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Headache

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Headache
Summary
  • Primary Headaches include migraine, cluster and tension Headaches.
  • A Migraine is a severe form of headache that lasts from 4 to 72 hours.
  • Secondary Headaches are a symptom of an underlying disorder such as infection; tumour; hypertension and diseases of the eyes, nose and throat.
Description

Headaches can be classified as primary or secondary. Primary Headaches include migraine, cluster and tension Headaches. Secondary Headaches are a symptom of an underlying disorder such as infection; tumour; hypertension and diseases of the eyes, nose and throat 1.

PRIMARY HEADACHES INCLUDE:

  • Migraine: is a severe form of headache that lasts from 4 to 72 hours2. Migraine attacks are usually unilateral (on one side only), involve moderate or severe pain and are pulsating3. Other symptoms may include nausea, vomiting and avoidance of light (photophobia). Between 10 and 20% of Migraine sufferers experience what is called an 'aura'. This is a sensation that warns them of a Migraine attack. An aura may be a visual sensation (e.g. blurred vision, flashing lights, spots in front of the eyes), difficulty speaking or numbness or tingling sensations. Auras occur about one hour or less before the Migraine starts. Migraines can occur at any age but usually start between the ages of 10 and 40 and occur more often in women than in men4. See the Migraine topic on the Healthpoint for further information.

  • Cluster: headache usually begins suddenly and lasts for under an hour. It often begins with an itching or watery discharge from one nostril, followed by intense pain on the nostril-affected side of the head, which spreads around the eye. After the Headache has gone, the eyelid on the pain-affected side of the face may droop. People usually experience a number of Cluster Headaches over a period of 6 to 8 weeks. The Cluster Headaches then go away for a period of several months but usually recur.5 See the Cluster Headache topic on the Healthpoint for further information.

  • Tension Headache: is a type of headache caused by muscle tension in the neck, shoulders and head. The muscle tension which causes Tension Headache may be the result of being in an uncomfortable body position, stress or fatigue. 6 See the Tension Headache topic on the Healthpoint for further information.
  • Management

    Always consult your Doctor for diagnosis and advice. In no way is this information intended to replace the advice of a medical practitioner.

    In order to determine the cause of the Headache, a Doctor will need to know how often the Headache occurs, how long it lasts for, how severe the pain is; what makes it better or worse and other symptoms experienced with the Headache. Your Doctor may order certain tests to help with this assessment.
    Treatment of primary Headaches will depend on the Headache type. Treatment of secondary Headaches involves treating the underlying disorder7.


    Lifestyle

    Diet Hints

    Food sensitivities may be a causative factor for some Headache sufferers8.
    Caffeine intake is linked with Headaches. The withdrawal from regular caffeine consumption may also cause Headaches9.

    Cheese and chocolate have been linked with Headaches, which may be due to their phenylethylamine content10.

    Other food sensitivities linked with Headaches include milk, nitrates and nitrites (e.g. hot dogs and other cured meats) and tyramine-containing foods (e.g. aged cheeses, some red wines, fermented sausages, sour cream, etc). Aspartame (artificial sweetener) may also cause Headaches11. Manipulation of dietary fatty acids may be a useful tool in treatment of Headaches. It has been shown that reducing the consumption of animal fats and increasing the consumption of fish can play a beneficial role in Headache control12.

    • Eat a healthy diet.
    • Eat regular meals - avoid skipping meals.
    • Limit the amount of caffeine and alcohol you consume.13
  • Pharmacist's Advice

    Ask your Pharmacist for advice.

    1. Follow the Diet Hints.
    2. Avoid stress as far as possible.
    3. Lower the intake of caffeine. Caffeine-containing drinks include tea, coffee and cola drinks.
    4. Use a cold pack on the forehead and rest in a darkened room. Your Pharmacist will help choose a cold pack.
    5. Ask your Pharmacist about some pain relieving products.
    6. Keep the bowels regular. Ask your Pharmacist for advice on suitable fibre products.
    7. If the diet is inadequate, consider some supplements.
    8. Relief may be obtained by taking a warm bath and adding some bath salts containing Epsom Salts. This salt contains magnesium which is a muscle relaxant.
  • Notes

    See your Doctor immediately if any of the following symptoms are present:14 - Visual disturbances, in particular, a blind spot, tunnel vision, blurring of central vision or visual hallucinations.

    • Stiff neck.
    • Any speech difficulties, numbness, weakness or lack of coordination. 
    • Severe throbbing in either or both temples, in conjunction with generalised joint and muscle pain.
    • A morning Headache that is made worse by lying down but improves after an hour or two.
    • Headaches that are made worse by straining, coughing, sneezing or laughing. 


    References

    1. Beers M and Berkow R (eds). The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station (N.J.); Merck Research laboratories: 1999.
    2. Beers M and Berkow R (eds). The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station (N.J.); Merck Research laboratories: 1999.
    3. Dowson, A. Migraine. The Pharmaceutical Journal 2000 Oct; 265(7117):519-23.
    4. Beers M and Berkow R (eds). The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station (N.J.); Merck Research laboratories: 1999.
    5. Merck Manual Home Edition. Cluster Headaches. [cited 2002 Jul 22]. Available from: URL: http://www.merckhomeedition.com/interactive/data/s06/c062/0606203.htm.
    6. Merck Manual Home Edition. Tension Headaches. [cited 2002 Jul 24]. Available from: URL: http://www.merckhomeedition.com/home.html.
    7. Beers M and Berkow R (eds). The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station (N.J.); Merck Research laboratories: 1999.
    8. Mansfield-LE. Food allergy and migraine: Whom to evaluate and how to treat. Postgrad Med; 83 (7): 46-55, 1988.
    9. Huges-JR et al. Caffeine self-administration, withdrawal, and adverse effects among coffee drinkers. Arch Gen Psychiatry 48: 611-17, 1991.
    10. Sandler-M, et al. A phenylethylamine oxidising defect in migraine. Nature 250:335, 1974. 
    11. Lipton-R, et al. Aspartame as a dietary trigger of headache. Headache 29:90-92, 1989. 
    12. Murray-M; Pizzorno-J. Encyclopaedia of Natural Medicine, 1990. Little, Brown and Company, UK, p416.
    13. HealingWell.com. Headache Facts: What Everyone Should Know.[cited 2002 July 23]. Available from: URL: http://www.healingwell.com/library/migraines/info8.asp.
    14. Dight, D. Headaches. A need for caution. Australian Pharmacist 2000 Aug; 19(7):408-14.
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