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Tension Headache

Do you feel a dull ache on both sides of the head? Do the muscles in the neck and head feel tight ? You are most likely suffering a tension headache or stress headache as it is otherwise referred. Such headaches are one of the most common forms of headache and can occur in adults and adolescents. The pain due to tension headache is vise-like and is generalized. Tension headaches may result from fluctuations in the levels of brain chemicals such as serotonin, endorphins and others. Tension headaches are noticed more often in women.


Tension headaches occur due to contraction of neck and scalp muscles. This contraction can be a reaction to stress, anxiety or posture. Excessive smoking, alcohol use, sinusitis, eye strain can also bring on tension headache. Unlike migraine, tension headaches do not cause nausea and vomiting or numbness. Episodic tension headaches come a couple of times a month and last a few hours. If there are frequent episodes of tension headache, the condition is chronic. Skipping meals, stress, hormonal changes and hypertension medication can trigger tension headaches. Such headaches often have a genetic predisposition.


Tension Headache and Treatment

Treatment:
There are many issues to consider before arriving at treating headaches - frequency, severity, the effect on lifestyle, the results of previous treatment and any history of drug abuse. Mild cases of tension headaches which occur occasionally can be managed with symptomatic treatment by using Analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs).

Tension headaches are treated with NSAIDs, aspirin or acetaminophen. A non sedating muscle relaxant such as Skelaxin provides relief to persons suffering from tension headaches. Those who suffer from frequent bouts of tension headaches may need medications to reduce anxiety such as amitriptyline, nortriptyline or desipramine. But overuse of these medicines can lead to rebound headaches. You can try some of the following measures to bring tension headaches under control:


  • Enough rest

  • Regular exercise regimen

  • Warm or cold compress on the head and neck

  • Relaxation exercises, yoga, deep breathing, acupuncture

  • Good posture while sleeping, reading, using the computer

  • Massage

  • Swimming


Prophylactic Therapy :
If the frequency of headaches is so regular or if the severity of the headache is so high that the patient can't normally cope, then prophylactic therapy might be indicated. Antidepressants are the drugs of choice for treating tension type headache. Relief of headache may take about 3 to 4 weeks and the patient may have the following side effects:


  • sedation
  • dry mouth
  • blurred vision
  • constipation
  • urinary retention

Amitriptyline - single dose of 25 mg at bed time may be a good option. Trazodone (75 to 300 mg at bedtime) or Fluoxetine (20 to 40 mg at lunchtime) are other options if the patient does not tolerate the sedative and anticholinergic effects of amitriptyline.

There are other alternate options like Cervical Epidural Nerve Block which can be performed on a regular basis depending on clinical symptoms.


Migraine

Nearly everyone gets headaches. But while some are tension headaches or headaches caused by a cold. Migraine headaches tend to be severe and recurrent and are often accompanied by nausea. What begins as a pain on one side of the head may spread to both sides. Most migraine headaches are caused by a change in the blood flow pattern to the brain.


Triggered by stress or other factors, arteries supplying blood to the brain may constrict. Serotonin, a chemical may also have a role to play since it is released from nerve fibers that coil around the blood vessels. To tackle this, certain arteries within the brain may dilate to accommodate better oxygen supply. This dilation may result in migraine headaches. While anyone can get migraine headaches, they are more common in women.


Causes of migraine

Often changes in weather or altitude can cause migraine headaches. If you have irregular sleeping patterns (too much or too little), it may be the cause for migraine headaches. An interruption of your regular sleep pattern may bring on a headache. Strong odors, bright lights and loud noises are known to be triggers for a migraine attack. Fasting is yet another triggering factor for migraine headache. Women may experience migraine headaches on account of their menstrual cycle, birth control pills or hormones. Women who are on oral contraceptive pills are more likely to develop migraine headaches as a side effect.


Symptoms of Migraine

  • Throbbing pain on one or both sides of the head
  • Nausea and vomiting
  • Stiff neck
  • Sensitivity to light and sound
  • Visual hallucinations such as zigzag lines and flashing lights
  • Tiredness, irritability and confusion
  • Mood swings
  • Sensitivity to cold
  • Diarrhea and increased urination


Treating Migraine

Medication to treat migraines can range from ergots like ergotamine or triptans like sumatriptan and rizatriptan. Sometimes isometheptenes are also prescribed. Ergotamines narrow the blood vessels to reduce the throbbing pain. Triptans perform the dual function of narrowing the blood vessels as well as balancing the chemicals in the brain. Eat a healthy diet and keep your weight under check. Obese people are more likely to suffer migraine headaches. Smoking and excessive alcohol consumption can bring on severe migraines.


Some anti migraine drugs work by constricting blood vessels in the brain. These drugs should not be take by patients with coronary heart disease or circulatory problems. Sometimes migraine attacks may not respond to the treatment. If the headache lasts longer than 3 days it could be a condition called as Status Migrainosus which may call for a different level of treatment involving hospitalization as the patient might suffer dehydration owing to nausea and vomiting.


Alternative Treatment For Migraine: Some herbal remedies have been reported to be effective against migraine in some cases. Feverfew - Tanacetum Parthenium, a herb reduces the intensity of a migraine attack as well as its frequency. However it may not alleviate the pain once it occurs. Petadolex - a preparation made from Butterbur root - Petasites Hybridus is another herbal remedy to control migraine.



Weekend Headache Syndrome

Weekend Headache Syndrome is often related to imbalances in lifestyle. For example, a person working in a stressful environment throughout the week is at rest all of a sudden during the weekend. This transition may spontaneously trigger the release of neurotransmitter associated chemicals from the brain leading to painful and disturbing headaches called as weekend headaches or weekend headache syndrome. The pain production is due to the vasodilation of cranial arteries. Weekend headaches trigger the onset of tension type headaches.


Triggers for weekend headache

Sleep patterns: Inconsistent sleep patterns can play a major role in the onset of headaches. The biological transition of a person is altered because of irregular sleep pattern.

Stress: Stress is the most predominant predisposing factor in headaches. However, the conditions associated are different because the individual who is prone to a stressful week of work does not adapt to a quiet weekend. This eventually triggers the onset of headaches.

Eating habits: Eating habits especially with relation to the diet consumed during the weekend plays a significant role in weekend headache syndrome. A diet which is high in caffeine and M.S.G and artificial sweeteners trigger the onset of headaches. In addition to this, sudden caffeine withdrawal can also lead to headaches.

Drugs: People who consume marijuana and other narcotics during the weekend are prone to these headaches when they resume their week days.

Chemicals: Constant exposure to toxic chemicals such as paints, fertilizers, molds etc. can cause headaches.


The effects of weekend headache syndrome can also lead to psychological conditions such as depression. This is associated with the individuals work and family life. The predisposing factor is stress. Since weekend headache syndrome is associated with factors pertaining to sudden change in lifestyle, the treatment lies in the gradual change of habits. Some people are advised to take L-tryptophan, an antidepressant amino acid. This helps in relaxation of the mind. Other therapies such as maintaining a positive balance in the work environment. This is also followed by a continuum that has to be followed even during the weekend in order to prevent the biological system from undergoing any kind of sudden unprecedented transitions. Gradual withdrawal from habits such as intake of caffeine can result in prevention of these headaches. Since some weekend headaches are associated with lack of exercise or inconsistent exercise, a pattern of regular exercise can help reduce instances of headaches.

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Collection of Pages - Last revised Date: July 15, 2019