By Diana Giraldo, Reporter
We’ve all felt it, that annoying bothersome feeling in your head, a pressure that doesn’t let you continue with your day-to-day activities and all you do is wonder when will this headache finally go away.
The most commonly experienced headaches are primary headaches, which are caused by problems with an overactivity of pain-sensitive structures in your head, according to Mayo Clinic.
A primary headache is one which isn’t a symptom of an underlying disease but rather the headache is the problem itself. The most common of these types of headaches are migraines, cluster headaches and tension-type headaches.
Migraine: The predominant primary headache specialists treat are migraines, said Melvin Helm, a board-certified neurologist and headache specialist at California Headache and Balance Center.
“They tend to be more disabling and that’s why, as a physician, you see more people complain about them,” he explained.
About 30 million people in the U.S. suffer from migraines, of that a third of the portion are women. Research has also shown migraines to be an inherited disease, said Ernestina Saxton, who specializes in the comprehensive treatment of headaches and migraines and is a Clinical Professor at University of California, San Francisco’s Fresno location.
“There are chromosome analysis that show that it is an inherited neurological disorder,” Saxton said. “Chromosome 19 maybe the one that makes one susceptible to migraines.”
When people who are suffering with migraines walk into her office, the first thing they complain about it the intense pain, Saxton said.
A migraine is characterised by a unilateral throbbing, pulsating or pressure feeling in one’s head that can last anywhere from three to four hours all the way up to three days, Saxton said, making the affected person feel as if their head was going to blow up like a balloon.
“People will tell you, ‘It feels like my heart is beating in my head,’” Saxton said. “They feel the pressure and they say they feel their head is too big for their scull.”
Although the headache is usually unilateral, affecting either the right or left side of the head, it can also be a generalised headache as well. People can also experience sensitivity to light, sound and smell and have nausea with or without vomiting.
“People who get migraines a lot of the time will have nausea, because with patients who have migraines their gut doesn’t move very well,” Saxton said. “It’s almost paralyzed, but it’s not that their migraine is caused by digestive problems. Part of the process of the migraine is that the gut doesn’t work very well, so people can digest food very well.”
When patients have migraines they also don’t want to move because any movement may make the headache worse, Saxton said.
“Even just getting up to go to the bathroom will make their head pound more then when they were lying down,” Saxton said. “Because the headache hurts so bad a lot of people have trouble keeping up with their jobs and sometimes they have to take time off if their headache is too bad.”
For people who suffer from many headaches, medications are prescribed to prevent heachaches, and those medications must be taken every day.
Saxton asks her headache patients to maintain a good diet and to make sure they eat at regular times because if they wait too long between meals the brain thinks it’s fasting.
Avoiding some foods that trigger migraines like aged cheese, nuts and alcohol, especially red wine, could be another way to manage the headaches. Not getting enough sleep or too much sleep and stress can also trigger migraines in some patients, but everyone’s trigger is different, Saxton explained.
“The patients who exercise do much better at controlling their headaches,” Saxton said. “The best exercise for migraine patients is walking and swimming. Running we don’t like migraine sufferers to do.”
Cluster headaches: The name of these headaches derives from the way they affect patients, Helm said, because they are clustered in time.
Specialists think cluster headaches can be triggered by season because they tend to appear only in cycles, Saxton said.
“They could occur everyday for a month and then you get this period where there is no headache and then they come back and cluster again,” Saxton said. “For some patients it comes on in the spring and the fall.”
Unlike migraines, cluster headaches are six times more common in men than females, Helm said.
Cluster headaches are much shorter than migraines but tend to be extremely intense, Helm said. This type of headache has a short duration, which usually last 15 to 20 minutes but in some cases can stay as long as three hours. It is always unilateral and concentrates in the forehead, temple and in and around the eyes.
“It’s a burrowing, gnawing, intense pain,” Saxton explained.
When patients are experiencing this type of headache it is not uncommon for their eyes turn red, have watery eyes, nasal congestion and runny nose. Some people even get a smaller pupil on the side that is affected, said Helm.
“The people who have cluster headaches, they are anxious, walking, moving, some even run when they have these types of headaches. Others want to hit their head on the wall,” Saxton said. “The pain is so bad that it makes them want to move and run, but the movement doesn’t make the headache worse in the way that it would for migraines.”
Specialists think cluster headaches are caused by a problem in the brainstem, like migraines which also involve the brainstem and other parts of the brain. But unlike migraines the correlation between inheritance may not be as significant.
There are crossovers in the treatment used for cluster headaches and migraines, Helm said. Fast acting medication, like an injectable, is the best to treat cluster headaches, he continued.
“For cluster you need something fast acting because it’s usually over by the time a pill can absorb,” Helm said.
To prevent cluster headaches, doctors prescribe pill forms of headache medication.
Tension-type head headaches: The most common type of headache is the tension type headache, Helm said.
“About 8 percent of the population will get a tension-type headache at a certain part of their life,” Helm continued. “But you are less likely to see them in the clinic because they are usually milder headaches and they don’t interfere with their activities.”
Tension type headaches don’t mean you have tension in your head or in the muscles — it’s just the name that they chose for it, Helm said.
“In the old days they used to think that it was caused by muscle tension, but it’s really not; it comes from the brain,” Helm said. “The mechanism of a tension type headache is not like a migraine — a migraine is a problem in the chemistry of the brain — but a tension type headache is more of a symptom than a disease and a migraine is more of an actual neurological disease.”
Tension-type headaches are thought to be symptom headaches, which means these types of headaches are usually an indicator that something else is going on within the body.
“The way we diagnose tension-type headaches is based on the lack of migraine symptoms,” Helm said. “A typical type of tension headache is kind of mild and then it goes away, you don’t really seek medical attention for it.”
This type of headache starts at the neck and then travels around the head like a vice, it feels like a squeezing pain around the head, Saxton said.
Even though there is no way to prevent a tension-type Helm said there is are relaxation techniques that can help.