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Rebound headaches are also called medication overuse headaches.

These types of headaches tend to:

* Occur every day, often waking you in the early morning
* Hurt worst at the beginning of the headache, as your medication wears off
* Persist throughout the day

Other signs and symptoms may include:

* Nausea
* Anxiety
* Restlessness, irritability and difficulty concentrating
* Memory problems
* Depression
* Trouble sleeping

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A headache in the face, cheeks, forehead, or around the eyes that comes on during a “cold,” or when the nose is congested and runny or filled with mucus, is probably a “sinus headache”: one caused by sinus infection. Another kind of sinus headache is the one that occurs in the sinus areas during descent (landing) in an airplane, especially if you have a cold or active allergy (this is called a vacuum headache).

Unfortunately there are many other causes of headaches that can be confused with sinusitis. For example, migraine and other forms of vascular or “tension” headaches also give pain in the forehead and around the eyes, and they may even cause a slight stuffy-runny nose. But they are more likely to come and go away in a day or so without a physician’s treatment, whereas sinusitis usually gives a headache that lasts for days or weeks until it is treated with antibiotics. Furthermore, intermittent headaches that cause nausea and vomiting are more typical of a migraine-type headache than sinusitis. Severe, frequent, or prolonged headaches deserve a visit to a physician for diagnosis and treatment.

What will a doctor do for my sinuses?

Your physician will ask you questions about your breathing, the nature of your nasal mucus, and the circumstances (time of day or seasons) that give you symptoms. Be prepared to explain your headaches: When and how often they occur, how long they last, and if they are associated with nausea, vomiting, vision changes, or nasal congestion. An otolaryngologist-head and neck surgeon is the kind of physician who will especially examine your ears, nose, mouth, teeth, and throat with particular attention to the appearance of your nasal membranes and secretions. He/she will check for deformities of your nose that impair breathing and for tenderness over your sinuses. X-rays of your sinuses might be needed.

Treatment will depend on the diagnosis that your physician establishes, Infections may require either antibiotics or surgery or sometimes both. Acute sinusitis most likely will improve on medication, but chronic sinusitis more often requires surgery. If your symptoms are due to allergy, migraine, or some other disease that mimics sinusitis, your doctor will have alternative treatment plans.

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Headache is a fairly common complaint. However, it is important to recognise the more serious types of headaches that are actually symptoms of more serious diseases.

Common Types of Headaches

Tension headache:
the most common form with ‘tight band’ especially over the temples. Associated with contractions of head and neck muscles due to physical or mental stress. May be aggravated by changes in the environment, drugs, or factors unique to the individual. Treatment is by simple painkillers, rest and removal of aggravating factors.

Migraine:
there is a heavy throbbing pain usually over one side of the scalp, forehead and about the eye, caused by abnormally dilated blood vessels. May be accompanied by nausea, vomiting or sensitivity to loud noises or bright lights. Known to be triggered by certain factors unique to the individual such as menstruation, alcohol or anxiety. Treatment is by special anti-migraine drugs that reduce the dilatation of blood vessels and painkillers together with resting in a cool, dark and quiet room. Solving the triggering factors also help.

Cluster headaches:
more common in males. It occurs in runs with tearing pain over the forehead or behind the eye(s) with flushing of the face. Associated with alcohol consumption. Treatment is by strong painkillers and rest.

Sinus headaches:
fairly common during acute sinus inflammation attacks. Pain is over the frontal forehead and the upper cheeks. Associated with fever and heavy mucus production. Treatment is by antibiotics for the sinus infection, antihistamines to reduce mucus production and painkillers.

Referred headaches:
these are caused by disorders of structures around the head. Common ones are earaches, toothache causing pain over an entire part of the face and temporomandibular joint dysfunction from mechanical pain from the jaw joint. Rarer causes include a rare blood vessel disease on the temples called temporal arteritis and other autoimmune diseases of the nervous system.

Serious Types of Headaches
These types of headaches are less common but should be recognised as they are potentially life-threatening.

