A headache
April 8, 2008
A headache is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. It ranks amongst the most common local pain complaints.
The vast majority of headaches are benign and self-limiting. Common causes are tension, migraine, eyestrain, dehydration, low blood sugar, and sinusitis. Rare are headaches due to life-threatening conditions such as meningitis, encephalitis, cerebral aneurysms, extremely high blood pressure, and brain tumors. When the headache occurs in conjunction with a head injury the cause is usually quite evident.
Treatment of an uncomplicated headache is usually symptomatic with over-the-counter painkillers such as aspirin, paracetamol, or ibuprofen, although some specific forms of headaches may demand other, more suitable treatment. It may be possible to relate the occurrence of a headache to other particular triggers, which can then be avoided.
Diagnosis for headaches
While, statistically, headaches are most likely to be harmless and self-limiting, some specific headache syndromes may demand specific treatment or may be warning signals of more serious disorders. Some headache subtypes are characterized by a specific pattern of symptoms, and no further testing may be necessary, while others may prompt further diagnostic tests.
Headache associated with specific symptoms may warrant urgent medical attention, particularly sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person with no previous history of headaches; and recurring headache in children.
The most important step in diagnosing a headache is for the physician to take a careful history and to examine the patient. In the majority of cases the diagnosis will be a “primary headache” which means that the headache, whilst unpleasant is not an occurring as a manifestation of a more serious condition. The main types of primary headache are tension headache, migraine and the trigeminal autonomic cephalalgias of which cluster headache is an example. As it is often difficult for patients to recall the precise details regarding each headache, it is often useful for the sufferer to fill-out a “headache diary” detailing the characteristics of the headache. When the headache does not clearly fit into one of the recognized primary headache syndromes or when atypical symptoms or signs are present then further investigations are justified. Computed tomography scans of the brain or sinuses are commonly performed, or magnetic resonance imaging in specific settings. Blood tests may help narrow down the differential diagnosis, but are rarely confirmatory of specific headache forms.
Great informative piece, Larry.
I’d like to add that chronic tension headaches are often caused by poor workplace posture. People who work at computers all day long are especially vulnerable.
This is because people tend to hunch over while at their computers, with their backs stretched out and shoulders rolled in. Worse, they tend to crane their heads toward the computer screen.
The effects of this posturing are tightness and muscle spasms in the neck, shoulders and upper back, which restrict blood flow to the back of the head and irritate nerve endings there, which in turn causes chronic tension headaches.
So, working in better posture goes a long way toward preventing tension headaches.