Headaches are a prevalent medical condition that can result in mild to severe discomfort in the head, scalp, or neck. Migraines, a specific type of headache, are characterized by intense, throbbing pain and are often accompanied by symptoms such as nausea, vomiting, and heightened sensitivity to light and sound.
A headache refers to pain or discomfort in the head, scalp, or neck, and it is a common affliction experienced by most individuals at some point in their lives. Headaches vary in intensity, ranging from mild to severe, and can manifest as either acute (short-term) or chronic (long-term). There are several types of headaches, including tension headaches, migraines, sinus headaches, and cluster headaches.
Signs and Symptoms
Tension-type Headache, also known as muscle contraction headache, induces a dull and diffuse pain at the base of the head, neck, forehead, and temples, creating a sensation akin to a tight band around the head or heaviness. While it may last only a few hours, it can become more frequent, persisting for days or even weeks. This type of headache is often associated with overwork and emotional tension. Effective management involves a combination of deficiency correction, medications, ultrasound-guided diagnostic nerve blocks (USGDN), and yoga-based physical therapy.
Cluster Headache is typically observed in middle-aged men and occasionally in women. The intense pain is usually centered around the eye, temple, or forehead and may be accompanied by tearing, nasal congestion, facial flushing, forehead sweating, and a smaller appearance of the affected eye. This type of headache can be exceptionally severe and might wake the person from sleep. Given its characteristic pattern, it is called a cluster headache as it occurs in clusters over 4-12 weeks and then resolves for months or even years. It predominantly affects one side, occurring at the same time every day, earning it the moniker ‘alarm clock headache.’ Treatment options include specific medications, ultrasound-guided diagnostic nerve blocks (USGDN), and neck exercises. In challenging situations, a sympathetic ganglion block at the sphenopalatine ganglion may be beneficial.
Migraine is the most prevalent type of primary headache, significantly affecting women. The pain is severe, typically occurring on one side of the head, and can impede day-to-day activities. Migraines are often accompanied by nausea, vomiting, aversion to sound and light, and can last from 4 to 72 hours. Effective treatment involves medication, as migraines do not resolve on their own.
Trigeminal Neuralgia presents as severe, shock-like, lancinating pain on one side of the face. It is triggered by activities such as mouth opening, chewing, brushing, or exposure to a breeze. While typical Trigeminal Neuralgia patients are pain-free between episodes, exceptions may occur.
Causes Of HEADACHE
Headaches could be primary headache, one that doesn’t have a detectable organic cause or it could be secondary to various issues like sinusitis, a tension headache or an eye problem. Rarely it might be something serious like a brain tumour, meningitis or a brain haemorrhage (<10%). The severity of the headache has no correlation with the cause and simple headaches can be as severe as those from serious causes.
Migraine: It is important to keep painkillers like paracetamol or ibuprofen or diclofenac or piroxicam handy. But as time progresses the patients are unable to get relief from these. In these patients, preventive medications can be taken on a regular basis as well as sprays of triptans before an attack. Botox and Pulsed Radiofrequency and Ultrasound Guided Dry Needling can be used to decrease the severity and frequency of the attacks. Occipital nerve block and Sphenopalatine ganglion block are also useful.
Trigeminal Neuralgia: Medications form the first line of TGN therapy. Interventional options, including percutaneous radiofrequency (RF) ablation, rhizotomy, and microvascular decompression are considered if medications are ineffective.