Meningitis / Encephalitis headaches:
caused by infection of the brain tissue (encephalitis) or the membranes surrounding the brain (meningitis). Can be caused by viruses, bacteria, parasites or poisons. Typically presents as a painful stiff neck with fever and other symptoms such as drowsiness, seizures and neurological problems including weakness and numbness. Needs immediate hospital treatment.
Cerebrovascular Accidents (haemorrhagic stroke):
one of the top killers in Singapore, a stroke happens when a blood vessel in the brain is blocked or bursts. Bleeding in the brain causes a sudden severe headache. There is also loss of consciousness and other neurological signs such as weakness, numbness and seizures. Needs immediate hospital treatment.

Brain Tumours:
it is rare. It is a gradual headache lasting for weeks, worse especially at night or early morning. Accompanied with nausea, vomiting, loss of appetite and loss of weight. By the time neurological symptoms appear such as seizures, numbness, weakness or blindness, the brain tumour has already grown to an advanced stage. Treatment includes surgery, chemotherapy or radiotherapy.

Treatment
What you can do

* Lie down in a dark, quiet room.
* Try muscle relaxation techniques or a gentle massage.
* Take a painkiller.
* For tension headaches, take a warm bath.
* For migraines, put an ice bag or cold towel on your forehead.

When to see a doctor:
Go to your family doctor or a government clinic

* If headache lasts for more than a day even after taking painkillers.
* If you get headaches very often.
* If headache feels different from your usual type.

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Stress, there’s a word we all know. Every day we are inundated with stress: deadlines at work, bills to pay and commitments to keep. This time of year though, in the height of our snowbird season, it seems people are extra edgy. There is more traffic on the roads, lines in the stores and sometimes, poor attitudes abound.
Stress leads to tension, physical and emotional strain. This in turn can lead to insomnia, headaches, fatigue, weight loss, weight gain and immune system dysfunction. We need all the help we can get, to learn how to relax. Here are some simple stress-relief techniques that can help you through the rest of season and beyond. Read them over, and choose which ones are right for your lifestyle.
• Exercise releases tension and stress. Try adding a little more activity into your daily routine.
• Deep breathing exercises are very relaxing. Breathe in through your nose slowly and deeply, and out through your mouth. Feel all of the tension flow out as you exhale.
• Massage therapy. It helps melt away pent up knots and tension that the body manifests.
• Aromatherapy. Employ other senses to help you relax.
• Walking. Fresh air and sunshine can do wonders to clear the mind. Walk in the park or on the beach; walking is a great stress reliever.
• Have fun, play. Do something you used to do as a child or long ago before you had commitments, such as playing with a train set or eating candy.
• Indulge yourself. Do something you like, such as shopping, taking in a movie or dancing.
• Treat yourself. Get a new outfit, a haircut or spend the day at a spa.
• Talk to someone. Talking relieves stress. Knowing that someone else understands and hears you without judging or necessarily offering advice can be a valuable asset.
• Sleep more. Lack of sleep leads to stress and this becomes a vicious cycle. More sleep can leave you with less stress.
• Eat right. A healthy diet, with plenty of fruits and vegetables is important for maintaining good health and leaving you stronger and better equipped to face whatever life throws at you.
• Stretching. It can take as little as 5 minutes a day and is an incredibly useful tool for releasing stress from the body.
• Focus on visual relaxation. Close your eyes and imagine you are somewhere nice, a deserted island walking along the shore or skiing on a snow covered slope with the brisk wind in your face. Whatever or wherever it is that makes you happy.
• Go outside. There are numerous hiking and biking trails. Nature can be very relaxing.

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For centuries, many households experiencing Headaches of all kinds. From Cluster headaches, to Tension Headaches, to Migraines. The majority of us have experienced them at one time or another. Even though we know we have them, how do we determine which one’s we are having and how to treat them? Hopefully this article will help you determine which symptoms you are having and ways to prevent them.

