Manage Your Headache

By Dr. Neeladri Misra, Internist, Roseville, CA

Waking up with a headache is one of the most uncomfortable feelings. According to statistics, headaches are the second most common reason patients visit a doctor, after lower back pain. About one-third of adults experience chronic headaches that disrupt daily activities. Fortunately, less than 2 percent of headaches are due to serious conditions.

Identifying Your Headache

Migraines

• Caused by vasodilation (blood vessel swelling) in the head.
• Often accompanied by an aura (e.g., ringing in ears, bright flashes, unpleasant smells), but not always.
• Typically one-sided, causing a dull to sharp sensation.
• Light sensitivity and relief in dark rooms are common.

Non-Migraines

• Include cluster headaches, tension headaches, high blood pressure, low blood sugar, sinus infections, eye strain, and tooth pain.
• Tension headaches often occur at the end of the day.
• Cluster headaches come in episodes over days or years.
• Diabetics should check blood sugar during headaches.
• Withdrawal headaches from caffeine, alcohol, or medication changes.
• Tooth pain and sinus infections can cause headaches.
• Eye strain, particularly in children, can lead to headaches.

What to Do if You Have a Headache

Initial Steps

• Close your eyes, take deep breaths, and take a 15-minute break in a quiet place.
• Massage the headache area with your fingers. Use pain balm or essential oils if available.

For Migraines

• Use caffeine to constrict blood vessels.
• Take acetaminophen (Tylenol) or Aleve (Naproxen) with caffeine.
• If headaches persist for 1-2 days, consult a doctor for Triptans (available in tablets, sprays, and injections).
• Frequent migraines may require preventive medication.

For Non-Migraines

• Eye Strain: Get an eye test to rule out eye problems.
• Sinus and Toothache Headaches: Identify sinus pain by pressing gently. Use steam, a Neti pot, or sinus spray for relief. See a doctor if accompanied by cough or fever.
• High Blood Pressure: Check BP; if above 180 mmHg, seek medical help.
• Tension Headaches: Feel like a band across the head. Treat with caffeine, Aleve, acetaminophen, or a nap. Chronic tension headaches may indicate job-related stress.
• Cluster Headaches: Require evaluation by a physician and possibly a neurologist.
• Low Blood Sugar: Check blood sugar if diabetic. Eat something if you haven’t eaten for a while.

When to Seek Immediate Attention

1. Morning headache with vomiting: Could indicate brain tumors.
2. Dizziness and headache: Could be inner ear problems, tumors, or infections.
3. Pulsating headaches near the eye: Require medical evaluation.
4. Headache after head injury: Needs urgent evaluation.
5. Headache with vision loss: Could indicate temporal arteritis.
6. Strokes: May present as headaches with weakness in hands, legs, or face.

Most headaches will resolve within a few days and don’t warrant any further medical attention. However, certain symptoms warrant immediate medical attention. Understanding your headache type can help you manage it effectively.

 

(Misra is a hospitalist who is interested in managing diseases through lifestyle changes.)

Manage Your Headache