Headaches: Common strategies to deal with a common problem

Most people have experienced headaches at least once in their lifetime. There are many well-known therapies available, but what does your headache really mean, and how to deal with it accordingly?

What is it?

Headaches refer to pain in the head region and are the most common type of head complaint. Recurrent headaches affect more than 40% of the population. Pain can be classified into different types:

1. Primary type headache: usually recurrent and not associated with underlying conditions. Includes tension-type headaches that can be episodic (once-off) or chronic (happens often) as well as migraines

2. Secondary type headache: type of headache caused by a combination of underlying conditions. Includes sinus headache brought about by cold and allergy, as well as head trauma or vascular defects.

Tension-type headaches are usually due to muscle contraction or stress and are more common in females. It usually occurs between 20-50 years old and is usually triggered by stress, anxiety, depression, emotional conflicts, and fatigue. It can be further divided into episodic or chronic types based on the number of days with headaches per month.

Episodic headache is when the headache is present for less than 14 days a month and Chronic headache is when the headache is present for more than 14 days per month on an average throughout 3 months.

Migraines are when there is more pain compared to the strain felt in tension-type headaches. The nature of the pain is usually of a throbbing nature and is normally felt only on one side of the head. The pain usually lasts between 4-72 hours and occur usually early in the morning. Some people may even feel an aura (shimmering/flashing areas/ blindspots in the visual area.

Cluster headaches are a more severe form of primary headaches and normally only present on one side of the head. It can last weeks to months and can be episodic or chronic. It is more likely in men and is uncommon.

Sinus headaches are usually reported in people with acute/chronic sinusitis (blocked nose). It occurs due to the inflammation which is secondary to the infection/blockage of the sinuses (cavities in the bones around the nose). It is usually felt upon wakening and blowing of the nose. Pain/pressure around the eyes, cheeks, and forehead is usually felt.

Headaches can also be triggered by the menstrual cycle. Ladies should be taking note of their menstrual cycle and see if it corresponds with the onset of headaches regularly.

The above list is not exhaustive. There are many types of headaches, each having a different set of accompanying symptoms and arising from a myriad of different reasons. Do seek medical help if the headache is interfering with daily life.

If you still have any concerns, do head down to your local pharmacy. Our community pharmacists are always more than happy to help!

What are some of the dangerous symptoms to take note of?

If you hit your head and injured it before the onset of a headache that is persistent and also shows symptoms of vomiting, you should visit a medical professional for help as it may be indicative of internal bleeding caused by trauma.

Do visit a medical professional as well if you feel stiffness in your neck together with a throbbing headache. This is a sign of meningitis, which is the inflammation of nerves within the nervous system. It is a dangerous condition that can cause paralysis and eventually death.

Nausea and vomiting accompanying the headache can also be due to internal bleeding, thus if you feel these symptoms together, it is advisable to consult a healthcare professional.

Common medications?

The most common medication your local pharmacist will suggest is Panadol. The active ingredient within Panadol is paracetamol (Known as acetaminophen in the US). Paracetamol is a common medication for pain and is generally safe to use. Your pharmacist may also recommend a combination product that may be more effective.

You may also choose to ask for other forms of painkillers, such as aspirin, but aspirin comes along with side effects, such as bleeding and prolonged wound healing, which can be dangerous if you are at high risk of bleeding. Most brands nowadays also do not contain the strength required to help with headaches (300mg), thus it is less likely used today.

Other common medications used are ibuprofen and naproxen, which are recommended if one is allergic to paracetamol. However, they can cause stomach discomfort if used long-term, resulting in them not being the first-line medications given to people with headaches.

You may have also heard of opioid painkillers. However, as they are a form of narcotic pain killers, they can only be obtained via prescriptions. Also, due to potential addiction, they are seldom used for headaches, especially those of mild to moderate severity.

How do you prevent headaches?

1. Keep a headache diary, to identify some of the trigger factors of your headaches.
   

2. Do relaxation exercises and breathe deeply. This is important in getting more oxygen into the body.
   

3. Sleep enough and at regular timings. This is useful in helping the body regenerate and prevent headaches caused by stress and overexertion.
   

4. Eat a balanced diet. A balanced diet can help with regulation of bodily functions that can help with headache.
   

5. Stress management. Both physical and psychological stress should be avoided. This can be done via mind-body therapy. It is said that stress management can also help with managing other problems such as insomnia, test anxiety, and other types of chronic pain.
   

6. Regular exercise should also be done
   

7. Avoid chocolate and caffeine, as they are well-known as triggers of headaches.

Complementary medications:

The most common form of complementary treatment used for headaches and migraines is acupressure and massage, to relieve tension in the muscles, and prevent tension-type headaches.

Vitamins can also be taken to prevent headaches. Vitamin B2 is known to help reduce the frequency, severity, and duration of migraine headaches. Calcium is also frequently used in adolescent girls as more than 50% of adolescent girls do not meet their daily requirement for calcium through diet alone and supplements are known to help with menstrual-related migraines. Magnesium is also known to help as well, especially in the US, where the diet of a typical American teenager is relatively deficient in magnesium-rich foods.

Essential fatty acids found in fish oil are also associated with significant reductions in headache frequency and severity, but improvements were not significantly better than in patients who took olive oil.

Butterbur can be used for a significant reduction in the frequency of migraine headaches. However, it can cause possible adverse effects including nausea, vomiting, diarrhea, and constipation.

Feverfew is frequently taken to prevent adult migraines. However, patients may experience rebound headaches if they take feverfew for a long period of time and stop suddenly. If you are interested in taking feverfew, do consult your healthcare professional and use standardized products from reputable manufacturers.

Coenzyme Q10 is also said to be able to help with headaches. It mainly acts by increasing antioxidants within the body. However, it is used mainly for migraine headaches and its effects are not as well known.

Useful links:

Kemper, K. J., & Breuner, C. C. (2010). Complementary, holistic, and integrative medicine: headaches. Pediatrics in Review, 31(2), e17. (Accessible here)