Ohhh, my aching….. head!
When is a headache not a headache? When it’s a sign that there is something else more serious going on….. that’s what we all worry about with our off-and-on aches and pains, but headache pain is particularly worrisome. We fear bleeds, stroke, cancers, seizures….
Fortunately most headaches are not dangerous and can be easily managed at home.
Headaches can be caused by illness, trauma, tension or stress, foods or exposures, underlying diseases such as hypertension, and sometimes have no clear source. Here’s a way to understand and manage headaches at home…and when to get help from your doctor.
Viruses are notorious for causing head pain: flu, colds, stomach flu are common causes. Try treating these at home with proper hydration, symptom control, sometimes ibuprofen or tylenol can offer relief. These headaches will improve with time as your immune system fights off the invader! If you have sinus pressure and get no relief from fever or pain after a week–or with worsening pain after at least 48 hours of treatment at home you may need to make an appointment with your doctor.
Trauma (car accidents, falls, sports injuries) can lead to head pain due to brain injuries such as concussion or a bleed. If you have a headache after trauma that does not get better, worsens or is “the worst headache of your life” seek medical attention immediately. This could be a life-threatening bleed.
No illness or trauma, but still feel a tight sensation at the temples, the entire scalp and even extending down your neck? This could be a muscle tension headache. These headaches can come on from overusing the head and neck muscles, such as needing to keep your head in certain positions for hours at work or when driving or with other prolonged activity. Life-stress can be a culprit too. Many of us carry our tension in our neck and shoulders and this can ascend to the muscles of the scalp resulting in spasm and headache. Stress reduction, stretching exercises, deep breathing can help here; sometimes muscle relaxant medicines are helpful for a short period of time.
Migraines are intense and recurrent headaches that can present in many ways. Classically they cause one-sided, intense and throbbing head pain and may feature light or sound sensitivity, nausea and vomiting. There are multiple ways to manage migraines; visit your doctor to help with treatment and prevention.
Other headaches can result from eye strain, from lack of food and resulting low blood sugar, from allergies or from withdrawing from caffeine, alcohol or other drugs or medicines you may have been using. Keeping a log of your symptoms, exposures, ingestions and activities can go a long way to determine the source of your headaches and thereby the best way to manage them.
Many times simple pain meds, such as ibuprofen or acetaminophen can help, along with proper diet, exercise and sleep. Do not wait too long to treat because the longer you wait, the harder it is to treat the affected pain nerve pathways and the longer your headache will last. If you are reaching for pain medicines frequently, you may contribute to a chronic daily headache–even mild medicines routinely taking can lead to a withdrawal headache and you may need help from your doctor in transitioning to pain free.
A headache that is ongoing, worsening and unresponsive to intervention may be a sign of undue pressure in the brain such as that caused by a tumor or sometimes elevated blood pressure.
Most headaches can be managed at home, but a headache that is persistent or recurring may be a sign that more is going on and a visit to your doctor may help uncover underlying sources and direct you to proper treatment for your head pain.
Be well!
Dr Hoffman
Dr. Rebecca Hoffman is a Family Practitioner and works at Kaiser Permanente in Salmon Creek, which is in Vancouver, Washington. Interests include using diet and healthy living to stay healthy and attending to mental health and its physical manifestations. Personal interests include hiking, jogging, music (she plays the harp), dance, theater, storytelling and writing. She lives with her husband and two daughters.
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