Focus on Headache This Week

< Jun. 09, 2010 > -- There are very few things more miserable than headaches. That is why doctors will be sharing information about the different types of headaches and what they can mean this week during National Headache Awareness Week, June 6-12.

The throbbing, crushing, skull-pounding pain of a headache can make you wince and moan. Yet headaches can tell a lot about a person. They can indicate things you are doing that are not good for you. They also can warn of serious illness.

"A headache can be a symptom of a simple organic disorder, a serious or complicated disorder, or it can be individually characteristic, like a tension headache or a migraine," says Dr. Seymour Diamond, director of the Diamond Headache Clinic and director of the inpatient headache unit at Saint Joseph Hospital in Chicago. "There are multiple causes or variations of headaches."

Different Headaches, Different Causes

Dr. Ellen Beck, a family physician and clinical professor in family and preventive medicine at the University of California, San Diego, says people normally have one of two types of headaches: those that result from muscle tension or strain, known as tension headaches; or headaches that result from swelling of the blood vessels in the tissues surrounding the head, called vascular headaches.

Dr. Beck says these headaches can be a clue that you are doing something in your daily life that is causing stress or harm to your body. Lifestyle causes of headache can include:

• not eating enough
• dehydration
• poor posture at a work station
• eyestrain

"The headache can be a message from your body," Dr. Beck says. "You don't want to just treat the headache with medicine. You want to play detective and figure out what is causing the headache."

Migraine Headaches

One dreaded form of vascular headache is migraine headache. People who have migraines often find the headache pain to be debilitating. Untreated attacks can last anywhere from four hours to three days, according to the National Institute of Neurological Disorders and Stroke (NINDS).

Migraine pain differs significantly from tension headache pain. "Tension headaches tend to feel like a tight band around the head," Dr. Beck says, and they are often accompanied by fatigue.

Migraines are not at all similar to tension headaches, says Dr. Beck. "Migraines are more like a hammering, pounding type of headache," she explains. Migraines usually are on one side of the head and sometimes are accompanied by nausea.

People with migraines need to figure out their warning signs and headache triggers. By learning the telltale signs of an oncoming migraine attack, they can take medication to stop the headache before it gets started. And, if they can figure out what triggers their migraines, they may be able to put a halt to them by avoiding the triggers.

Avoiding some migraine triggers can be as simple as wearing a hat and sunglasses when you are outside, or taking some medication or caffeine just before your period, Dr. Beck says.

And then there are signs that a headache might be indicative of a more serious medical condition. "These dangerous headaches are rare, but we physicians want to be able to identify them as soon as possible," says Dr. Beck. "If there's something that worries you, it's better to see your physician."

Dr. Diamond agrees. "If you're getting more than three or four headaches a week, or you're taking excessive amounts of analgesics on a daily or almost daily basis, you should seek out care," he says.

Always consult your physician for more information.

Theories about migraine pain:

Older theories suggested that blood vessels narrowed and/or widened, which started migraine pain and other symptoms. Now many headache researchers realize that blood vessels do not initiate the pain, but may contribute to it.

Current thinking regarding migraine pain has moved more toward the source of the problem, as improved technology and research has paved the way for a better understanding. Today it is widely understood that chemical compounds and hormones, such as serotonin and estrogen, often play a role in pain sensitivity for migraine sufferers.

One aspect of migraine pain theory explains that migraine pain occurs due to waves of activity by groups of excitable brain cells, which trigger chemicals, such as serotonin to constrict blood vessels. Serotonin is a chemical necessary for communication between nerve cells. It can cause constriction of blood vessels.

When serotonin or estrogen levels change, the result for some is a migraine. Serotonin levels may affect both sexes, while fluctuating estrogen levels affect women only.

For women, who experience more migraines than men, estrogen levels naturally vary over the life cycle, with increases during fertile years and decreases afterwards. Women of child bearing age also have monthly changes in estrogen levels. Migraines in women are often associated with these fluctuating hormone levels.

Some researchers suggest that when estrogen levels decline it may trigger contractions in blood vessels, leading to throbbing pain. Others suggest that lower levels of estrogen make facial and scalp nerves more sensitive.

People who get migraines may be able to identify triggers that seem to start the onset of symptoms. Some possible triggers include the following:

• stress and other emotions
• biological and environmental conditions, such as hormonal shifts or exposure to light fatigue
• glaring or flickering lights
• weather changes
• certain foods

Always consult your physician for more information.