Oh My Aching Head!

Most of us have experienced a headache at some point in our lives. Some of us more frequently than others. Figuring what is causing a patient’s head to hurt is enough to give a physician a headache.

The differential diagnosis for head pain ranges from trauma to tumor to tooth to tension to tryptamines. There are many more causes of a headache but they do not conveniently begin with the letter “T.” A sudden onset severe headache with no previous history of headache is usually cause to visit an emergency department. The root of chronic headaches is more complicated.

One of the best ways to help your physician find the cause of your pain is to keep a headache diary. A good example is available at http://www.webmd.com/migraines-headaches/guide/headache-diary

For women it is important to note where you are in your menstrual cycle. Migraines in particular have been related to low progesterone and other hormonal imbalances. Also note water consumption, environmental exposure (cleaning chemicals, dry cleaning, insecticides) and foods.

One of the most common causes of headache is dehydration. If your headaches come about the same time every afternoon, check to make sure you are drinking half your body weight in ounces of water. Withdrawal headaches are common with caffeine and sugar users. When the brain is deprived of the level of these that it is accustomed to, the result is a headache. If the headache resolves with coffee or sugar, it is time to wean off.

True headaches fall into three broad categories: tension, cluster, migraine. Tension headaches are common to both men and women, occur daily, and are a dull steady ache over the whole head. Cluster headaches usually occur in men, happen once a week, last less than four hours, are one sided and are severe in pain (think being stabbed in the head with an ice pick.) Migraines are more common in women, occur less frequently, can be one or both sided, can last 72 hours and are moderate in pain level. Migraines are further divided into classic, common and complicated. Classic have an aura or prodrome that let’s the victim know it is about to attack. Common lacks this feature. Complicated has sensory and motor impairments with the headache. And all three types of headaches can trigger each other.

The mouth can be a headache in and of itself. TMJ, grinding the teeth, root canal issues, and poor gum health can all lead to headaches. Sinus congestion can also manifest as a headache. Malposition of the spine can lead to headaches as well as somatic dysfunction. A common description of a headache is starting at the base of the skull and radiating behind the eye. This is usually caused by an over-used splenius capitis muscle and injection therapy or physical medicine is often the best solution.

The treatment of headaches is as varied as the causes of headaches. Avoiding triggers, balancing hormones and maintaining proper hydration are good starting points. And while you and your physician are looking for the source of your headaches, the World Health Organization recognizes acupuncture as an effective treatment for symptomatic relief of headaches.