Headaches

Regardless if you experience headaches randomly, suddenly or frequently, you know just how debilitating they can be. While they occur in many different forms, everyone experiences some sort of face, head or neck pain. While most headaches are caused by environmental or lifestyle triggers, there are times when headaches are a result of a medical condition, which is what makes it so important to visit your healthcare professional. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is expertly trained in the many different causes and treatments of headaches, with a goal to help their patients experience a pain-free and headache-free life. 

What is a Headache? 

Did you know there are more than 150 different types of headaches? You’ve probably experienced a few yourself. While most headaches aren’t serious, there are certain instances where they can be the sign of something more serious happening within the body. 

There’s the headache that is triggered by bright lights, the headache experienced after a stressful day, and then the headache that you can’t quite explain but always seems to happen when you least expect it. Each headache cause is unique, which is why seeking the help of a pain management specialist is so important to both keeping headaches at bay and reducing the pain felt due the headaches. 

Generally speaking, a headache is just that, pain felt in the head and face, quite possibly also the neck. Headaches are the most common reason that a person will visit their healthcare provider. The two classifications of headaches are either primary, unrelated to another condition, and secondary, relating to another condition. 

Primary headaches are the most common and are broken down into cluster, tension and migraine headaches. They are general, everyday headaches that occur for no particular reason. Most often, dysfunction or over-activity of pain-sensitive features in your head are the cause of primary headaches. Some people even have genes that make them more prone to experience primary headaches. 

On the other hand, secondary headaches are difficult to diagnose. Types of secondary headaches that aren’t dangerous and can resolve themselves include dehydration headache, sinus headaches and medication overuse headache. However, most secondary headaches occur as a result of an existing pathology or disease. Some of the several life-threatening conditions that can cause them include strokes, eye diseases, malignant tumors or malignant hypertension, meningeal infections, or hematomas/hemorrhages in the head. These all require immediate attention by a healthcare professional. 

What are the Different Types of Headaches?

The three main different types of headaches are cluster, tension and migraine. Properly categorizing the headache you’re experiencing is the key to treatment. 

Cluster:

Aptly named, cluster headaches occur in clusters, most often around the same time of day, affecting the same location of the head, during the same time of the year. The intense and debilitating pain is caused by the dilation of blood vessels that creates pressure on local nerves, and can last anywhere from 20 minutes up to a few hours. Cluster attacks can last between days and weeks, with the center of the pain being felt behind the eye on only one side of the head. After the attack passes, patients can experience a period of remission that can last anywhere from weeks to months. 

Most patients who experience cluster headaches describe the pain as far more severe than the other two types of primary headaches. Cluster headaches also most commonly affect men in the mid-20s, with an increased probability in those who take vasodilating medicine, drink and use illegal drugs. 

Tension: 

Tension headaches are the most common headaches adults experience, with the most common trigger being anxiety and stress. Most usually felt later in the day, tension headaches can be attributed to daily occurrences, such as work or personal stress issues, staring at a computer screen, or enduring loud noises and bright lights. These headaches are most often felt in the upper neck and back of the head (occipital) region, and are not associated with any disorders. They are, simply, caused by daily life. 

Most people describe tension headaches as a 360-degree tightness or pressure in the forehead, temples and back of the head that can begin slowly but is exacerbated by noise, light and stress. Additional pain feelings can be described as stabbing or throbbing in the head area. Other symptoms include depression, irritability, lack of concentration and inability to sleep. Most tension headaches occur as one-off episodes that come and go over time, and can last less than an hour with treatment. 

Migraines: 

Adult women are the greatest portion of the population who experience migraines, but they can affect men, too, as well as children and adolescents. Migraine pain can vary from person to person, but most people either experience pain on one side of the head or both sides of the head, most commonly accompanied by nausea and vomiting, as well as sensitivity to light. Most migraine headaches can last anywhere from an hour to up to three days. 

Migraines are classified as common or classical. While common migraines affect both sides of the head (bilateral) and have no visual disturbances, classical migraines affect one side of the head (unilateral) and are preceded by visual effects, such as auras and wavy lines that disturb normal vision. These could include flashes of light, seeing spots, unsteadiness, an altered level of consciousness, facial numbness or weakness. 

There are generally four stages to migraines, although not everyone who experiences migraines will endure all four stages. 

• Prodromal: the warning sign of a migraine that can often feature mood swings, anxiety and fatigue
• Aura: temporary visual disturbance that happens an hour before a migraine and could include intense head pain, nausea and sensitivity to light and sound 
• Attack: when the actual pain and possibly other physical symptoms occur
• Postdromal: also known as the “migraine hangover,” this stage occurs after the pain of a migraine attack has subsided, but brings along sensations of aches, stiff neck, mood changes, euphoria or even the feeling of being drained or tired. 

Why Do Headaches Happen?

The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. General risk factors for experiencing migraines include dehydration, poor nutrition and lack of sleep. However, each of the three types of headaches bring along with it different and specific causes. 

