You know how it feels. You didn’t sleep well last night and have been working a long, stressful day then start having this awful pain in your head to make your day even more fun. Or perhaps you were drinking the night before and are having a hangover? Or perhaps you hit your head, or slept funny and now your head hurts – A LOT. Or maybe just out of the blue, your head starts banging. Whatever the reason, headaches are a very common problem with some fortunate souls having more problems than others.
How headaches work
Headaches happen because of a variety of reasons. Most often they are from muscles tightening or being stretched on your head or neck resulting in overly sensitive pain receptors in your brain. Other times they are due to temporary abnormalities in the way signals are sent in your brain. Another reason is that the blood vessels in your brain react to less water in your brain, or blood, resulting in them getting larger (or sometimes smaller) and activating pain receptors in your brain. Whatever the actual mechanism, headaches are not fun to deal with.
Types of headaches
Over 90% of headaches can be classified into a few categories and others cannot really be classified. Everyone has a slightly different way they experience a headache as well. Most people when they complain of a “headache” they are referring to a tension-type headache. These are generally from tight muscles in your head or neck due to having too much stress, or any number of reasons. Tension headaches feel like someone put a really tight helmet on your head. Though generally not considered as severe as other types of headaches, anyone can tell you they can really put a damper on your day, which is about how long they last.
Migraines are the next most common type of headache. They typically involve one region of your head with a more throbbing or shooting pain. Migraines can last from hours to a few days. Sometimes, before the headache itself people experience what is called an “aura” – this is a kind of warning that indicates the migraine is about to happen. Typically people with auras will report that they had some vision loss, or smell issue, or other problems with their senses. Others do not experience any aura prior to a migraine. People with these headaches also tend to have them more regularly and not necessarily related to any specific cause. In addition, migraines sometimes have other features and referred to as “complex migraines” where you may have some other physical issue other than the headache itself.
One final type is the cluster headache. These are relatively rare and affect mostly men. They usually have a presentation where part of your face or head has extreme, stabbing pain. It is among the most painful experiences someone can have but typically last less than an hour (often around 20 minutes).
*Note that if you are having “the worst headache of your life” and have never had a cluster headache before, please go to the nearest emergency room as you could be having a potentially fatal problem called a subarachnoid hemorrhage. Also, if you have a headache that keeps getting worse and is not getting better after a few days, you should also see a provider, as this could indicate something wrong in your brain that cannot be treated with headache medicine alone.
How to treat headaches
Treating tension headaches
If you have a tension type headache, then they usually get better with acetaminophen (tylenol) or ibuprofen (motrin) combined with time (1-2 days). If these medications are not enough you can also try drinking something with caffeine (some headache medicines even combine caffeine with acetaminophen) or using a heat pack. Equally important is trying to avoid the headache to begin with. Easier said than done. But simple tips that you should be doing anyways even if you don’t have problems with headaches include: stay hydrated with regular water intake, try to avoid stress and consider daily exercise with a healthy diet.
When treating migraines, you can use the same approach as tension headaches but given that migraines are generally considered to be more severe, and sometimes occur more often in those affected, there are other treatments involved. At this point you would want to consider seeking the help of a specialist such as a neurologist or other physician/care provider that specializes in treating headaches.
The treatments differ depending on if you have more than 8 a month or seemingly ALL THE TIME (chronic migraines) or less than 8 a month (episodic migraines). They also depend on other features of your migraines or if you have other medical issues. Regardless, people focus on medicines to avoid migraines in the first place (preventative therapies) and if that doesn’t work – medicines to treat migraines once you have them (abortive or acute therapies).
Remember, there are multiple ways to have migraines or headaches in general. They could be problems with signals in your brain, or problems with blood vessels reacting with receptors in your brain, or any number of reasons. Because of this, medicines to avoid migraines are often used for other medical problems. Your doctor may prescribe you blood pressure medicines, antidepressants, seizure medicines, or other treatments for your migraines. You may even find yourself getting injections or other procedures. But anyone that has experienced a migraine knows that it is easier to go through the effort of trying to avoid migraines in the first place than trying to get rid of the migraine once you experience it. There are different options to treat migraines once you have them (the acute therapies) including a medication class known as “triptans.” Often you have to work with your doctor to try different treatment options to find what works for you.
Treating cluster headaches
If you are unlucky enough to have cluster headaches, you have probably also tried all these medications. One of the few treatments that help with cluster headaches is the use of oxygen. Other treatments exist but typically people have to wait for the cluster to end.
Don’t give up
Headaches can be awful to experience. You or someone you know may even have enough trouble that you have even sought help with dealing with a headache. It is possible that the treatment you had wasn’t successful because there is no one treatment that works for everyone. Luckily, our knowledge with medicines and other options to treat headaches is much better than it was decades ago. With the help of a qualified professional, you can conquer your headaches and live a better life.