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Video: Treating problem headaches

TODAY
updated 7/20/2008 9:59:03 AM ET 2008-07-20T13:59:03

It's critical to identify which type of headache you suffer from so that the correct treatment can be prescribed. In one 2004 study, 80 percent of patients with a recent history of self-described or doctor-diagnosed sinus headache — but none of the signs of sinus infection — actually met the criteria for migraine. And two-thirds of those patients expressed dissatisfaction with the medications they were using to treat their headaches. Health.com has a cheat sheet to help you put a name to your pain and how to treat it.

Tension headaches
Tension headaches, the most common type, feel like a constant ache or pressure around the head, especially at the temples or back of the head and neck. Not as severe as migraines, they are not usually accompanied by nausea and vomiting, and they rarely stop someone from continuing their regular activities.

What to do: Over-the-counter treatments, such as aspirin, ibuprofen or acetaminophen (Tylenol), are usually sufficient to treat tension headaches, which experts believe may be caused by contraction of neck and scalp muscles (including in response to stress), and possibly changes in brain chemicals.

Cluster headaches
Cluster headaches, which affect men more often than women, are recurring headaches that occur in groups or cycles. The headaches appear suddenly and are characterized by severe, debilitating pain on one side of the head, often accompanied by a watery eye and nasal congestion or a runny nose on the same side of the face. During an attack, sufferers are often restless and unable to get comfortable and not likely to lie down the way someone with a migraine usually does. The cause of cluster headaches is unknown, but they may have some genetic component.

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What to do: There is no cure, but medications such as Verapamil or Lithium can reduce the frequency and duration of attacks. Breathing in 100 percent oxygen can also treat these headaches in many cases.

Sinus headaches
When a sinus becomes inflamed, usually through an infection, it can cause pain. It usually comes with a fever, and can — if necessary — be diagnosed by MRI or CT scan (which can both detect changes in fluid levels), or by the presence of pus viewed through a fiber-optic scope.

What to do: Headaches due to sinus infection can be treated with antibiotics, as well as antihistamines or decongestants.

Rebound headaches
Overuse of painkillers for headaches can, ironically, lead to rebound headaches. Culprits include over-the-counter medications like aspirin, acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), as well as prescription drugs. One theory is that too much medication can cause the brain to shift into an excited state, triggering more headaches. Another is that the headaches are a symptom of withdrawal as the level of medicine drops in the bloodstream.

What to do: The most effective treatment is to slowly wean yourself off headache medicines — especially painkillers. Even better is prevention: Do not use any acute headache medicine more than 10 days per month.


Migraine headaches
Migraine headaches come from a neurological disorder that can run in families and are defined by certain criteria.

At least five previous episodes of headaches
Lasting between four hours and 72 hours
Having at least two out of four of these features: one-sided pain, throbbing pain, moderate-to-severe pain, and pain that interferes with, is worsened by, or prohibits routine activity
Having at least one associated feature: nausea and/or vomiting, or, if those are not present, then sensitivity to light and sound.

An oncoming migraine attack may, for some, be foreshadowed by an aura, which can include visual distortions (such as wavy lines or blind spots) or numbness of a hand. It's estimated, though, that only 15 percent to 20 percent of migraineurs experience this.

What to do: Mild migraines may respond to over-the-counter medicines like ibuprofen or naproxen, or acetaminophen. For more severe migraines a prescription medicine may be required.

For more health tips and news, visit www.Health.com

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