Headache is most common local pain complaint in all ages and stages of life.Pain and aches localized to head. Headache may be caused by general fatigue,tension or stress -that is reversible and headache may be caused by some serious pathology of head as tumors -that may be not reversible. But more than 80% cases of headache have simple and reversible causes.
Headache has many different patterns and different causes. Very strangely, brain is not a pain sensitive organ,brain lacks any pain sensitive nerve fibres. But outer covering(Meninges) of brain,muscles of head, blood vessels in head,subcutaneous tissue and skin are pain sensitive parts. Pain due to eyes,ear and nose may start headache. Spondylitis of neck is a common cause of headache these days.
Types of Headache
Different Types of headache are:
1.Tension Headache
2.Migraine
3.Cluster Headache
4.Chronic Headache
5.Trigeminal Neuralgia
6.TMJ-Temporo Mandibular joint
7.Pregnancy Headache
8. Ice cream Headache
9. Sinus Headache
10.Gastric Headache
There are many other pattern of headache beside these common pattern.
Tension headache
It is the most common form of headache and accounts for 70 per cent of headaches.This type of headache results from contraction of head and neck muscles. It is most common in adults and adolescents. The sensation is that of a dull ache on both sides of head. This type of headache is the one that feels like a tight band, or a vice grip, is running across forehead. Possible causes of muscle contraction associated with tension headaches are- stress, fatigue, wrong posture, eye strain, tobacco and alcohol use, in women- hormonal changes occurring before and after a menstrual period.
Migraine headache
20 per cent of all headaches are Migraine. This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels.
Migraine is usually experienced as a throbbing pain on one side of the head with an associated feeling of nausea, vomiting, visual disturbances, sickness and sensitivity to light and sound. In many patients, it may be bilateral and generalized. It is more common in females than males (3:1) and may occur in childhood, adolescent and adult life.
Diagnostic pointers for migraine:
Attacks last from 4 to 72 hours
Patients are usually symptom-free between attacks
Headache is at least two of the following
a. Unilateral (on one side)
b. Pulsating
c. Moderate to severe
d. Aggravated by routine activities
Associated symptoms may include
a. Photo phobia (more sensitive to light)
b. Phonophobia (more sensitive to noise)
c. Nausea and Vomiting
Factors that have been identified as being associated with migraines:
1. Family history of migraine.
2. Prolonged muscle tension and stress.
3. Alcohol use.
4. Smoking or exposure to tobacco smoke.
5. Lack of sleep.
6. For women, menstrual periods and the use of oral contraceptives.
7. Certain foods such as chocolate, nuts and fermented or pickled condiments, as well as foods containing the amino acid tyramine (aged cheese, red wine, smoked fish) and foods containing preservatives and artificial sweeteners.
Cluster Headache
Cluster headache is one of the most painful types of headache. Cluster headache is an excruciating condition but fortunately it is rare. It affects 1 in 1000 men and 1 in 6000 women; mostly found in adults or older and in habitual smokers.
Cluster headache is distinctive in ways other than the severity of the pain. A striking feature of cluster headache is that the attacks occur in cyclical patterns, or clusters — which gives the condition its name. Bouts of frequent attacks, known as cluster periods, may last from weeks to months.
Pains are unilateral, intense, around the eye, make eye red and watering, ptosis (droopy eyelid) may occur, followed by a remission period when the headache attacks stop completely. Although the pattern varies from one person to another, most people have one or two cluster periods a year. During remission, no headaches occur for months, and sometimes even years.
Chronic daily Headache
Chronic Daily Headache is defined as a headache type, which is present on most days for example :- more than four hours per day, and 15 or more days per month. The chronic daily headache usually evolves over a period of months or years, typically occurring over a six-month period or longer. Males are two times more affected than females. It can occur in children as well as in very old persons.
About 50% of cases a doctor attends everyday are of chronic daily headache. Chronic Daily Headache Type is characterized by a combination of background, low-grade muscle contraction-type symptoms, often with stiffness in the neck, and superimposed migrainous symptoms, history of injuries to the head and neck, such as a whiplash injury may be found. Patients might have had migraine in the past, prompting them to increase their analgesic intake. These analgesics can then lead to a worsening of the chronic headache pattern resulting in analgesic dependence, a combination of treatments includes:
1. Identify Stressors in life and reduce sources of stress
2. Physical measures in the neck and shoulder areas (eg, exercises or formal physiotherapy, acupuncture or osteopathy or chiropractic).
3. Avoidance of analgesics and ergotamine to break the cycle.
4. Use of effective, regular prescription medicines, usually drawn from the antidepressant or anti epileptic groups.
Causes of headache that must not be missed:
1. Meningitis: usually accompanied by fever and neck stiffness in an obviously ill patient.
2. Intracranial tumours: produce headache when they are large enough to cause raised intracranial pressure, which is usually apparent from the history. Papilloedema or focal neurological signs, or both, will usually be present. Fortunately these are very rare.
