Headache Treatment Bangalore Dr Arun L Naik Neurosurgeon

Dr Arun L Naik

Neurosurgeon Bangalore India

Headache may be a ‘pain in your head’!

Nearly thirty million people suffer from headache each year in our country. Although headaches can be very uncomfortable and often disabling, majority is not associated with any serious illness. Many a times they can be relieved by resting in a room or by taking a simple painkiller. Many headache sufferers ‘suffer in silence’, not seeking the attention they need because of the stigma of headache, the perception that ‘headaches are all in the mind’.

When someone has a headache, many areas in the head can be paining, including scalp, face, mouth, ear, eye and throat. Rarely, headache is a symptom of a dangerous condition such cerebral aneurysm, brain tumor, stroke, TIA, meningitis, or encephalitis. Very high blood pressure can cause headaches and this situation is an emergency. There is a wide range of precipitating factors that can trigger headaches and include dehydration, sport, head injury, inadequate workstations, stress and diet. Headaches can also be related to depression, marital conflict and substance abuse.

Types of headache

Tension-type headache is the most widespread of headache disorders. Onset is often in the teenage years and prevalence peaks in the fourth decade and then declines. Tension-type headache is more common in women, develops gradually. It often involves the entire head as well as the neck and shoulders. It is probably caused by increased muscle tension, although not agreed by all specialists. Most people get tension headaches occasionally and these can usually be treated simply. Some people get them often, but there are usually some useful interventions to help decrease the number of sick days.

A migraine headache is throbbing, moderate to severe pain, usually on one side of the head, that is worsened by physical activity, light, sounds, or smells and may be associated with nausea and vomiting.There are mainly two types of migraine, classic and common. The basic difference between the two types of migraine is the appearance of an “aura” seen in classic type. The aura is the occurrence of neurological symptoms 10-30 minutes before the attack. You may see flashing lights, zigzag lines or may temporarily lose vision. Other symptoms of classic migraine include speech difficulty, confusion, arm or leg weakness and tingling of face or hands.

The pain of a classic migraine headache is described as an intense throbbing or pounding felt in the forehead/temple, ear/jaw or around the eyes. Classic migraine starts on one side of the head but may eventually spread to the other side lasting for one or two days. The common migraine is more ‘common’ and not preceded by an aura. Some people do experience a variety of vague symptoms before common migraines - mental fuzziness, mood changes, fatigue, and unusual retention of fluid. During the headache phase of a common migraine, you may have abdominal pain and diarrhea, increased urination, nausea and vomiting. Both classic and common migraines can strike as often as several times a week or rarely as once every few years.

Cluster headache is an extraordinarily painful, rare chronic disease more common in men. Cluster headaches usually develop between the ages of 20 and 40. The term ‘cluster’ is used as the attacks usually occur in groups or clusters, typically for several weeks once or twice a year at the same time of year. People with cluster headaches often describe the pain as similar to an ice pick.

Sinus headaches are those frontal headaches that some people experience with sinus infection and with changes in the weather. Allergies can also provoke them.

Headache triggers

Although the tendency to have frequent headaches is probably inherited, the way you live your everyday life could influence how often those headaches occur. If headaches are a serious problem for you, it makes sense to pay extra attention to factors that could trigger or aggravate headaches.

Potential headache precipitating factors (triggers) are many and varied. Different types of headaches have different triggers. Triggers are not the same for everyone, and not necessarily the same for different attacks in the same person. Identifying triggers may be complicated by the fact that it often takes a combination of triggers to set off a headache. For example, a stressful day followed by a few glasses of red wine that evening and oversleeping the next morning might trigger a migraine whereas red wine at lunch may have no effect. It is important to understand your trigger factors and avoid them as far as possible.

• Stress and time pressure, major hassles, major losses, anger and conflict.

• Smells and fumes, tobacco smoke, light glare or dazzle, weather changes.

• Monthly periods, birth control pills, estrogen therapy.

• Sleep disturbances.

• Hunger, fasting, specific foods or beverages. (See table 1.)

• Excessive physical strain.

• Foods: Cheese, beer, wine, hard liquor, coffee, tea, cola, chocolates, pizzas, seasoned Salt, canned soups, snack chips, saccharin, ice cream, milk, yogurt, pickles, oranges, grapes, lemons, onions, bananas, peanuts, sandwich meats, hotdogs, fresh breads etc.

Management of headache

Headache management is indeed a great challenge. A number of treatment options, preparations and methods of administration may have to be tried to discover what works best for each headache sufferer. The role of the doctor is vital in this process. Once your headache is correctly diagnosed, your headache management plan can be developed. The plan should be evaluated and updated regularly.

While there is still no absolute cure for headache, there are a number of treatment options, both medications and other forms including complementary therapies. Always consult your medical practitioner. Some medications are given once the headache has begun (acute treatment) and others are taken daily to reduce the frequency of attacks (prophylactic treatment). Acute episodes are treated by various analgesics. Prophylactic medication is taken daily, regardless or whether a headache is present, to reduce the incidence of severe or frequent headaches. Your doctor will be able to help you find out what type of medication is best suited and safest for your needs.

Complimentary therapy

This offers a natural solution to pain relief and headache management. There are a number of options available. Most are concentrated on releasing tension in the body, thus easing pressure in the head. Not all these options will work or be available to everyone.

A Healthy Lifestyle may help reduce or eliminate headaches or will at least improve your overall health and involves eating healthily and regularly, drinking less caffeine and alcohol and plenty of water, exercising regularly, avoiding fatigue and having plenty of rest, having sufficient regular sleep, good posture and ensuring that work and living areas are well ventilated and well lit.

Stress management involves learning to be able to control stress and relax. Everyone has periods of stress. Stress has benefits in that it can result in us pushing ourselves and getting things done. This can precipitate a headache. Simply taking some deep breaths and maybe tensing then relaxing your muscles can relieve occasional mild stress. Regular stress may require learning to say “no”, not taking too much on. Becoming fit, eating regularly, and proper sleep can help combat stress. Learn better organizing skills, not setting standards that are too high and deal with problems as they arise, can all help. As can, adopting stress management techniques such as meditation, biofeedback, relaxation therapy and yoga.