Dr. Abdul Majid and Dr. Aijaz Ahmad
Headache has troubled mankind from the dawn of civilization. Headache or ‘Cephalgia’can be defined as a symptom that refers to any pain located in the head or neck. Headache, an almost universal human experience, is one of the most common complaints of patients who present for medical treatment. Headache is a highly prevalent condition, which is both a symptom and a disease.
Headaches are broadly classified as Primary and Secondary. A primary headache has no known underlying cause. The most common types of primary headaches include, Migraine headache, Tension headache, Cluster headache etc.
Secondary headache is the result of another condition causing traction on or inflammation of pain-sensitive structures. This includes Traumatic Headache, Bleeding: Intracerebral or Subdural Hematoma, Cranial or cervical aneurysm, Space Occupying Lesions, Withdrawal Headache (Opioid Withdrawal, Alcohol Withdrawal), Meningitis, Encephalitis, Sinusitis, Post-herpetic neuralgia, Ear Infection, Eye Infection, Cerebral Ischemia, Psychiatric Disorders, Occipital Headache etc.
Global Burden of Disease revealed that headache is one of the major public-health concerns globally. In the 2019, headache alone was second among the causes of disability, and first among women under 50 years of age. Headaches can be extremely distressing, prevalent in every country affecting all genders and all socioeconomic levels. The estimated lifetime prevalence of headache is 66%: 14% to 16% for migraine, 46% to 78% for tension-type headache, and 0.1% to 0.3% for cluster headache. Besides impairing the routine activities of the affected people including loss of livelihood.
Triggering factors for headache
- Sudden changes in weather or environment
- Sleep disturbance
- Strong odors or fumes
- Anger, crying or other emotions
- Stress
- Too much of work
- Sudden loud noises
- Travelling long distance
- High or low blood sugar
- Not taking food on time or fasting
- Tobacco /Alcohol/Drugs
- Head trauma
- Some medications
- Menstrual periods or hormonal changes in females
- Too much of screening time
- Some foods can trigger the headaches: Aged Cheeses, Alcohol (especially wine), Artificial Sweeteners , Caffeine (withdrawal or in excess), Chocolate, Citrus Fruits etc.
Headaches that can be serious and needs urgent medical attention includes:
- First or worst headache of your life.
- Recurrent headaches not responding to conventional treatment.
- Headache beginning at unusual ages, ≤5 years old or ≥50 years old.
- The presence of cancer, HIV, pregnancy etc
- Abnormal physical/neurological examination
- With seizure or syncope
- Stiff neck
- Rash
- Vomiting
- Confusion
- Slurred speech
- Fever of 100.4°F (38°C) or higher
- Paralysis in any part of your body
- Visual loss
- Pregnancy or postpartum state
Headache hygiene is the practice of taking care of yourself in a way that will reduce the likelihood, frequency, intensity, and severity of headaches.
These include two simple steps: Lifestyle changes and trigger avoidance.
★Get Regular Sleep
- Go to bed and wake up at regular times each day.
- Do not sleep excessively on the weekends.
★Eat Regular Meals
- Eat regular meals three times each day including protein, fruits, vegetables.
- Avoid too much of sugar/fats.
★Exercise regularly
- Moderate exercise for at least 30 minutes three times a week.
- Too much exercise or inconsistent patterns of exercise may trigger headache.
★Drink Plenty of Water
- Dehydration may cause headaches
- A normal adult should drink plenty of water throughout the day
★Limit Caffeine, Alcohol and other Drugs.
★Reduce stress.
★Schedule a relaxation period.
★Try to rest in a quiet, dark room away from loud noises and bright lights.
★Consult a doctor if nothing helps.
The effective management of headache disorders remains a moving field and a potential challenge to the doctors. The frequency of headache and its burden of disability make it essential for physicians to manage headache in an informed way.
