Most people will experience a headache of some kind during their lifetime. For some it’s a one-off minor irritation, but for others headaches can be severe, affecting an individual’s work, study and day to day activities.
In the US, around 50 to 60 million people suffer from headaches. In around four per cent of cases, the headaches are severe enough to send people to the Emergency Room.
Headache is a term broadly used to describe all types of pain in the head or upper neck. There is no single cause of headache, just as there is no single set of symptoms.
Generally speaking, headaches fall into four main categories: sinus, cluster, tension and migraine, each with different symptoms.
Sinus pain is usually felt as pressure in the sinus cavities, behind the brow bone and/or cheekbones, which may intensify with sudden movement or straining.
Cluster headaches are felt in and around one eye or on one side of the head and usually occur in ‘clusters’ over the course of several weeks or months. The pain is intense and often described as having a piercing or burning quality that is throbbing or constant. Most sufferers experience one to two cluster cycles per year.
Tension or stress headaches are the most common type of headache in adults and symptoms are often described as the feeling of tightness, or pressure around the forehead or back of the head and neck.
Tension headaches vary in intensity but are characterised by a pain that is almost always present. Tension headaches do not affect vision, balance or strength.
Migraine, a moderate to severe type of headache, is often accompanied by blurred vision, light sensitivity, sound sensitivity, nausea or vomiting, loss of appetite, dizziness, fatigue and bright flashing lights or dots. The pain may affect the whole head or can shift from one side to the other.
Of the millions of people affected by headaches worldwide, an estimated 20 per cent suffer from migraines. The causes are not known, but what is known is that it is genetic and that women suffer from them more than men, says Dr. Risa Ravitz, a board certified doctor of psychiatry and neurology who specialises in headache medicine. Ravitz visits the Cayman Neurology Pain Management clinic, in the West Shore Plaza, West Bay Road, on a monthly basis.
“This type of headache is very common and debilitating and is a frequent reason to miss work and daily activities and often is painful enough to bring people into an emergency room,” says Ravitz. “These types of headaches are treated with over-the-counter medicines, migraine specific prescription medications, seizure medicines and antidepressants and, more recently, Botox.”
Patients attending the Headache Clinic may undergo a series of diagnostic tests, including imaging studies and other tests to determine whether they may be underlying causes for the headaches, such as tumours, strokes or infection, explains Dr Ravitz.
Medications may be prescribed both for pain relief and as preventive measures.
A more recent treatment for migraines, she adds, is Botox.
Botulinum Toxin was licensed for the treatment of chronic migraine in July 2010. Injections of Botox around the head and neck at 12 week intervals have been found to dull future headache symptoms, in individuals who suffer from migraines 15 or more days per month.
“Most of the insurance plans cover these investigations and treatment,” says Ravitz.
As with many chronic conditions, a healthy lifestyle can help to alleviate symptoms.
“Patients who have headaches should maintain a regular schedule,” Ravitz advises. “This should include regular sleep, five to six glasses of water per day, regular cardiovascular exercise, no caffeine, and no smoking. Certain foods, such as MSG and nitrates should be avoided.” People who suffer from recurring headaches often believe they just have to learn to “live with it”. New diagnostic tools and treatments however, mean that up to 75 per cent of headaches can be successfully treated.