Wednesday 16 April 2014

Am I suffering from headaches or migraines?

I've been having a lot of headaches lately – they can be quite severe and I sometimes feel sick with them. I am 35 and probably healthier and fitter than I have been in many years as I took up running last year and have lost quite a bit of weight. My mother gets migraines and I wonder is that what I have now?

Sincerely, Aine

Headaches are a very common ailment. 90pc of people suffer with these at some time. The good news is that the majority of these are totally harmless.

Tension headaches are the most common kind. They often start at the back of the head and spread around the head like a band. The pain is often described tight or gripping.

These headaches are most often due to lifestyle issues such as tiredness, anxiety, stress, or withdrawal from caffeine. Other causes can include holding your head in one position (at a computer for example) for a prolonged period, poor sleep or muscular damage or strain.

The neck and shoulders often feel tense. These headaches can last a while or reoccur. Cluster headaches can cause tightness around the head also, but they occur in sharp bursts. These can occur for days or weeks at a time but they often then go away again for prolonged periods.

Another common cause of headaches is sinus congestion. These headaches usually cause a dull ache over the eyes and across the cheeks and teeth. Muscular problems in the neck or arthritis of the bones in the neck can also cause headaches. These often start at the back of the head and cause a tight or pulling feeling.

Many people call any severe headache a migraine but these are actually a very specific kind of headache and can be particularly debilitating. Migraines are thought to affect about 10pc of people worldwide. They are three times more common in women than men. Pain is described as pulsing or throbbing and usually starts on one side of the head around the eye area but can spread to both.

There is often associated nausea and occasional vomiting with the headache. Migraines can go on for hours or, in rare instances, days.

Those who suffer migraines are often aware of factors that predispose them to a headache. These factors are called triggers and can include exhaustion, stress, dehydration, hunger, certain foods, hormones and even flashing lights. Triggers vary hugely from person to person, so it is best for those with migraine to keep a diary and identify their individual list of triggers. We do not really know what causes migraines but they can run in families and genetics do seem to play a role.

The important common factor in all the headaches listed is that although the pain can be very severe, they are all innocent causes of headache and once the pain or cause is relieved there is no for concern.

These will provide relief for the majority of people. I advise avoiding painkillers containing codeine as frequent use of these can actually lead to a flare of headache when painkillers are stopped.

This is called an analgesia overuse headache and is felt to be a type of withdrawal.

You mention you have improved your health lately – I wonder, have you reduced your caffeine intake? Stopping this can cause a flare in headaches in some people. If so, this will eventually settle. As you are exercising more be aware of your fluid needs and make sure to drink plenty water before and after exercise.

You mention that you have lost weight. I assume this was intentional, but it is also important to ensure that despite reducing calories you are eating a healthy varied diet. As there are many causes of headaches, it is worth going to your doctor for a check-up. He or she can ask specific questions about the intensity, location and frequency of headaches to help decide if these are migraines at all.

High blood pressure can cause headaches, although this is less likely in view of your age and fitness. You don't mention if you are on the pill or not – oestrogen in pills can contribute to migraine headaches in some people and this may be worth reviewing.

There are a number of headaches that require more urgent checks. It is unlikely that you have any of these. Go to A&E if the headache is the worst you've ever had and is sudden and severe; if you have any associated slurring of speech, loss of vision, or loss of power; or if you have associated fever, rash or neck stiffness. These headaches could be a sign of a haemorrhage or meningitis. For those who are over 50 and have a new onset of headache, especially if it is worse when eating, if the headache wakes you at night, is worst first thing in the morning or if it lasts more than a few days and not relieved by rest, fluids and simple painkillers, I advise an early doctor's appointment.

Irish Independent

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