Headaches happen when pain-sensitive nerve endings called nociceptors react to headache triggers (which could include stress, certain foods or odors, or a person’s use of medicines) and send messages through the trigeminal nerve (a large, three-part nerve in your head that provides sensation to the face) to the thalamus, the brain’s sensation process center.

However, headaches can happen for different reasons at different times. So while a person could experience one headache due to environment changes or having to endure loud noises, there are also medical opportunities for a person to experience a completely different type of headache. This is why medical help is so important for determining the best causes and treatments. 

How Can I Prevent Headaches?

The goal of headache therapy is to prevent headaches from happening in the first place, as well as reducing the frequency and duration of headaches when they do occur. More often than not, pain treatments are used in conjunction with other therapies to attempt to prevent an attack as well as to lessen the harmful effects of an attack. 

The first step in preventing headaches is to make appropriate lifestyle changes, including getting enough sleep, eating a proper diet, exercising, drinking enough water, avoiding tobacco products, limiting or eliminating alcohol and drug use, and practicing stress management techniques.  

You can also focus on and recognize what triggers the headaches so you can avoid the triggers. For instance, if a particular smell, food, lack of sleep or poor posture is the cause of headaches, then you can combat those by not eating those foods, getting enough sleep and sitting or standing in a different manner. If a person is not able to identify triggers, or avoid them altogether, then it’s helpful to seek the care of a pain management specialist who can create a multidisciplinary approach to avoid headaches from happening or at least minimize the harmful effects. 

In addition to those efforts, taking preventative medications, such as antidepressants and antihistamines could help to reduce migraine attacks, as well as treating behavioral disorders such as depression and anxiety. Focusing on the holistic approach is a fundamental way to treat the occurrence, duration and severity of migraines, and help to provide the patient with a way to avoid both dependency on medications and surgical options. 

How are Headaches Diagnosed?

It’s important to reach out to your healthcare provider if you are concerned about the severity or frequency of your headaches. He/she will conduct a complete examination on your physical and mental health, as well as inquire about your family health. It’s important to provide information about your history of headaches, including:

• Pain sensation
• Level of pain
• Frequency of headaches
• Duration of headaches
• Stress level 
• Sleep habits
• When headaches occur
• Type of headache
• If there’s a history of headaches in your family
• Symptoms before, during and after headache attacks

Additional signs and symptoms a healthcare provider might look for include fever, infection, excessive tiredness, issues with balance, dizziness, seizures, nausea and vomiting, vision problems, loss of consciousness, muscle weakness or feeling of numbness, high blood pressure, mental confusion, personality changes, or more.  

Due to the fact that headaches could be caused by serious medical conditions, your pain management specialist might opt for taking imaging tests, such as X-rays, MRIs or CT scans, or even neurological tests. These help to determine if there is an issue with your central nervous system that is causing the headaches to occur, or can even rule out diseases that might cause headaches. 

What are the Best Headache Treatments?

Headache treatment focuses on reducing the frequency, painfulness, and duration of headache occurrences, as well as increasing the patient’s quality of life. Behavioral modifications have also proved to help thwart the effects of migraines, and include biofeedback training, alternative therapies and cognitive behavioral therapy. 

Biofeedback training is a non-invasive approach that utilizes self-control to help deal with stress, by focusing on using the mind to control the body’s physiological response in order to promote well-being from within, without having to rely on medicine or medical solutions. Alternative therapies, such as acupuncture, chiropractic methods, yoga and exercise by reducing stress, balancing energy and restoring health. Cognitive behavioral therapy focuses on identifying and combating negative thoughts and responses to stressful events with a goal to self manage headaches in regard to frequency and pain intensity. 

However, if a person’s headaches are due to medical conditions, it’s imperative to seek the help of a pain care specialist who can recommend necessary therapies and/or treatment to help stop migraines from happening or at least minimize the effects of migraines. If behavioral modifications and medications/lifestyle changes don’t help to reduce the frequency or side effects of migraines, then additional treatments might be warranted. These include: 

• Nerve blocks – sphenopalatine, supratrochlear and supra/infraorbital 
• Cervical injections – epidural steroid and facet 
• Occipital nerve blocks and stimulation

It’s important to note that the best way to combat headaches is to utilize a combination of therapies, including lifestyle changes, stress management practices and interventional procedures. Because the cause and symptoms of headaches are so varied, there is no one particular solution for every person. This is why it’s important to place your trust in a team of dedicated pain management specialists who are adept at recognizing, addressing and treating all forms of headaches. 

The California Pain Consultants team is available to help all community members in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas manage their headaches. If you’re tired of experiencing the debilitating effects of headaches and are ready for permanent solutions, please call or click to make an appointment today. We offer a complete range of solutions to help our family of patients achieve the pain relief they’re looking for, and we are confident we can help resolve all headache issues in just a few quick and comfortable visits.