Making sense of headaches
While most will ease after some time, other conditions may require medical attention.
Is it a sign of something serious if you wake up with dizziness and a throbbing pain in your head? Almost everyone would have experienced headaches at some point in their life, but most headaches are not triggered by threatening conditions, says Dr Jonathan Ong, an associate consultant with the Division of Neurology, National University Hospital (NUH).
“These are known as primary headache disorders,” he explains. “Common primary headaches include tension-type headaches and migraine. Other less common primary headaches include cluster headaches.”
Here are types of headaches you should know:
1) Tension headache – People who suffer from this often experience a squeezing or pressure sensation on the head. The headache can last from a few hours to several days. Occasionally, it may become more persistent and last for months. “Despite the discomfort, most people can carry on with their daily routine without any issues,” says Dr Ong.
WATCH OUT FOR:
- Tightness in the muscles at the back of the neck and over the scalp. Factors such as poor posture, and mental and physical stress may worsen tension headaches.
- Consuming too much caffeine or alcohol.
2) Migraine – This type of headache is usually characterised by a one-sided, throbbing pain. It can last a few hours or up to three days. Sometimes, a chronic form of migraine may develop. Common causes include physical and mental stress, hunger, eating certain foods, irregular sleep patterns and dehydration. Movement or physical exertion could also aggravate the pain.
“Often, one would need to stay in bed to try and sleep off the migraine,” says Dr Ong.
WATCH OUT FOR:
- A heightened sensitivity to bright lights, sounds and odours during episodes of migraine.
- Nausea and vomiting.
- Seeing flashing lights or zig-zag lines. About one-third of migraine sufferers experience this “aura” before a migraine kicks in.
3) Cluster headache – One of the most excruciating types of primary headaches, it occurs in periodic patterns or clusters, with men being more susceptible to it. Cluster headaches tend to strike around the same time like clockwork.
“A single attack may last from 15 to 180 minutes. Bouts of frequent attacks, known as cluster periods, may last from weeks to months, followed by remission periods when the attacks stop completely,” says Dr Ong. There is no known cause for cluster headaches, but once it strikes, consuming alcohol can quickly trigger a splitting headache.
WATCH OUT FOR:
- An intense pain in or around one eye on one side of the head.
- Excessive tearing, redness of the eye, congested or runny nose, drooping eyelid, sweating or pale skin on the side affected by the headache.
4) Hormonal headaches – Headaches in women, particularly migraines, are tied to shifts in the levels of the female hormone oestrogen throughout the reproductive cycle.
Migraine headaches are most likely to occur in the two days leading up to a period, or the first three days during a period. “This is due to the natural drop in oestrogen levels at these times. The attacks are typically more severe than migraines at other times of the month,” Dr Ong explains.
Women approaching menopause may also experience worsening headaches because of disruption to the normal hormone cycle. Headaches could also intensify during the first few weeks of pregnancy, but they usually ease or stop completely during the last six months.
5) Secondary headaches – Unlike primary headaches, secondary headaches are linked to an underlying illness or injury, and these conditions should be evaluated by a doctor (see sidebox below on “When do I see a doctor?”). One such headache is the sinus headache. Caused by inflamed sinuses, sinus headaches usually occur after a cold or an upper respiratory viral infection.
“You get a constant, throbbing pain in the face, a pressure and ‘full’ sensation in the cheek or forehead, or an achy feeling in the upper teeth coupled with a congested nose,” says Dr Ong.
“Whatever your headache, there are quick, effective ways to ease the pain, or consult your doctor.”
|SIDEBOX: 6 ways to fight that pain in the head
|SIDEBOX: When do I see a doctor?
“These symptoms require early medical evaluation for more serious causes such as brain tumour, inflammation and infection,” says Dr Ong. If these indications arise, usually a detailed neurological assessment followed by a brain scan will be conducted. If a brain tumour is suspected, a neurosurgeon may be involved.
“Generally, benign brain tumours have a better diagnosis and are more responsive to various treatments,” adds Dr Ong.
(** This article has been reproduced with permission. It was first published in “Lifeline”, a publication of the National University Hospital.)
(** PHOTO CREDIT: Bob Smith, freeimages.com)