Is it a Headache, or is it a Migraine?
posted by Lehi Willow Creek Family Medicine | August 25, 2016
Are you one of the 45 million Americans who suffer with chronic headaches of one type or another? These often debilitating – or sometimes just mildly unpleasant – pains in one or both sides of your head can cause throbbing and pressure. They might be localized to your forehead, temples or the base of your skull and the back of your neck. The most common type of headache is a tension headache, according to the Mayo Clinic. Stress, anxiety, lack of sleep and muscle strain are often to blame for these types of headaches. Unlike some forms of migraine, tension headaches usually aren’t associated with visual disturbances, nausea or vomiting.
Cluster headaches are extremely painful headaches that usually start suddenly, occur on one side of the head, and come in cycles. A sufferer might have one headache every other day, or several headaches per day, followed by a headache-free period.
Cluster headache pain is often felt most behind or around the eye, and it may spread to the forehead, temples, teeth, nose, neck or shoulders. People describe it as a “constant and deep burning or piercing pain.” Some people know that a cluster headache is on the way when they experience the telltale visual disturbances, such as flashes of light, before the headache begins.
Doctors believe that cluster headache pain is caused by:
The dilation of the blood vessels that supply blood to your brain and face, which puts pressure on the trigeminal nerve, the largest cranial nerve.
Abnormalities in the hypothalamus, a small area of the brain that regulates body temperature, blood pressure, sleep and the release of hormones.
A sudden release of histamine, which fights allergens.
A sudden release of serotonin, which regulates mood.
Many people find they are able to prevent cluster headaches by avoiding:
Foods that contain large amounts of nitrates such as bacon, hot dogs and preserved meats
Hot and humid weather
Your doctor might recommend you treat your headache pain with:
A nasal spray called sumatriptan (Imitrex), or other triptan medications that constrict blood vessels and help ease your headache.
An injected medication called dihydroergotamine (DHE) that can often relieve cluster headache pain within five minutes of use.
Topical capsaicin cream applied to the painful area.
Blood pressure, steroid, anti-depressant or anti-seizure medications
Sinus headaches are often confused with migraines or tension headaches. They usually coincide with sinus infection symptoms including fever, cough, congestion, stuffy nose and facial pressure.
This deep and throbbing pain in the front of your head and face, called sinusitis, is caused by an inflammation in the sinus cavities around your nose, eyes and cheeks. This may be due to a respiratory infection, such as a cold or flu, or allergies. These conditions block the nasal passages and prevent the sinuses from draining, which gives bacteria, viruses and fungus a chance to thrive.
Risk factors for sinus headaches include:
A history of asthma or allergies, especially hay fever
Nasal polyps, swellings in the nasal passage, deviated septum or cleft palate
Frequent swimming or diving
Climbing or flying to high altitudes
The most effective way to prevent a sinus headache is to treat the underlying sinus inflammation. Your doctor may prescribe antibiotics, corticosteroids or allergy medications and medicated nasal sprays. Lifestyle changes, such as using a humidifier, irrigating your nasal passages with salt water, and adding certain dietary supplements and herbs may also help.
Migraines affect 38 million Americans, or 12 percent of the population, making this condition the third most prevalent illness in the world. While most sufferers experience attacks once or twice a month, more than 4 million people have chronic daily migraine, with at least 15 migraine days per month, reports the Migraine Research Foundation.
Migraines are most common in adults in their 30s and 40s, but they often begin at puberty, and even children can suffer from migraines. Women are up to three times more likely than men to have migraines. Other facts about migraines include:
Migraine pain is usually a severe throbbing located on one side of the head, but in about 33 percent of attacks, both sides are affected. Approximately 25 percent of migraine sufferers also have a visual disturbance called an aura, which usually lasts less than an hour. Attacks typically last between 4 and 72 hours and are frequently accompanied by:
Nausea and vomiting
Extreme sensitivity to sound, light, smell and touch
Numbness or tingling in the extremities or face
Although “25 percent of sufferers would benefit from preventive treatment, only 12 percent of all sufferers receive it,” notes the Migraine Research Foundation. Certain preventive medications can help reduce the intensity or frequency of symptoms.
In addition to the medications mentioned above to treat cluster headaches, your family doctor might prescribe the use of beta-blockers, calcium channel antagonists, or CGRP receptor blockers to help prevent migraines. But not all people with migraine symptoms need to take medications. Dietary supplements that may help include:
Magnesium – 400 mg daily reduces 50 percent of migraine symptoms for about 50 percent of sufferers. Give it at least three months to gauge effectiveness, advises the Association of Migraine Disorders.
Vitamin B-2 (riboflavin) – 250-500 mg daily taken with food.
Coenzyme Q10 – up to 100 mg three times daily can reduce damage to cells caused by the environment and increase a cell’s energy production. Small studies have found CoQ10 is two-to-three times more effective than a placebo in reducing the number of migraines.
Melatonin – 3 mg at bedtime helped 78 percent of migraine sufferers in a small study, with 50 percent experiencing a reduction in headaches and 25 percent enjoying a complete cessation of migraines.
Other ways to reduce the intensity and frequency of migraine attacks is by keeping a symptom diary to help you avoid your personal triggers and track the effectiveness of your treatment plan. Use a simple spreadsheet with columns noting each symptom, when it happened, how intense (on a scale of 1 to 10), and how long it lasted. Be sure to list what you were doing and what you ate and drank for 24 hours before the attack.
You may find that like many people, your triggers include:
Foods like aged cheeses, smoked meats and chocolate
Food additives, such as monosodium glutamate (MSG), and artificial sweeteners
Perfumes and other strong odors
Glaring or flickering lights
Lack of sleep
When you avoid your own personal triggers and reduce stress, you decrease the stimulation of the nervous system. Employing a healthy diet, regular exercise, good sleep hygiene and other relaxation techniques can make a significant difference in the alleviation of painful and debilitating migraine and headache symptoms.
If you’re battling frequent and painful headaches that are interfering with your ability to work, play and enjoy your life, help is available. Dr. Brandon Hall offers compassionate care in a broad range of disciplines, including the diagnosing, treatment, and prevention of headaches and migraines. Dr. Hall is eager to partner with you to help you understand your treatment options and intelligently tailor your own healthcare plan.
This information is not intended to replace the advice of a medical professional. You should always consult your doctor before making decisions about your health.