A headache, or cephalgia, is pain that occurs anywhere on the head or neck. Headaches have many causes, including daily stress. They may also be the result of referred pain — pain from a neck strain, upper back issue or tired eyes. Headaches have also been linked to hormonal fluctuations, depression, sinus infections, reactions to food and perhaps the most common cause — lack of sleep.
Given the wide range of or causes for headaches, finding a way to control them can be challenging. A pain specialist will classify the headache as primary or secondary. Primary are caused by an underlying disease or condition. Secondary are benign. Acute headaches are considered primary; these types of headaches include migraines, tension and cluster. Less common versions include cold-stimulus, benign cough and benign exertion headaches.
When examined, a pain physician will ask many questions about the nature, duration and type of pain caused by the headaches to determine the ultimate source. Specifically, the physician will ask about the worse headache experienced, and review the patient’s age. The onset of acute headaches in those age 50 and older can be a sign of temporal arteritis or mass lesion.
Treatment for acute headaches is two fold: abortive and preventive. Abortive treatments stop headaches that have already started, while preventive measures come from identifying and eliminating headache triggers. There are pharmaceuticals designed for both treatments. Non-steroidal anti-inflammatory drugs (NSAIDs) are an immediate relief in many patients. Also commonly prescribed to headache patients are serotonin-binding ergot alkaloids and triptans; these have effective vessel-constricting qualities.
Other medications used to control headache includes: antidepressants, antiepileptics, beta-blockers and calcium channel antagonists. Many studies have shown the effectiveness of these drugs in treating acute headaches. Also, anti-emetics may be prescribed to help control nausea that often accompanies headaches.
Also, therapeutic options for headaches include: a review of diet, occipital nerve stimulation, botox injections, cervical facet injections, cervical epidural steroid injections, occipital nerve blocks, sphenopalatine ganglion blocks, supratrochlear nerve blocks, spura/infraorbital nerve blocks, and radiofrequency ablation.
Patients often misuse drugs for acute headaches, leading to other health issues. Also, these pharmaceuticals may not work. Some 98 percent of migraine suffers say they find temporary relief in medication, but their lives are still greatly influenced by pain and debilitation associated. In turn, there are non-pharmacological treatment options acute headache patients may also consider. Specifically, diet control has shown great results in reducing acute onset headaches. A headache and food journal may provide necessary answers to those dietary triggers causing acute attacks.
Other treatments to consider include cognitive behavioral therapy and biofeedback. Both help teach symptom reduction, or coping, skills.
While serious causes of headaches are not common, regular acute headaches may be a sign of a more serious disorder. A pain physician should be consulted if a patient has sudden, severe headaches — especially if they are ever in tandem with a stiff neck, fever, loss of consciousness or pain in the eye or ear.