Tension Headaches: Tension headaches are the number one form of headaches in the population today. Though this fact should not be at all surprising considering all of the stress in our day to day lives. It is stated that 90% of all adult will/have experienced them in their lifetime. Here are a few symptoms of Tension headaches:

- Pain around the head
- Pain in the back of the neck
- Pain below the eyebrow

Cluster Headaches: Cluster headaches come in spurts. Most cluster headaches last periods of months sometimes years. it is also known that cluster headaches can go for years in between with no headaches at all. About 85% of cluster sufferers are men. Below are a few of their symptoms:

- Sharp pain in the eye
- Pain behind the ear
- Pain creates a mood of desperation for relief.

With cluster headaches they usually reoccur at the same time each day. Lasting for weeks and many sufferers complain of getting several headaches in a reported day.

Migraine Headaches: Migraines are considered the second leading headache in the world. There are many debilitating factors about Migraine headaches and 12% of the population currently gets migraine headaches. Though they are most common in women, men and children get those more frequently now too. Here are some symptoms of migraine headaches below:

- Pain in one side of the head/sometimes both
- Sensitivity to light and sound
- Nausea and vomiting
- Change of taste and smells
- Dizziness or fainting
- Lasting 4-72 hours

Migraines usually cause the sufferer to feel tired or wore down for up to 24 hours after the attack has occurred. The sufferer has trouble functioning after each attack and it can affect the quality of life if they don’t get them treated.

So now that we know a little more about them how do we get rid of them or, better yet, prevent them? There are many theories to this but it is always safer when you use natural remedies. You could make use of some natural plants and herbs like; Noni better known as the “Headache tree” which has been used for centuries in countries like China and India. There is also a treatment for headaches caused by inflammation; Serrapeptase which has been used for the better part of 25 years in Europe. Sometimes however the best treatment is simply finding your triggers and avoiding them at all costs.

Some known triggers are:

- Caffeine
- Cigarette Smoking
- Sugars
- And perfumed items

Keeping track of when you get your headaches and what you are doing right before you get them is another logical way to find your triggers. Over all the best remedies for headaches and other sicknesses is to do it the natural way!
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There are a number of commonly held beliefs about migraines that make it hard for sufferers to get proper diagnosis and treatment.

1) Migraines are not real (all in the head, an overreaction to a normal headache, etc.).

Not true. Migraines are a biologic primary headache disorder. Even migraine pain is not confined to the head, though that is generally where it is worst.

2) Migraines have a known cause.

Sadly, no. There have been several interesting theories put forward in the last decade, but no single, definitive biological cause of migraines has been identified thus far.

3) All migraineurs have the same symptoms.

No, they don’t. This is one of the things that makes migraines so hard to diagnose, particularly if a patient’s doctor is only familiar with the most common symptoms.

4) A doctor can tell if it’s a migraine or not.

Not always. The wide spectrum of symptoms that can accompany migraine can make it difficult to diagnose, more so if the patient is not forthcoming with their doctor about all their symptoms.

5) Migraines are curable.

Again, no. Once properly diagosed many migraineurs still have to devote a lot of time and energy to managing their condition through medications, natural and homeopathic remedies, and diet and lifestyle changes. The various available coping methods work differently for each individual, so there is not even a single protocol of care.

6) Migraines are a woman’s headache.

Women migraineurs do outnumber the men 3 to 1, but there is no evidence the condition is sex-linked in any way.

7) Only adults get migraines.

Migraines have been diagnosed in adolescents, children, and even infants.

Every headache a migraineur is a migraine

Not true. Migraine sufferers can have regular sinus, tension, or stress headaches just like anyone else.

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Here are nine more things you may not know about tension headache:

* Although sleep may be possible, whensoever the sufferer awakens, the is present.

* Most sufferers will complain of squeezing (non-throbbing) and tightness- ‘like a tight band around the head’ which aches rather than pains. The ache is usually generalized rather than localized to any particular part of the head.

* It can occur in children, adolescents and adults. Females are more afflicted than males. Stress at work/home is an weighty precipitant.

* The onset of a given attack is more gradual than is seen in migraine.

