Last updated: Wednesday 18 September 2013
Originally published: Wednesday 13 June 2007
A headache, medically known as cephalalgia, is a continuous pain in the head. The pain can be anywhere in the head or neck. As the brain has no pain receptors, headaches are not felt in the brain. The pain is caused by disturbances of the pain-sensitive structures around the brain.
The American Academy of Neurology says there are four types of headache:
● Vascular headaches - thought to be caused by blood vessel swelling and hyperemia (increase of blood flow). The most common type being migraine. Migraine sufferers typically have severe pain on one or both sides of the head, visual disturbance, and/or upset stomach. Other forms of vascular headaches include cluster headaches and toxic headaches. Click here to read our separate article "What Are Cluster Headaches? What Causes Cluster Headaches?".
● Muscle contraction (tension) headaches - also known as myogenic headaches, are caused by the tightening/tensing of facial and neck muscles, these account for nearly 90% of all headaches. Researchers at the University of Copenhagen reported in the Journal of Clinical Epidemiology that 3% of the population has chronic tension-type headaches.
● Traction headaches - these are usually caused by pulling or stretching pain-sensitive parts of the head, as may occur during eyestrain and eye muscles are tensed. G. Kim Bigley wrote in the book "Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition, "Headaches can result from intracranial mass lesions such as metastatic tumors, abscess, or hematoma (a solid swelling of clotted blood)."
Traction headache is caused by organic diseases involving structures in the head.
● Inflammatory headaches - these headaches are symptoms of other disorders, including sinus infection, meningitis, or stroke.
The American Academy of Neurology adds that headaches may be warning signals of more serious disorders, especially those caused by inflammation.
Tension headaches
According to the U.S. National Library of Medicine, tension headaches are the most common type of headache, and generally affect adults and adolescents - they can affect younger children, but this is not common.
About 90% of all headaches are tension headaches
During a tension headache, there may be muscle tightness in specific parts of the head, scalp and/or neck - these areas are uncomfortable and often painful. Some studies, however, have indicated that muscle tightness is not as common among sufferers as was once believed.
People who suffer from tension headaches say they feel like a tight band or vice on the head. The pain is usually dull, and covers most of the head.
It was thought that tension headaches were mainly caused by tension that builds up in the scalp and neck muscles as a result of stress, depression, anxiety, or a head injury. However, the exact cause or causes are unknown. Recent research indicates that there does not appear to be any significant increase in muscle tension in people known to suffer from tension headaches.
Experts today believe that a change in certain brain chemicals may be the main factors that contribute to tension headaches. These chemicals are the ones that help nerves communicate, such as serotonin, endorphins, and several others. We are not sure why the levels of these chemicals change. We suspect that the fluctuations activate pain pathways to the brain and probably undermine our ability to suppress pain.
What causes tension headaches?
These factors are thought to contribute to tension headaches:
● Stress - an Italian study found that stress factors are among the major triggers of headaches and migraines in children.
● Depression
● Anxiety
● Bad posture
● Staying in one position for a long time
● Working in an awkward position for a long time
● Clenching one's jaw
● Caffeine - individuals who drink large amounts of coffee tend to get more headaches than those with low consumption or people who never drink coffee, Norwegian researchers reported in the Journal of Headache Pain.
Some people believe food allergies may be the main factor for some people. However, further studies are needed.
A team at the University of Cincinnati College of Medicine linked teenage headaches with smoking, lack of exercise and/or being overweight. In another study at the same university, investigators found that lightning can trigger headaches in some people.
What are the treatment options for tension headaches?
The ideal treatment for tension headaches depends on many factors, including the patient's overall physical and mental health, and lifestyle.
Some people manage to deal with their pain without the help of a health care professional. Over-the-counter medications are usually effective for most cases of tension headache. However, be careful, overuse can lead to further headaches.
● Painkillers - such as aspirin, acetaminophen (paracetamol, Tylenol), naproxen and ibuprofen. Prescription drugs are also available for more severe symptoms, including naproxen, indomethacin and ketorolac.
Patients with severe migraine or headache who are hospitalized may benefit from intravenous aspirin, researchers at the University of California, San Francisco reported in the journal Neurology.
● Combination drugs - aspirin or acetaminophen may be combined with a sedative or caffeine.
● Triptans and opiates - for sufferers of both migraines and tension headaches. Triptans are effective in relieving the symptoms of both tension headaches and migraines. With opiates there is a risk of dependency and unpleasant side effects.
Scientists at The University of Adelaide in Australia reported on a study that found that frequent and large doses of codeine can result in greater sensitivity to pain.
● Acupuncture - researchers at the Technical University of Munich in Germany carried out two systematic reviews on acupuncture therapy. They found that acupuncture can be effective for patients with tension headaches or migraine.
Senior investigator, Klaus Linde said "In Germany, acupuncture is frequently used for headache. Most private health insurances, in fact, reimburse for acupuncture, although they cover only about 10 percent of the population."
A headache diary - if you keep a diary it may help you identify your headache triggers. When a headache starts write down when it started, include notes of what you drank and ate during the previous 24 hours. Note down how long you had slept, whether it was a good night's sleep, when you slept. Record in your diary what was happening in your life immediately prior to the onset of your headache - were you under unusual stress? Write down how long the headache lasted, and if you can, what made it stop.
Hot or cold showers - some people find that taking a shower helps. While one person may benefit from a hot shower, others may find a cold one gives better results.
Lifestyle - some simple changes in lifestyle may reduce, and sometimes completely eliminate the recurrence of headaches. Getting enough sleep, doing plenty of exercise, stretching the neck and back muscles regularly may be all you need.
Diet - are you eating properly? A good diet with plenty of fruit, vegetables, minerals and fiber will help you stay in good health and might help reduce the intensity and frequency of your headaches.
Work related headaches - if you suspect your job may be at the root of the problem, try to find ways to make it less stressful - talk to your boss, or human resources manager.
Depression - if the tension headache is chronic (longterm), there is a chance you could be suffering from depression and prescribe an antidepressant.
Yoga or Tai Chi - ff you are lucky enough to have a good trainer, yoga or Tai Chi have been known to treat many types of headache effectively. It is crucial that the therapy is done with a well trained expert. Researchers at UCLA in California found that Tai Chi provides significant benefits for adults with tension headaches.
Using sleep to treat chronic tension headaches can lead to insomnia - scientists at Rush University Medical Center found that women who use sleep or napping as a way of coping with chronic pain caused by tension headaches risk developing chronic insomnia.
What is the outlook? Will I get better?
In the majority of cases, tension headaches respond well to treatment. They are unpleasant but not usually harmful if they do not occur as a symptom of another condition. For treatment to be effective it is important that the patient adheres to the doctor's instructions. Non-compliance or non-adherence is one of the most common reasons for treatment failures - not only for tension headaches.
When tension headaches occur as a symptom of another condition, they will generally get better when that underlying condition is treated successfully. If painkillers are used too often and for too long, there is a risk the patient may develop rebound headaches.
Video - Symptoms of Tension vs. Migraine headache
The video below contains a list of the symptoms that help to differentiate tension from migraine headache.
Written by Christian Nordqvist
Source: http://www.medicalnewstoday.com
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