Headache: Diagnosis and Treatment

The headache is a very common disorder of the nervous system. which can be caused by a variety of reasons. Tension headache and migraine are the most common forms and tend to affect women more often. Headaches can have a major impact on people's quality of life and can cause disability, pain and financial loss.

Types of headaches

Headaches can affect people of all ages. There are different types of headaches, each with different symptoms and characteristics. This section will discuss the most common types of headaches.

Migraine

Migraine is characterised by a sensation of intense, throbbing pain on one side of the head. Migraine can last from a few hours to several days and is often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraine is often triggered by certain foods, hormonal changes, stress or lack of sleep.

Tension headache

It is characterised by a sensation of pain and pressure on both sides of the head that can last from a few hours to several days. The tension headache is triggered by emotional problems, stress, poor posture or lack of sleep.

Cluster headache

The cluster headache is characterised by an extremely painful sensation on one or both sides of the head. Cluster headache usually lasts from a few minutes to several hours and may occur several times a day for weeks or months. The triggers for cluster headache are not known with certainty, but it has been associated with the use of alcohol, tobacco and certain foods.

Headache due to overuse of painkillers

Painkiller overuse headache is caused by chronic use of painkillers to treat headache pain. Painkillers can become a cause of headaches if they are used excessively or over a long period of time. Painkiller overuse headache can last from a few hours to several days and may be accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound.

Causes of headaches

Headaches can have a variety of causes, known as triggers, which can vary from person to person. The following are some of the causes of headaches:

Triggering factors

• Emotional or physical stress
• Changes in sleep patterns
• Hormonal changes
• Changes in weather or atmospheric pressure
• Consumption of certain foods or beverages, such as alcohol, chocolate, cheese and caffeine
• Intense physical exercise or lack of physical exercise

It is important to bear in mind that not all people who suffer from headaches have the same triggers.

Excessive consumption of medicines

Another common cause of headaches is the overuse of painkillers and other medications to treat headaches. frequent headaches. This type of headache is known as analgesic overuse headache.

It is important for people suffering from frequent headaches to avoid taking excessive medication and to consult a health professional to treat their headache appropriately.

Other health problems

In addition to triggers and medication overuse, other health conditions can contribute to headaches, including:

• Disorders of the cervical spine, such as herniated discs or cervical injuries
• Infections, such as sinusitis and meningitis
• Diseases of the brain, such as tumours or aneurysms
• Vision problems, such as presbyopia or astigmatism

It is important to note that not all headaches are caused by serious health problems and that many headaches can be successfully treated with the right treatment and appropriate medical care.

Symptoms of headaches

Headache is a very common disorder that can affect various age groups and genders. The symptoms related to headache can be different and varied. 

In general, the main symptom is headacheThe headache may occur on one or both sides of the head. However, headaches may be accompanied by other symptoms that will vary depending on the type of headache.

Nausea, vomiting and other symptoms

Headache may be accompanied by a variety of symptoms such as nausea, vomiting, sensitivity to light and sound. These symptoms are more common in migraine and cluster headache. 

Migraine, for example, can be preceded by a series of symptoms ranging from impaired vision to tingling sensations in one part of the body to slurred speech (so-called migraine auras).

Chronic headache

Some people may experience chronic headachewhich is characterised by a headache that lasts more than four hours a day, at least 15 days a month. This symptom can affect people's quality of life and may limit their ability to perform daily tasks. People with chronic headache may experience depression, anxiety and other emotional symptoms.

Treatment of headache symptoms varies depending on the type of headache. However, in all cases it is important to monitor symptoms and seek medical attention if symptoms worsen or become chronic. Early diagnosis and treatment of headaches can help reduce the impact on people's quality of life.

Diagnosis of headaches

Diagnosis of headaches is made through a detailed medical evaluation including a physical and neurological examination as well as specific medical tests.

Physical and neurological examination

A physical and neurological examination is the first step in diagnosing headaches. During the physical examination, the doctor assesses the patient's head, neck, eyes, ears, nose and throat. A neurological examination may also be performed to detect any abnormalities in the central nervous system.

The doctor may ask about the patient's headache types, duration and frequency, triggers, associated symptoms, and previous head or neck injuries. He or she may also investigate whether the patient has a family history of migraine or other types of headaches.

Medical tests

If the physical and neurological examination does not provide a clear explanation for the patient's headaches, the physician may order specific medical tests to assist in the diagnosis. The most common tests include:

• Computed tomography (CT) o Magnetic Resonance Imaging (MRI)These tests are used to detect any abnormalities in the structure of the brain, such as tumours, haematomas or brain lesions.
  
  
• Lumbar puncture or cerebrospinal fluid (CSF) analysisThis test is performed to detect any inflammation or infection in the brain or spinal cord.
  