* It is a common continued for both tenseness cephalalgy and common migraine to coexist in the same individual. The management of such persons may need treatment of both types of headache.

* In contrast to migraine, in which pain is periodic and lifelong, with tendency to lessen in late adult years, tension headache occurs more often in middle age and may persist for many years.

* The ache is more due to dilatation of blood vessels in the head rather than sustained muscle .

* A common feature of tension headache is that analgesic remedies have little effect in alleviating the uneasiness. Relaxation almost through all ages relieves it. Such relaxation could include bed rest, massage, and/or formal biofeedback .

* Psychological studies of groups of patients with tension headaches have revealed prominent symptoms of depression and anxiety. It is on record that 65% of depressed patients have tension headache and that over 60% of patients with tension headache have depression.

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What is headache? Headache is a term used to describe aching or pain that occurs in one or more areas of the head, face, mouth, or neck. Headache involves the network of nerve fibers in the tissues, muscles, and blood vessels located in the head and at the base of the skull. Almost everyone has occasional headaches, especially when they are sick, tired or otherwise under stress. Headache is the result of pain signals caused by interactions between the brain, blood vessels, and surrounding nerves. During a headache, the pain comes not from the brain. It comes from specific nerves surrounding the skull, head muscles, and blood vessels that are activated and send pain signals, interpreted by the brain as a headache. The reasons why these nerves are activated are not clearly understood. Most headaches go away on their own or are easily treated with over the counter (OTC) drugs. Headache types There are two main categories of headache: primary and secondary. The major types of primary headaches include:

- Tension headache
- Cluster headache
- Migraine

Primary headaches are not caused by other underlying medical conditions. More than 90% of headaches are primary. Secondary Secondary headaches result from other medical conditions, such as cerebrovascular disease, head trauma, infection, tumor, and metabolic disorder. These account for fewer than 10% of all headaches. Head pain also can result from syndromes involving the eyes, ears, neck, teeth, or sinuses. In these cases, the underlying condition must be diagnosed and treated. Also, certain types of medication produce headache as a side effect. Many people have occasional headaches that get better on their own or go away with OTC drug treatment. Most of these people never see a healthcare provider for their headaches, however, there are several circumstances in which an evaluation by a physician may be useful or important:

- Headaches that are getting worse over time
- Severe headaches that start suddenly
- Headaches that start after a head injury
- Headaches that always occur on the same side of the head
- Headaches that are not responding to treatment
- Severe headaches that interrupt work or the enjoyment of daily activities
- Daily headaches
- Aggravated by exertion, coughing, bending, or sexual activity

