What is a headache?

A headache is pain in any region of your head. Headaches are one of the most common disorders of the nervous system, appearing as sharp pains, dull aches or throbbing sensations.

What are the different types of headaches?

A. Tension

• Most common headache disorder
• More common in women, with a women to men ratio of 3:2
• Often begins during teenage years
• Caused by stress or musculoskeletal problems in the neck
• A tension-type headache (TTH) includes:
  • Pressure or tightness, like a band around the head
  • Sometimes the pressure/ tightness can spread into or from the neck
• TTH can be episodic or chronic
  • Episodic TTH
    • More common, occurring on less than 15 days per month
    • Usually lasts from a few hours to several days
  • Chronic TTH
    • Occurring on more than 15 days per month
    • Can be unrelenting, much more disabling than episodic TTH

B. Migraine

• Caused by the stimulation of a mechanism in the brain that triggers the release of pain-producing substances around the nerves and blood vessels of the head
• Typically begins at puberty, is recurrent and often lifelong
• More common in women, with a women to men ratio of 2:1
• Often occurs in those aged between 35-45 years old
• A migraine includes:
  • One-sided headache of moderate/ severe intensity; pulsating in quality
  • Nausea, which is the most common associated feature of migraine
• Usually lasts 4-72 hours, frequency of occurrence can be anything between once a week and once a year

C. Cluster

• Relatively uncommon
• More common in men, with a men to women ratio of 6:1
• Often develops in those in their 20s or older
• A cluster headache includes:
  • Frequently recurring, brief but extremely painful headache
  • Usually focused in or around one eye, with tearing and redness of the eye, eyelid on the affected side may droop
  • Running/ blocked nose on the affected side
• Cluster headaches can be episodic or chronic

D. Medication overuse

• Caused by long-term and excessive use of medication to treat headache
• More common in women, affecting up to 5% of some populations
• A headache caused by medication overuse:
  • Usually starts when you wake up
  • Is persistent

E. Sinus headaches

• Caused by seasonal pollen-related issues or due to foods, dust and pets that builds up pressure within the sinus cavities
• Results in dull aching pain in the forehead, eye or face
• To treat sinus headaches, the allergy has to be treated

What are some headache symptoms that hint towards a more serious condition?

Headaches are common disorders that many people experience, and many brush it off as something mild and temporary. However, there are some symptoms associated with headaches that hint towards a more serious condition (e.g. infection/ tumours/ neurological illnesses). They include:

If you experience any of these headache symptoms, do get medical care immediately:

• Sudden, new and severe headache
  • Especially if it is after the age of 55, or after a head injury
• Headache that is associated with other neurological symptoms:
  • Dizziness
  • Paralysis/ Difficulty in moving limbs
  • Speech difficulties
  • Sudden loss of balance
  • Seizures
  • Issues with vision (e.g. blurry/ double vision, dark spots)
• Fever/ shortness of breath
• Pain to the point where you wake up at night
• Severe nausea/ vomiting

Any of the above symptoms may suggest more serious neurological conditions, such as stroke, brain aneurysms or brain tumours, which require immediate medical attention.

If you experience any of these headache symptoms, do arrange for an appointment with a doctor or a headache specialist:

• Frequent headaches (more than 3 times a week)
• Headaches that keep worsening
• If you need to take pain relievers all the time for your headaches (or need more than 2-3 doses of medications per week to relieve symptoms)
• Headaches triggered by: physical exertion, coughing, strenuous activity
• Recent change in headache symptoms

While the above symptoms are not necessarily linked to serious medical conditions, do still consult a doctor for a detailed check-up. Treatment may also be given to help relieve your headache symptoms.

How can the doctor accurately conclude which type of headache I have?

When visiting a doctor, do take note of the following questions:

• When did you start getting headaches?
• Where is the pain located? (which part of the head)
• What symptoms do you have along with a headache?
  • Do your symptoms of headache remain the same?
• How often do you get a headache?
• What are the causes of the headache? (e.g. stress, food, certain actions)
  • Your stress level/ sleep habits/ caffeine drinking habits
• Do you have any family history of headaches?

Knowing the answers to the above questions will allow the doctor to diagnose your headache much more accurately.

The doctor may also perform a series of physical and neurological examinations:

• Measuring your blood pressure
• Taking your temperature
• Testing your vision/ eyesight
• And more

These tests may help to rule out any serious diseases that may also cause headaches.

While special diagnostic tests are often unnecessary, it may sometimes be recommended if the doctor thinks that your headaches are caused by another medical condition.

• Computed tomography (CT) scan/ Magnetic resonance imaging (MRI) scan
  • These scans produce images of the brain, helping to confirm if there are any issues with your central nervous system
• Electroencephalogram (EEG) scan
  • A test that detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp
  • May be necessary if you have fainted during a headache before
  • Helps to diagnose
    • Epilepsy
    • Brain tumours/ damage
    • Stroke
    • Sleep disorder

For more information or if you require a medical consultation, please contact My Healthcare Collective here.