanied by a series of symptoms such as hypersensitivity to light, sounds and smells, as well as gastrointestinal discomfort such as nausea or vomiting,” explains Dr. Leroux. “The pain is also increased by effort and movement.”
Some people feel the pain like a heartbeat in their head, and about 20 percent of migraine sufferers experience auras, which are vision problems (flashes, bright spots, blurred vision) that are precursors to the headache. Migraines last from four to 72 hours and recur over time. To be diagnosed with migraine, you must have had at least five migraines in your life (or two with aura).
Triggers
Dr. Leroux says that the brains of migraine sufferers do not like sudden changes. A series of factors can trigger a migraine attack, including:
- lack of sleep
- stress and strong emotions
- hormonal changes associated with menstruation and premenopause (which partly explains why women are more affected)
- strong odours
- loud noise and light
- climatic variations (snowstorms, heat waves, seasonal changes)
- hunger, skipping meals or being dehydrated
- alcohol
“Some people can also have food-related triggers,” she adds, “but this is not very common.” For example, aspartame, monosodium glutamate (found in Chinese food), nitrites and sulfites can sometimes trigger migraines. Each person is unique and does not necessarily have the same triggers.
By recognizing and avoiding personal triggers, we can reduce the frequency of our migraines. “I recommend that my patients keep a migraine diary,” says Dr. Leroux. “They can note the intensity of their attack and the context surrounding the onset of their headache to identify possible triggers.”
Treatment
Migraines cannot be cured, but the pain and frequency of the attacks can be reduced. To protect your brain, you’ll have to avoid attack triggers and adjust lifestyle habits. Here's what you can do:
- have a healthy, balanced diet and eat at regular times
- Have good sleeping habits
- find ways to better manage stress and avoid overworking yourself
- take time to relax and do yourself some good (massage, yoga, qi gong, tai chi, acupuncture, etc.)
- exercise regularly (a 20-minute walk every day)
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aspirin® or ibuprofen, can calm nerve inflammation and stop the pain of a migraine. But if that's not enough, a prescription for triptans can be a big help. "These are medications specifically designed for migraines," says Dr. Leroux. They act on serotonin in the brain.
If you’re experiencing a bad, painful migraine attack, it’s suggested to combine a triptan and an anti-inflammatory for greater effectiveness. Dr. Leroux advises not to wait for the pain to set in before taking medication. "The longer you wait, the more difficult the pain is to control," she says.
If your attack is accompanied by vomiting, take an anti-nausea medication and use a nasal spray triptan. "It is not always easy to find the triptan that suits you among the seven available in Canada," she says. "You have to try it out before finding the one that will give you relief."
3. Chronic Migraines
Some people suffer from chronic migraines, a severe form of the disease. This means that they have headaches more than half our their time (more than 15 migraines per month). Unsurprisingly, "migraines mean that these people have to reduce their professional activities," says Dr. Leroux. "They are also at a greater risk of having anxiety or depression."
Treatment
In addition to those intended to relieve migraines, there are preventive treatments that can reduce the number of attacks. “These are medications that are taken every day; they change the brain’s chemistry to make it more resistant to daily stimuli and triggers. They can reduce the number of migraine attacks by half,” says Dr. Leroux. “Depending on the patient’s profile, we prescribe either an antidepressant, an antiepileptic or a beta-blocker.”
But even then, there is a lot of testing to be done to find the right preventative medication. Since 2011, Botox injections have also been authorized for the treatment of chronic migraines.
4. Cluster Headaches
This very rare headache causes unbearable pain and affects less than 0.1 percent of the population, and men three times more than women. It generally appears between the ages of 20 and 40, and its exact cause is not well defined. The most recent research indicates that an abnormality of the hypothalamus could be the cause. This gland, which controls the production of several hormones as well as the sleep and wake cycles, activates the nerves responsible for the pain.
Symptoms
“It’s an excruciating headache,” says Dr. Leroux. “The pain is felt on one side of the head, over one eye or temple. The eye becomes red and waters. The eyelid closes, and the nose runs. The intensity of the pain is so great that some people think about committing suicide during the attack, which is why it is also called “suicide headache.” This headache occurs at specific times of the year for a few weeks or months. Attacks last from 30 minutes to three hours. They can occur every other day or recur up to eight times a day.”
Triggers
In affected individuals, alcohol consumption can trigger an attack.
Treatment
Triptan medications can relieve the attack of a cluster headable, but they must be taken as an injection or nasal spray because the oral form does not work quickly enough. The attack can also be relieved by inhaling oxygen under a mask.
Some medications (e.g. verapamil, lithium carbonate, cortisone) can be prescribed to prevent attacks, and in very severe cases, a new approach called neurostimulation can be effective. “These are electrodes that are implanted behind the head,” says Dr. Leroux. “They send electrical signals that modify the nerve connections and thus reduce pain.” She specifies, however, that this treatment is reserved for extreme cases that are resistant to other treatments. “The waiting list is about three years.”
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