Headaches and Migraines
Headaches & MigrainesA
lmost everyone of us has suffered from Headaches or Migraines at some point in our lives. These can range from just a mild annoyance to a debilitating condition that can put you in bed, in a dark room for a day or more at a time. Headache is common throughout the world with up to 75% of adults experiencing headache at least once per year. 30% of these adults have reported migraine. Symptoms can include blurry vision, nausea, vomiting, fever, neck pain or stiffness, and increased sensitivity to light or sounds.
While most causes of headache are not serious, symptoms of confusion, difficulty walking, difficulty speaking and excessive sleepiness are a cause for concern and need to be looked into further. If you have frequent or non-stop headaches, you need to be evaluated by your primary care provider who can help determine the cause of the headaches. Sometimes neurologists are consulted to rule out more serious causes of the headaches or to help treat particularly difficult cases.
There are many treatments for headaches that have been tried over the years. Lifestyle changes are often the first line of treatment. Controlling stress in our busy, demanding lives can often bring about significant improvements in symptoms. Avoiding headache triggers such as certain foods, alcohol, caffeine, strong smells or noise will help to decrease the frequency of many headaches. Over the counter pain medications like acetaminophen (Tylenol), aspirin, ibuprofen (Advil), or naproxen (Aleve) are generally very helpful for most of us. However, it is important to take these medications only as directed in the instructions on the bottle. Taking more than is recommended can greatly increase the risk of side effects on these medication which can include ulcers, bleeding, and liver or kidney damage.
Opioid type pain relievers like hydrocodone, oxycodone or morphine are generally poor choices to treat chronic headache unless the headache is very severe and these medications are used only short term.
Chronic use of opioid pan medications for headache often leads to a condition called “rebound headache” or medication overuse headache (MOH), where the headache recurs every time you try to stop the medication. This can turn an episodic headache into one that now occurs daily and is very difficult to treat.
Migraine headaches are common and often begin in childhood or early adulthood. They may be preceded by an aura which is a symptom warning that a migraine is starting. These symptoms can be flashes of light, blurry vision, pins and needles sensation, hearing noises, difficulty speaking or even uncontrollable jerking movements. Though migraines are common, why they occur is poorly understood. There is often a family history of migraines and women are three times more likely than men to have migraines. There are many medications that can be used in migraine in addition to the over the counter medications listed above. Triptans like sumatriptan (Imitrex) or eletriptan (Relpax) can help to stop a migraine from occurring if taken at the onset of the migraine headache.
Some medications are used to prevent a migraine from occurring at all. Certain blood pressure medications, antidepressants, and anti-seizure medications have all been used with success to prevent migraines from occurring. When migraine headaches are frequent and severe, Botox injections have been proven to be effective in decreasing both the severity and frequency of migraines. This simple, in-office procedure is completed in a matter of minutes and has pa proven safety record. Treatments need to be repeated every 12 weeks in order to maintain its effectiveness. If you have 15 or more migraine headaches per month, with headaches lasting at least 4 hours, you may be a candidate for Botox therapy. With good management techniques, most headache sufferers can be treated successfully and keep up happy and productive lifestyles.