What is a headache?



Throbbing or diffuse pain in any region of the head, restricted to one location in the head, at different locations and on one or both sides of the head, is called headache.



Headaches are generally categorized into primary headaches and secondary headaches. Primary headaches being more common than secondary ones. Here is how you can differentiate between the two:



Primary headaches:



Thought to be brought on by no obvious reason, primary headaches are also not the result of any other underlying disease. Scientists at Johns Hopkins believe that this category of headache likely has a ‘complex interplay of genetic, developmental, and environmental risk factors’. ‘We think of these headaches as a result of a problem with brain function rather than brain structure. While painful or even disabling, primary headaches are almost never dangerous in themselves,’ they say.



According to experts, these headaches may be caused by environmental stimuli such as noises, lights, stress, and/or behaviors for example, sleep disturbance, excessive exercise, too little physical activity, blood sugar changes, and even foods. Alcohol, particularly red wine can also lead to a headache. 



Health practitioners believe that spending large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, can increase joint irritation and muscle tension in the neck, upper back and scalp and cause a primary headache.



Most importantly, a primary headache generally include sinus headache, migraine, tension headache, and cluster headaches.



Sinus headache



A sinus headache is characterized by:

Frontal headache accompanied by pain in one or more regions of the face, ears, or teeth or teeth.

Headache and facial pain developed simultaneously with the onset of a sinus headache.

Headache and/or facial pain that resolves within 7 days after remission or successful treatment of sinus.

Migraine



This is Diane’s story, ‘A year ago I sustained a head injury after being assaulted by an ex-boyfriend. Since then I have suffered with severe debilitating migraines, nausea, light-headedness, dizzy spells, sensitivity to light, noise and smells. I have difficulty with speech when I am tired. My entire face, skull, head and temples throb unbearably during a migraine. The migraines have increased in frequency and the level of pain is always plus 10.’



Diane showed typical symptoms of migraine which includes –

At least 5 headache attacks lasting 4-72 hours ( which is untreated or unsuccessfully treated)
Headache that has at least two of the following characteristics:
Unilateral location (present on one side of the head)
Pulsating quality
Moderate or severe pain intensity
Aggravation by routine physical activity
During a headache, at least one of the following accompanies the pain:
Nausea and/or vomiting
Photophobia (sensitivity to light) and phonophobia (sensitivity to noise).
Tension headache


Researchers are still divided about the distinction between a migraine and tension headaches or episodic tension type headache (ETTH) as they prefer to call it. Some believe that these two are different types of headaches while others believe the difference is only in the severity of the episodes. But, all physicians do



agrees on the symptoms of tension headache, they are:

Infrequent episodes of headache lasting minutes to days.
The pain is typically bilateral, pressing or tightening in quality and of mild to moderate intensity, but does not worsen with physical activity.
There is no nausea, but a person might suffer from bouts of photophobia or phonophobia.


According to the American Chiropractic Association, a person suffering from a tension headache should avoid teeth clenching as well. According to them, when upper teeth touch the lower teeth, it results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull. This leads to TMJ irritation and leads to a form of tension headache.



Cluster headache



Although scientists are not absolutely sure what causes cluster headaches, they think that the area of the brain responsible for regulating temperature, blood pressure, hormone release, and sleep starts working abnormally. And the pain is thought to be caused by a combination of widening of the blood vessels and inflammation of the nerves of the face.



JD started getting cluster headaches in late summer 8 years ago. The attack came on the right temple, right nostril was plugged, right eye runny and always with intense pain. Fourteen months later he had a repeat attack and quickly realized that alcohol was the trigger. After 4 days of tolerating the pain, he went to hospital where he was diagnosed with cluster headache.



Cluster headaches usually begin as headaches that occur over several weeks, followed by many months or even years of no symptoms. This is why it is called the cluster headache. It’s symptoms include:

Excruciatingly severe stabbing headaches located behind one eye or the other
Redness and tearing of the eye
Nasal congestion
The eyelid may droop, and the pupil may change size


The headaches are usually more brief and more intense than migraines. In some patients cluster headaches go on to become chronic, then the treatment is the same as the ones used to treat occipital neuralgia and trigeminal neuralgia.



Secondary headaches



A secondary headache occurs more likely as a symptom of an underlying disease that activates the pain-sensitive nerves of the head. Many diseases can cause secondary headaches, some of them are:



Occipital neuralgia



Sometimes, a headache can originate at the base of the skull or upper neck and radiate to the back, front, side, or behind the eyes. This type of headache is called occipital neuralgia. 



This kind of headache can be caused by:

a direct blow or ‘whiplash’
spinal column compression
nerve lesions
infections or inflammation
gout
diabetes
local tumours


Cervicogenic headache



This type of headache is similar to occipital neuralgia in the sense that this too begins in the neck region at the base of the skull. It then spreads unilaterally up to the forehead region and the part of the head above it (oculo-fronto-temporal areas).



In the beginning, the headache comes and goes, but it then progresses to an almost continuous non-throbbing pain. The pain can be triggered or exacerbated by neck movement or keeping one’s head in a particular neck position. The pain can sometimes also extend to the neck and between the shoulders.



Scientists believe that one of the most prominent causes of cervicogenic headache is stressing the muscles and bones of your neck and spine. Other risk factors include fatigue, problems sleeping, disc problems, current or prior injuries, poor posture and stress on the muscles.



Trigeminal neuralgia



Trigeminal neuralgia is an extremely painful condition usually involving one side of the face. It is characterized by feeling of ‘shock-like’ pain which travels through the face in a matter of seconds, but can occur in a repetitive fashion. The pain can be triggered from anything ranging from touching the face to chewing, to shaving or brushing.



Usually, the first time sufferers link it to toothache or simply a headache.



Scientists attribute the cause of trigeminal neuralgia to vascular compression, which means, the blood vessels that travel with the nerve put pressure on the nerve and cause the pain. 



Some other medical conditions that can cause secondary headaches are –

Blood clot in the brain
Brain aneurysm (bulging of the artery in the brain)
Glaucoma
Acute sinusitis
Concussion
Meningitis
Influenza
Haematoma in the brain
Monosodium glutamate (MSG)
Panic attack
Stroke and host of other disorders


Hangovers and monosodium glutamate too can cause headaches. ‘Sexual’ headaches, thought till date to be the typical ploy women reject male advances, is actually very real. Medically known as headaches associated with sexual activity (HAS), these headaches are not life threatening conditions but the symptoms can be same as in serious life threatening cerebral conditions, according to a study published in the British Journal of Medical Practitioners.



Headaches are not life threatening but do consult your doctor if you have frequent headaches. Early treatments can even cure your headaches permanently.[font=Lucida Sans Unicode][/font]

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