Tension Headache Tension headaches are the most common type of headaches. They affect up to 75% of all headache sufferers. Tension headache is usually episodic but may be chronic, occurring daily or almost daily for more than 15 days a month. This type of headache is linked with tension in neck and scalp muscles, affecting blood flow within the skull. Tension headaches often start in the afternoon or early evening. The pain is typically on both sides of the head, pressing or tightening. Some people get tension headaches in response to stressful events. Tension headaches usually do not get worse with physical activity (such as walking or climbing stairs). Treatment The occasional tension headache can be alleviated by a hot shower, massage, sleep, and through patient recognition and avoidance of stress factors. For episodic tension headaches that occur less than three times per week, OTC pain relievers such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are convenient and effective. Combination products of pain medication with caffeine may help some people, but also may be habit forming. Use of any OTC pain reliever should be limited to no more than two or three days per week. If pain medications are overused, rebound headaches may occur on the days that medications are not taken. Chronic tension headaches are more difficult to treat, because rebound headaches are common when pain relievers are stopped. The most effective medications for treatment of chronic tension headaches are tricyclic antidepressants (amitriptyline HCl, doxepin HCl, nortriptyline HCl). However, it is often more effective to prevent these headaches than to treat them. Some people are able to treat their tension headaches without medications. An ice compress, a heating pad or a massage to any tight areas in the neck and shoulders can be extremely helpful. Relaxation techniques, such as deep breathing exercises or acupuncture, may help to decrease the frequency of headaches. Cluster Headache Cluster headaches are relatively rare, affecting about 1% of the population. They are distinct from migraine and tension headaches. Cluster headaches primarily affect men between the ages of 20 and 40. Attacks usually occur in a series, or “clusters” of 1 - 8 headaches per day over a period of several weeks to months. The pain is extremely severe but the attack is brief, lasting 15 minutes to 3 hours. The pain of cluster headache almost always occurs on one side of the head. During cluster headaches, the eye on the same side as the pain may become teary or droopy or develop a small pupil. There may also be nasal congestion on the affected side of the face. About 80% of cluster headaches occur at night, and in about 70% of patients, drinking alcohol can trigger a cluster headache. Unlike migraine sufferers, those with cluster headache often feel better if they keep moving during the headache. Treatment It is difficult to stop the pain of a cluster headache that is in progress, because the headache usually disappears by the time the patient reaches the emergency room or doctor’s office. Because the onset of cluster headache attacks is rapid and may occur several times a day, the best approach to treatment is with daily preventive drugs to decrease the severity and frequency of headaches. Lithium (Carbolith, Duralith, Lithane, Lithobid, Lithonate and others) and verapamil (Isoptin, Calan, Chronovera, Verelan, Novo-Veramil) are the two drugs that are most effective at accomplishing this. Other drugs used for this purpose include prednisone (Deltasone, Meticorten, Orasone 1, Winpred and others), cyproheptadine (Periactin) and methysergide (Sansert). Prophylactic medications usually are begun early during a cycle of cluster headaches and continued for two weeks longer than the usual cycle. Abortive treatments include inhalation of 100% oxygen. Inhaling 100% oxygen for about 15 minutes through a facemask has proven to be helpful when it is done at the first signs of an attack. This oxygen must be prescribed by a doctor and obtained through a medical supplier. Other types of drugs that may be effective when used at the outset of cluster pain include the triptans (Imitrex, Maxalt, Zomig, Axert, Amerge), ergotamine (Cafergot) and indomethacin (Indocin). Migraine Headache Migraine headaches are less common than tension headaches. About 6% of all men and 18% of all women experience a migraine headache at some time. Migraine headache occurs on one or both sides of the head. The pain is typically pulsating or throbbing in nature. Nausea, with or without vomiting, as well as sensitivity to light and sound often accompany migraines. Migraines are made worse by activity, bright lights and bright noises. In most cases, migraine attacks are occasional, or sometimes as often as once or twice a week, but not daily. Women who have migraines often find that their headaches occur or worsen around the time of their menstrual periods. One unique feature of migraines is an unusual sensation that a migraine is about to occur. This sensation is called a prodrome. Prodrome symptoms can include fatigue, hunger and nervousness. Not all people who get migraines have prodromes. An aura is a complex of neurological symptoms that occur just before or at the onset of migraine headache. An aura involves a disturbance in vision that may consist of brightly colored or blinking lights in a pattern that moves across the field of vision. Most patients with migraine have attacks without aura. About one in five migraine sufferers experiences an aura. Treatment How your migraines are treated will depend on the frequency and severity of attacks. People who have a headache several times per year often respond well to nonprescription pain relievers. There are two types of medications to treat migraines:

* abortive medications - drugs that are taken when a headache starts
* preventive medications - drugs that are taken every day to prevent migraines

Abortive Medications Migraine-specific abortive medications usually are necessary for moderate to severe migraine headaches. When possible, an abortive medication should be taken immediately after an aura or migraine headache starts. However overusing abortive medications can lead to chronic headaches, that occur day after day without a specific cause or diagnosis. Several prescription and nonprescription drugs are used as abortive medications: aspirin, ibuprofen (Advil, Apsifen, Motrin, Nuprin and other brand names) or naproxen (Aleve, Anaprox, Naprosyn) Effective agents available by prescription include:

