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Headaches: What a pain

How common are headaches?

More than 50 percent of adults reported having a headache in the last year, according to the World Health Organization. A 2013 Global Burden of Disease study found that worldwide, headache disorders are the third highest cause of years of life lost due to disability. That means headache sufferers are more likely to miss important work days, family affairs and social gatherings. Yet, headaches remain undertreated and underdiagnosed.

Most common types of headaches

Migraine headaches tend to be more common in women than men, and are usually the worst for people in their 30s and 40s. Attacks tend to be on one side of the head, throbbing in quality, and lasting hours to days. They are commonly associated with nausea and vomiting, light and sound sensitivity, and can occasionally be preceded with an aura, or changes in vision or speech, prior to the onset of the attack, like a warning of what is to come.

Tension headaches are the most common headache. They tend to affect women more than men and are associated with stress and musculoskeletal problems in the neck. These headaches usually last for hours, not days. The attacks are described like a band around the head, pressure-like in quality, and spreading to or from the neck. Tension headaches affect three in four people during their lifetime.

Cluster headaches are relatively uncommon but unlike other headaches, they tend to affect men more than women. The attacks are brief, but cause severe pain on one side of the head, usually around the eye, and can be associated with a runny nose, eye watering, and an eyelid droop on that side. These headaches can occur many times in one day.

Medication overuse headache, formerly called “rebound headache,” is caused by chronic overuse of headache medications used for acute treatment. These types of headaches are generally seen in people ineffectively using pain-relief medications for headache more than two to three days weekly. The character and location of attacks vary but the headache is usually present nearly daily and on awakening. Medication overuse headaches are treated by stopping the acute pain medications and starting preventive medications and alternative non-medical therapies.

Warning “red flag” headache, also called a “thunderclap headache,” is any headache associated with a fever, weight loss, persistent vision changes, numbness or weakness, problems with speech or trouble concentrating. If you have this type of headache, you may be referred to an emergency department or hospital for imaging tests of your brain, such as an MRI or imaging of the blood vessels that supply the brain.

How are headaches treated?

Treatment varies depending on the type of headache. Your doctor can prescribe daily preventive medications as well as “abortive” medications to be used during an attack. There are also new therapies, such as injections of monoclonal antibodies, that target CGRP, a protein that is associated with migraines, nerve blocks given via injection or dripped in the nose, and even Botox injections into the head or neck.

At home, acetaminophen, ibuprofen and naproxen can all be used for acute treatment, but should be limited to three to four times per week to avoid an overuse headache. Over-the-counter vitamin D, B and magnesium supplements may be recommended by your doctor.

The four most common headache triggers are:

  • Caffeine
  • Chocolate
  • Sleeping too much or having lazy days
  • Weather

Help prevent or lessen headaches by:

  • Controlling your stress
  • Getting enough sleep
  • Drinking plenty of water

If your headache persists, speak to your doctor.

Sources: American Headache Society; American Migraine Foundation: World Health Organization