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Clinician’s Corner: Headache Basics

There are many types of headaches, and your Thompson Pharmacist can be a great resource.  In the upcoming weeks, we will explore treatment of the various types of headache.  Here is a overview of headache types:

Tension Headache definition: Tension headache: also referred to “chronic scalp muscle contraction headache” it affects BOTH sides of the head and scalp with pain that may radiate to jaw and shoulders. Due to blood vessel changes taking place from muscular components, causing a “band like vise” around the head. Chances are, that if an OTC recommendation can be made and is successful, it is probably a tension headache.  Patients usually do not go to the physician to get treatment for tension headaches.

Migraine headache definition: A migraine is a type of headache, usually occurring with symptoms such as nausea, vomiting, or sensitivity to light and sound. In many people, a throbbing pain is felt only on one side of the head. Migraines may last from 4-72 hours, patients will lay down for relief (turn out lights, have quiet).   Migraine headaches tend to first appear between the ages of 10 and 45. Migraines may run in families.

GENDER DIFFERENCES:

  • Women are twice as likely to get migraines than men. Some women, but not all, have fewer migraines when they are pregnant.
  • Women report a longer attack duration, increased risk of headache recurrence, greater disability, and a longer period of time required to recover
  • Women are more sensitive to triggers of smell and are more likely to become nauseous.
  • Men are 35% more likely to report overexertion as a migraine trigger.  Men are more sensitive to light.

Classic migraine (migraine with aura): recurring headache that strikes after or at the same time as sensory disturbances called aura. These disturbances can include flashes of light, blind spots and other vision changes like zigzags or loss of vision. Aura patients have more dramatic presentation of multiple clinical manifestations. May see tingling in the hand or face. Migraine with aura is associated with a 2-fold higher risk for stroke. About 1/3 of patients with migraine may experience aura although most do not experience aura with every migraine

Common migraine (migraine without aura): associated with nausea, vomiting, or both and are frequently accompanied by sensitivity to light, sound, and movement. If untreated, these headaches can last up to 72 hours.

Allodynia: feel pain from stimuli that do not normally cause pain, such as combing one’s hair. Is caused by central sensitization in the brain.  Most migraine drugs do not give adequate relief.

Cluster headache: a form of migraine often characterized by brief, but frequently recurrent bouts of severe headache. Frequently referred to as “suicide headaches”. Headaches may last from 45 minutes to 3 hours, maximum. May occur every other day or up to 8 times per day, even the same time each day known as circadian periodicity.

  • Patients will not lie down; they are extremely agitated and incapacitated. They walk and pace and have been known to bang their head off a wall to deflect the pain.
  • Clusters may occur in groups of up to 8 a day lasting for weeks or months.
  • Pain is intense, concentrate on 1 side of head, with tearing of the eye, runny nose, fullness of the ear and a droopy eye on the same side.

Typical patient: is a middle-aged male who smokes.

KNOW YOUR Triggers: Learn to identify and avoid your triggers…skipping meals, disrupted sleep, stress, alcohol, wine, cheese, aspartame, etc.

Your Thompson Pharmacist can be a great resource with over the counter remedies as well as prescription meds to treat your headache. We recommend that you keep a “headache diary” to help your physician decide what treatment approach might be best for you. Go AHEAD and ASK… at Thompson Pharmacy it’s ALL for YOU!