* Triptans - sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig) and rizatriptan (Maxalt). Triptan drugs are effective in 60% to 65% of patients, completely or significantly relieving migraine pain and associated symptoms within 2 hours of administration. Triptans reduce inflammation and constrict the blood vessels. The triptan with the longest history of use is sumatriptan (Imitrex).
* Ergots - sublingual ergotamine (Ergomar) and dihydroergotamine (Migranal). Ergots cause constriction of blood vessels, but ergots tend to cause more constriction of vessels in the heart and other parts of the body than the triptans, and their effects on the heart are more prolonged than the triptans. Ergots are not as safe as the triptans.
Midrin. It is a combination of isometheptene (a blood vessel constrictor), acetaminophen (a pain reliever), and dichloralphenazone (a mild sedative)

Preventive Medications Preventive medication are prescribed when migraine attacks that don’t respond well to abortive medications or adverse reactions to abortive medications occur, migraine attacks occur too often, complicated migraines. Many drugs are listed as potentially useful to prevent recurrent migraine attacks. The drugs in the following classes are useful to prevent recurrent migraine attacks:

Beta-blockers. Propranolol (Inderal) and nadolol (Corgard) have a good track record of being safe and effective. Metoprolol (Lopressor) and atenolol (Tenormin) are reasonable alternatives. Beta-blockers have been used for many years to prevent migraine headaches. It is not known how beta-blockers prevent migraine headaches.
Tricyclic antidepressants. These medications are very effective, but often have troublesome side effects such as sedation, blurred vision, dry mouth and constipation. The first choice is often amitriptyline (Elavil). Nortriptyline (Pamelor, Aventyl), doxepin (Sinequan), imipramine (Tofranil) also can be tried.
Anticonvulsants. Of the drugs in this class, valproate (Depakote, Epival) has the best evidence to support using it for prevention. Gabapentin (Neurontin) and topiramate (Topamax) also are effective. It is not known how anticonvulsants work to prevent migraine headaches.
Serotonin antagonists. Methysergide (Sansert) has been available for many years and is very effective. Methysergide prevents migraine headaches by constricting blood vessels and reducing inflammation of the blood vessels. However, this medication has side effects that are potentially very serious and therefore is not widely used.
Rebound Headache Increasing headache over time with repeated use of pain medicines can lead to a rebound headache. The headache is typically located on both sides of the head and is described as a pressing or tightening type of pain. When headache sufferers use too much pain medicine, their headaches often recur. This leads to a repeated cycle of taking more medicines and still having headaches. Rebound headache may appear if:

- taking analgesics on 15 or more days per month for more than 3 months
- taking opioid or combination medication 10 or more days per month for more than 3 months

When analgesics are discontinued, the headache may get worse for several days and it may take up to 30 days to recover from the rebound process. Non-drug approaches, such as biofeedback, relaxation therapy, and exercise, can be helpful in reducing both headache frequency and need for medication. Headache Triggers Triggers are not direct causes of the headache, but they facilitate or provoke the beginning of an attack. Anything that stimulates the pain receptors in the head and neck can cause a headache. Some of the more common triggers for headache:

Emotional triggers: problems at work, success at work or school, anticipation, anxiety, an emotional crisis, a new job. Emotions can bring on headaches, keep them going, and make them worse. Emotions don’t cause your headaches, they just make you more vulnerable to them.
Environmental triggers: bright light, different kinds of aromas like perfume, tobacco, odors (such as gasoline), loud noises, altitude, barometric pressure changes.
Stress triggers: strenuous exercise, excessive physical work at the work place or at school, physical sickness, not enough sleep or too much sleep
Chemical triggers: changes in hormone levels (that occur during the premenstrual period, during the post-menstrual period), low blood sugar.
Food and beverage triggers: caffeine, alcohol (especially red wine), hard cheese, vinegar, hot dogs, chocolate, nuts, MSG (monosodium glutamate), pizza, pork. Foods containing nitrites as preservatives can also trigger headaches. Fasting or missing meals is a major headache trigger.
Changes in the weather can change body chemistry, and have been known to trigger headaches.
Heavy cigarette smoking.

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