3. Subarachnoid hemorrhage: headache is often described as the worst ever, and is usually (but not always) of sudden onset. Neck stiffness may take hours to develop. In elderly patients particularly, classic symptoms and signs may be absent.
4. Temporal arteritis: headache is persistent but often worse at night and sometimes severe, in a patient over 50 who does not feel entirely well. It may be accompanied by marked scalp tenderness.
5. Primary angle closure glaucoma: rare before middle age, may present dramatically with acute ocular hypertension, a painful red eye with the pupil mild dilated and fixed and, essentially, impaired vision, and nausea and vomiting. In other cases, headache or eye pain is episodic and mild. The diagnosis is suggested if patient reports colored halos around lights.
6. Idiopathic intracranial hypertension: rare cause of headache; occurs especially with obese young women. May not be evident on history alone; papilloedema indicates the diagnosis.
7. Subacute carbon monoxide poisoning: uncommon but potentially fatal. Symptoms include headaches, nausea, vomiting, giddiness, muscular weakness, dimness of vision, and double vision.
Pregnancy Headache
Headaches, like many ailments, can occur in pregnancy just as they do at other times of life. However, there are a few causes of headache that are related to pregnancy.
During pregnancy headache can be miserable and debilitating, but in most cases they’re not dangerous. Pregnancy headaches tend to diminish or even disappear during the second trimester, when the flood of hormones stabilizes and the body grows accustomed to its altered chemistry.
Warning signs that a headache needs urgent evaluation by a physician include:
1. if it is severe and different than any headache you have had before;
2. if it occurs immediately upon wakening in the morning or wakes you from sleep;
3. if you are already being monitored for high blood pressure and the pain doesn’t respond to acetaminophen;
4. if it is associated with neurological symptoms, such as vision problems or numbness or weakness, that you have not previously experienced.
Facial Headache Types
Sinusitis is caused by infection of one or more of the cranial (skull) sinuses. These are the bony inner structures of the skull. Acute sinusitis lasts for days up to three weeks. The International Headache Society’s criterion of purulent discharge and acute febrile illness is indicative of acute sinusitis (sinus headache). The site of the pain varies according to the location of the infection. Maxillary sinusitis pain is mostly in the cheek, gums, teeth and upper jaw. When pain is presented between and around the eyes this is referred to as ethmoidal sinusitis. Frontal sinusitis pain is seen in the forehead and sphenoidal sinusitis presents with pain at the crown of the head. The pain often has a a dull aching quality which is worsened by bending. Very rarely complications can occur such as meningitis or abscesses.
Post Herpetic Neuralgia Shingles (herpes zoster virus) can cause pain resulting from various cranial nerves. The pain may start during an acute rash of herpes but the main problem is pain that persists after the herpes rash has gone. Common symptoms include a constant deep pain, with repeated stabs, or needle pricking pain. Even light touch can trigger these symptoms which may be accompanied by itching. Half of patients have no pain after three years.
Trigeminal Neuralgia
Trigeminal neuralgia is considered to be the most common neurological syndrome in the elderly. Women are three times more likely to get it than men. Over 95% of cases are unilateral. The pain is often described as an electric shock or spasm or burning sensation in one or more of the three divisions of the trigeminal nerve. The pain lasts from 2-120 seconds. The ophthalmic division supplies the forehead, eyes and scalp, the maxillary supplies the cheek and the mandibular supplies the lower cheek, lower lip and chin. The condition has been called ‘tic douloureux’ because the facial muscles may twitch. Patients can sometimes have a dull ache as a continuous symptom. The trigger can be cold air, washing the face or cleaning the teeth. The pain can be excruciating. The most common cause is thought to be vascular compression resulting from abnormal arterial roots near the nerve root. MRI scans can confirm this. Other possible causes include malignancy, multiple sclerosis, intrac cranial aneurysms and cranial arteritis.
Treatment of Headache:
Conventional Treatment:
Treatment of uncomplicated headache is usually symptomatic with over-the-counter painkillers such as aspirin, paracetamol (acetaminophen) or ibuprofen, although some specific forms of headaches (e.g., migraines) may demand other, more suitable treatment, usually triptans.
Homeopathic Treatment:
Homeopathy has very specific approach to treat headaches. Homeopathic medicines not only relieve headache but cure permanently. Acute headache, Chronic Headache, Sun headache, Gastric Headache, Migraine headache, Sinus Headache, headache related to pregnancy and even homeopathy has wide scope in serious headache cases.
Homeopathy offer wide range of 260 medicines for headache. Medicines are prescribed on individuality of patient according the symptoms, modalities of time, weather, position. Treatment remains continue according the chronicity of case.
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