  
• Electroencephalogram (EEG)This test is used to detect any abnormal electrical activity in the brain.

Specific medical tests are important to determine the underlying cause of headaches and to rule out any other diseases that may be causing the patient's symptoms.

Treatment of headaches

The treatment of headaches can vary according to the type and frequency of headaches. Several treatment options are presented here, including painkillers and other medications, cognitive behavioural therapy, alternative treatments and headache prevention, in any case a neurologist should be consulted to determine the appropriate treatment in each case.

Painkillers and other medicines

• Over-the-counter painkillers, such as ibuprofen and paracetamol, can relieve mild to moderate headache pain. It is important not to take more than recommended and not to take them frequently, as this can make headaches worse in some cases.
  
  
• In cases of severe headache or migraine, doctors may prescribe specific medications such as triptans and non-steroidal anti-inflammatory drugs (NSAIDs). It is important not to overuse these drugs to avoid dependence and side effects.
  
  
• Tricyclic antidepressants and antiepileptic drugs are medicines used to prevent chronic headaches. They can also be effective in the prevention of migraine.
  
  
• Muscle relaxants can be used to relieve the pain associated with tension headache.

The cognitive behavioural therapy is a form of psychotherapy that can help people change the way they think and behave in the face of headache. It can encourage them to relax and reduce stress, promote a healthy routine and improve problems of insomnia and depression.

Alternative treatments

In addition to medication, there are several alternative treatments for headaches:

• The acupuncture can help reduce the frequency and intensity of headaches.
• The biofeedback is a technique that uses devices to measure body activity and provides the user with feedback to regulate the body's response to stress and pain.
• The massages, hot or cold compresses and ice therapy may also provide temporary headache relief.

Prevention of headaches

Some ways to prevent headaches include:

• Identify triggers (such as certain foods, drinks or environmental factors) and avoid them as much as possible.
• Adopt a healthy lifestyle that includes a balanced diet, regular exercise and a regular sleep pattern.
• Reduce stress by using relaxation techniques such as meditation or yoga.
• Avoid excessive alcohol consumption and smoking.

Global burden of headaches

The negative impact of headaches on public health is significant and affects all regions of the world.

An estimated 50% of the world's population has experienced some form of headache at some time in their lives. In addition, more than 10% of the population suffers from headaches on a regular basis, which has a high impact on their quality of life.

Global incidence and prevalence

Headaches are one of the leading causes of disability worldwide. According to the World Health Organisation, headaches rank third on the list of the most disabling diseases.

In Europe, it is estimated that almost one third of the population (31%) suffers from headaches, while in the United States the figure is around 12%. Women are more likely to suffer from migraines, which may be related to hormonal factors. In fact, it is estimated that three times as many women as men suffer from migraines. On the other hand, tension headache is the most common, affecting almost 80% of the population at some point in their lives.

Impact on people's quality of life

Headaches have a negative impact on the quality of life of those who suffer from them, due to their symptoms and prolonged pain. In addition to the physical burden of the disease, they can also have negative psychological effects, including depression, anxiety and social isolation.

The chronic headache can severely affect a person's ability to carry out daily activities, work and enjoy hobbies.

Economic losses

Headaches also have a significant impact on the economy, due to the direct and indirect costs associated with their treatment and work disability. According to studies, migraine alone is responsible for an annual cost of 27 billion US dollars in lost productivity.

In addition, people who suffer from chronic headaches are more likely to miss work and have problems staying at work.

Frequently asked questions about headaches

Headaches are a common disorder of the nervous system that can be caused by a variety of factors. Here are answers to some frequently asked questions about headaches.

What is rebound headache?

The rebound headache is a type of headache that occurs as a result of too frequent use of headache medication. Overuse of over-the-counter or prescription painkillers can lead to rebound headache. This type of headache is more common in people who have suffered from headaches for a long period of time and have taken medication frequently.

The rebound headache treatment is to reduce the use of medication. It is important to talk to a doctor about how to do this safely and effectively.

How are chronic headaches treated?

The treatment of chronic headaches may involve the use of various medications, such as painkillers, tricyclic antidepressants and muscle relaxants, as well as cognitive behavioural therapy and alternative treatments such as acupuncture, biofeedback and massage. It is essential to talk to a doctor about the symptoms and seek a proper diagnosis before starting treatment.

The prevention of chronic headache can involve lifestyle changes, such as reducing stress, maintaining a regular sleep schedule and avoiding known triggers.

Are there differences in headache incidence and prevalence by age, gender and race?

Yes, there are differences in the incidence and prevalence of headaches by age, gender and race. Women are more likely to suffer from migraines and chronic headaches than men. Older people are also more likely to experience chronic headaches.

In terms of race, people of African descent have a higher frequency of chronic migraines. It is important to talk to a doctor about any headache symptoms and seek a proper diagnosis in order to receive appropriate treatment.