A heads-up on headaches

Posted on 26 May 2017

We asked Dr Yaseen Yacoob, specialist neurologist at Mediclinic Pietermaritzburg, about common causes and treatments of headaches – and how they’re classified.  

Headache or migraine?

When your head hurts, it’s important to distinguish between headaches and migraines, because it means you can get more effective treatment for faster relief. In short, a headache is usually a dull pressure that occurs mostly around the forehead, but also around the temples or back of your neck, affecting both sides of the head. Migraines, on the other hand, are intense, throbbing pains usually on one side of the head, and come with other symptoms like nausea and dizziness.

Types of headaches

Dr Yacoob explains that the main types of severe headaches, or primary headaches, are tension headaches and cluster headaches.

• Tension headaches feel like a tight band around your head and are the most common type of headache people experience.
• Cluster headaches, a series of relatively short-lived but extremely painful headaches that occur every day for weeks or months at a time, often occurring around the eyes. This type is quite rare and can be mistaken for seasonal allergies because they may only occur at a certain time of the year. These can be more severe than a migraine but usually don’t last as long.

Headaches are also classified as either acute or chronic:

• Acute: Headaches that clear up overnight or so. They hurt, but don’t hang around too long.
• Chronic: If you experience headaches for more than 15 days per month over the course of at least three months, it’s considered to be chronic.

Scientists aren’t really sure what exactly causes primary headaches, but it is believed there are a number of contributing factors, including:

• Sinusitis
• Poor posture
• Stress
• Alcohol
• Irregular sleeping patterns

There is also a condition called secondary headaches, where examples include headaches from drug abuse/ withdrawals or trauma-related headaches.

‘Some headaches may even be a manifestation of vascular (blood vessel related), inflammatory or psychiatric disturbances, which may not be easy to pick up on routine examination. This is where radiological investigations are often required,’ says Dr Yacoob.

Treating the tormentor

‘For most headaches, simple over-the-counter analgesics like paracetamol is usually the first line of treatment’, says Dr Yacoob. ‘If the headache is persistent and/or doesn’t settle with simple analgesics, you should seek professional medical help.’

However, he cautions to steer clear of non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen, as these may affect the gastric lining and kidney function, among other side effects, if taken over a long period of time.

Prevention is better than cure

While there is still a debate about what exactly causes headaches, and thereby how one can avoid them, Dr Yacoob advises that a healthy lifestyle can go a long way to preventing headaches:

• Follow a healthy diet and avoiding stimulants
• Get enough sleep
• Try to steer clear of too much stress
• Exercise regularly