Healthcare
Headaches – self care, triggers and when to see your doctor

 

 

 

 

 

Headaches are very common. There is a wide variation in the type of pain you could experience with a headache, and how long it may last.

Causes of headaches:

  • The toxic effects of alcohol or other substances.
  • An infection elsewhere in your body.
  • Muscle tension.
  • Inflamed arteries (which cause migraine or cluster headaches).

Most headaches are not a cause for worry, but occasionally they are a symptom of something serious.

Self care
If you know what causes your headaches (eg, alcohol, chocolate, cheese) it’s best to avoid these things if you can. If you have a headache, drink regular amounts of fluid – especially water – and don’t skip or delay meals (unless you’re vomiting). Also, try not to smoke.

If you get a headache, try the following:

  • Take painkillers such as paracetamol or ibuprofen.
  • Lie in a dark, quiet room (and if possible, sleep).
  • Alternate warm and cool compresses (for 20 minutes each) on your forehead, the base of your skull or your upper neck.
  • Get someone to give you a gentle but firm massage to your neck, temples, scalp, back of head and shoulders.
  • Have a warm, relaxing bath.

When to see your doctor
If you or a family member has a headache, see your doctor if it doesn’t go away after self care, or if it gets worse.

When it’s urgent
If you, a friend or family member has any of the following symptoms, get them along to your doctor or after-hours medical centre quickly:

  • Drowsiness, confusion or weakness in their arms or legs.
  • Difficulty waking up or bright lights hurt their eyes.
  • A seizure (fit).
  • Vomiting.
  • Loss of vision (they have trouble seeing).
  • Neck pain or stiffness.

Migraines
We don’t fully understand all the causes of migraine headaches. We do know that they’re related to changes in the blood flow to the head and brain. Migraines tend to run in families and usually first show up in the teenage or young adult years. They’re more common in women and often occur during, or right before, a period.

A typical migraine causes a severe throbbing pain on one side of the head. The pain builds up during an attack and can last for several hours.

Sometimes migraine pain covers both sides of the head and is a dull pain.

Other symptoms include:

  • Seeing stars, flashes or zigzags.
  • Blurred vision.
  • Bright lights hurt the eyes.
  • Nausea and/or loss of appetite.
  • Forgetfulness, especially words.
  • Numbness or tingling.
  • Weakness or clumsiness.

Triggers
Although causes are not fully understood, some people find certain things trigger a migraine attack. These include:

  • Stress
  • Lack of sleep
  • Skipping a meal
  • Alcohol, particularly red wine
  • Taking birth control pills
  • Changes in the weather
  • Chocolate
  • Food preservatives or additives, such as monosodium glutamate (MSG)
  • Caffeine (in coffee, tea and carbonated drinks).

When to see your doctor
If your headaches are frequent or you can’t control them by avoiding triggers, see your doctor. There are specialised migraine medicines that may help.

Self care
Try to identify what happens before a migraine starts, then avoid those triggers in the future. When you get a migraine, rest in a dark, quiet room. Cool compresses on your forehead may help. You can get painkillers from a pharmacy – but make sure you read the instructions and precautions carefully.

Cluster headaches
Cluster headaches often occur at night and usually cause sudden pain on one side of your head – often around the eye. They can happen several times a day for a period of time, then disappear for months or years. If you get cluster headaches, try to identify the triggers and avoid those things. If they become a problem, see your doctor.

Cluster headaches usually cause sudden, extreme pain on only one side of your head, often around or behind the eye.
They often occur at night and can last anywhere from 30 minutes to several hours.

Cluster headaches may happen several times a day for four to 12 weeks, then disappear for months or years. Related symptoms include a stuffy or runny nose, watery eyes and redness in your painful eye.

Self care
Try to identify what happens before cluster headaches start, then avoid those triggers in the future. You can get painkillers from a pharmacy – but make sure you read the instructions and precautions carefully. Aspirin, ibuprofen or paracetamol usually don’t help – because usually the headache goes away before the pill starts working.

When to see your doctor
If your cluster headaches are frequent or you can’t control them by avoiding triggers, see your doctor.

Sinus headaches
Your sinuses are lined with a membrane – similar to that on the inside of your nose – which keeps them moist and produces mucous. When germs settle and grow on this surface, the surface swells and begins to produce too much mucous. It’s the pressure from the swelling inside your sinuses that causes the headache.

Your sinuses are hollow spaces in your skull bone, above and between your eyes and behind your cheeks.

  • Most sinus problems follow a cold or a sore throat.
  • Some occur after a dental infection.
  • Sometimes hay fever or irritation from dust or smoke will cause the swelling.

If you have a sinus infection and it isn’t treated, your sinuses will become more and more clogged. The excess mucous gives the germs a good place to multiply. These germs could be viruses, bacteria or even fungi. If you have a sinus headache, the pain will be in your face and forehead – and sometimes behind or between your eyes.

  • It can be dull or severe.
  • Often the pain is worse in the morning and improves by the afternoon.
  • The pain may be worse when you bend your head forward.
  • It can feel worse on cool, damp days.

You may have a fever with a sinus infection.

Other signs are mucous coming out of your nose that is an unusual colour (red, yellow or green) or that smells foul.

Self care
Treatment of a sinus headache involves helping your sinuses drain and treating any infection.

  • Inhaling steam or mist from a hot shower, or putting moisture in the air with a vaporiser, often relieves the clogging.
  • You can get nasal sprays or pills that unclog sinuses (called ‘nasal decongestants’) from a pharmacy. The sprays usually work better than the pills. Don’t use the sprays for more than three days at a time.
  • Smokers should stop smoking and avoid other people’s smoke, and other irritants in the air.
  • Try not to lean over, and use an extra pillow to raise your head in bed to relieve pressure.
  • Warm compresses to your face may relieve pain.

When to see your doctor
See your doctor if:

  • Your sinus pain doesn’t go away after self care, or if it gets worse.
  • You have sinus pain and a fever, or foul-smelling mucous from your nose.

Source: Ministry of Health NZ 

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