The Problem

Millions of working hours are lost every year because of headache and yet they seem to be shrugged off by many of those who do not suffer from them. Worst of all, though, is that while there is research into the causes of some times of primary headache, interest in and funding for such research seems to be limited. It has also been suggested that headaches are given insufficient attention in medical schools. Consequently, it is believed by some that doctors quite often misdiagnose headaches.

Types of Headache

I have already used the expression "primary headache". Headaches can be classified under three main headings: primary headaches, secondary headachse, and neuralgias and facial pain although some writers on the subject list the third group as primary headaches.
In the primary group, tension headaches are the most common type followed by migraine and then cluster headaches.
Secondary headaches are those which are caused by some other disorder such as sinusitis, cervical vascular disorder, substance withdrawal or over-medication. These headaches are, of course, dealt with by treating the underlying cause; sometimes easier said than done, however.

Treatment

Many primary headaches, even migraine headaches which, with cluster headaches, are often claimed to be the most severe, can often be easily treated with over-the-counter medication. However, when a medical practitioner is not consulted, it is easy to fall foul of "rebound headaches", headaches caused by over-medication which is sometimes thought to over-excite the brain and thus causing more head pain. Such headaches may also be symptomatic of withdrawal from the medication, leading (as with illegal substances!) to even more use. Even prescribed medicine, when not as effective as the patient hopes, can, without appropriate advice, be used to excess also resulting in rebound headache.

Preventatives

Initially, however, it is advised that sufferers should keep a migraine diary in which they note when the headaches occur and under what conditions. As certain foods and drinks can trigger migraine, e.g. coffee, cheese, red wine, citrus fruits, it is a good idea to include in the diary a record of what possible trigger foods and drinks have been consumed.

If the headaches persist, despite dietary control, over-the-counter treatments and prescribed

medicines, preventative measures should be discussed with the doctor. Prophylactics, however, are powerful drugs and the side effects can be rather unpleasant for some patients. Such preventatives include triptans, beta-blockers, serotonin antagonists, and even anti-convulsants which are usually prescribed for epilepsy.

Surgery

Surgical treatments are possible but are appropriate and effective for only a minority of sufferers.

Alternative Therapies

Alternative remedies abound, herbal, chiropractic, acupuncture, hypnosis among numerous others but usually they are costly and the results often disappointing.

Much more research is needed into the cause and treatment of headaches, in particular of primary headaches. We can only hope that the coming decade will be when it happens!
John Murphy

www.migrainerelieffast.com