While headaches often feel like a pain inside your brain, most are caused by nerves with the muscles and blood vessels that encapsulate your head, neck, and face. These delicate pain-sensing nerves can be triggered by stress, muscle tension, enlarged blood vessels, and other triggers. At the Minnesota Head and Neck Pain Clinic (MHNPC) we understand how painful suffering from headaches can be. We’ll answer some common questions here.
A headache is a painful experience that occurs in any part of the head, ranging from sharp to dull, that may or may not occur with other symptoms. People often ask us, what is a headache? or where is this pain coming from? Understanding how pain receptors transfer pain messages to the brain and our nervous systems is our passion and profession. Primary headaches can happen independently and are not caused by a separate medical condition.
There are four types of headache: vascular, muscle contraction (tension), traction, and inflammatory. All four can hinder getting the sleep you need to heal. The most common type of vascular headache is migraine. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and, at times, disturbed vision. Women are more likely than men to have migraine headaches. After migraine, the most common type of vascular headache is the toxic headache produced by fever.
Other kinds of vascular headaches include “cluster headaches“, which cause repeated episodes of intense pain, and headaches resulting from high blood pressure. Muscle contraction headaches appear to involve the tightening or tensing offacial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Like other types of pain, headaches can serve as warning signals of more serious disorders. This is particularly true for headaches caused by inflammation, including those related to meningitis as well as those resulting from diseases of the sinuses, spine, neck, ears, and teeth. A relationship nay exist between headaches and bruxism; meaning it is best to obtain a Bruxism Parafunction Risk Assessment.
Headache frequency is typically determined by the average number of headache days per month in the last 3 months and headache history length as the duration in years between the first migraine episode and the date of the first visit to a headache clinic.
As the number of headaches you experience increases, the more headaches you are likely to incur. Headaches that occur 5 days per month, that don’t even last all days, increase your risk 6 X that they may happen more than 15 days per month in the next year in comparison with individuals with fewer headaches. “Ten (10) days with some degree of headache increases your risk 20 X compared to those with 0-4 HA days, sometimes even leading to everyday HA”, according to the American Migraine Foundation.
Phillip Bain, MD’s August 2015 Headache Progression — What You MUST Know About the Development of Chronic Headache article encourages working closely with your physician.
When headaches occur three or more times a month, preventive treatment is usually recommended. Physical therapy for tension headaches, biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Regular exercise, such as swimming or vigorous walking, can also reduce the frequency and severity of migraine and tension headaches. Drug therapy for migraine is often combined with biofeedback and relaxation training.One of the most commonly used drugs for the relief of migraine symptoms is sumatriptan. Drugs used to prevent migraine also include methysergide maleate, which counteracts blood vessel constriction; propranolol hydrochloride, which also reduces the frequency and severity of migraine headaches; ergotamine tartrate, a vasoconstrictor that helps counteract the painful dilation stage of the headache; amitriptyline, an antidepressant; valproic acid, an anticonvulsant; and verapamil, a calcium channel blocker. Medication-overuse headaches (MOH) is another class of headaches that we treat carefully. In the past, opioids have been used too often for pain treatment. We believe that they need to be carefully prescribed by doctors to treat persistent or severe pain. We first try to treat your pain without a heavy reliance on pills. The headache mechanism is considered by many to generate an increase in headache pain receptors. MOH is often closely associated with taking medication for the treatment of headaches. If the medication is actually taken for something else, the same effect is not reported, other than for some headache-prone people. This is thought to relate to heightened receptor sensitivity in these pain patients, who have an increased propensity that may upgrade the headache receptors.
Not all headaches require medical attention. But some types of headache are signals of more serious disorders and call for prompt medical care. These include sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions, or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person who was previously headache-free; and recurring headache in children.Migraine headaches may last a day or more and can strike as often as several times a week or as rarely as once every few years. To gain an accurate diagnosis for persistent headaches, you may need more than a standard x-ray.
Brain tissue itself lacks pain-sensitive nerves and does not feel pain. Headaches occur when pain-sensitive nerve endings called nociceptors react to headache triggers. The thalamus controls the body’s sensitivity to light and noise and sends messages to parts of the brain that manage awareness of pain and emotional response to it. – Headache: Hope Through Research by NIH
Brain chemicals known as neurotransmitters are involved when headache pain is ignited. The spinal cord carries the message that there is pain from its receptors all the way up to your brain. This is when your body knows of it through you thalamus and sends to your cerebral cortex. This is part of your brain that processes the pain message. When experiencing reoccurring chronic pain, get in touch with one of our chronic pain specialists.
Medical professionals and pain specialists classify headaches as either primary or secondary. A primary headache is a headache that is not tied to another condition or sickness causing it.
Many things may trigger a severe headache. In some cases, headaches are generated from a blow to the head, other physical trauma, misuse of alcohol or medication, neck or back strain due to poor posture, sustained depression, and other emotional stresses. Rarely, but it does happen, it’s a sign of a more serious medical problem.
Try a home massage – most people can do a simple one themselves. A few minutes of massaging your forehead, neck, temples, and shoulders can help ease a common headache that has resulted from stress or poor posture. If you’ve experienced a small injury, try to lightly apply gentle, rotating pressure to the painful area. Or call your pain specialist and ask if they think you’ll benefit from a trigger point injection.
The first step in providing headache treatment involves treating any specific disorder or disease that may be causing it. It helps us identify the type of headache you may be suffering from if you can describe where it hurts, how often the headaches occur, and how long they last. Feel free to draw a picture or use an analogy of where the pain is and how it feels. Our team of pain specialists can take from there and provide you the best options.
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