Types of Chronic Headaches
The three most common types of chronic headaches are migraines, tension headaches and cluster headaches. Because they all have different underlying causes, they cause different and distinct types of pain. Treatment for chronic headaches is usually medication-based, however a number of different complimentary and alternative treatments may be effective as well.
Migraines
The exact cause of migraine headaches is still under debate, but researchers agree that they are neurological in nature. Formerly, migraines were thought to be caused by dilation of blood vessels in the brain; however, newer research indicates they may be caused by changes in brain activity at the cellular level. A migraine can be triggered by external factors such as excessive heat or light, or internal factors like stress or hormonal fluctuations.
Migraines cause severe headache pain, often on one side of the head. Unlike other types of headaches, however, migraines often come with a whole other list of symptoms, including one or more of the following:
- Visual disturbances, such as auras or flashing lights
- A metallic taste in the mouth
- Sensitivity to light
- Sensitivity to sound
- Nausea
- Vomiting
- Fatigue
Migraines can be treated with over-the-counter medication such as NSAIDs, however chronic and severe migraines require prescription medications. These include tricyclic antidepressants and beta blockers. A number of complimentary and alternative migraine treatments may help too, such as yoga and acupuncture.
Tension Headaches
A tension headache often feels like a band of pressure around the head, and may be accompanied by pain in the neck and shoulders. Researchers previously believed that tension headaches were caused by tightness or pain in the neck and shoulders, leading them to sometimes be labeled muscle tension headaches. Newer research indicates they may be caused by excessive input from muscles of the head going to the pain control center in the spine.
How do you know if your headache is a tension headache? Tension headaches are often felt all over the head, and most frequently described as dull pressure that is worse over the temples and the back of the neck. They have no neurological symptoms, and can last anywhere from 30 minutes to several days.
While the exact cause of tension headaches is not certain, several factors are believed to be triggers, including:
- Alcohol
- Caffeine
- Overexertion or fatigue
- Smoking
- Nasal or sinus congestion
- Eye strain
How do you treat a tension headache? Depending on the severity of the headache, over-the-counter or prescription doses of NSAIDs or other simple analgesics are often effective. Regular use of tricyclic antidepressants may keep tension headaches at bay. Complimentary treatments such as meditation and massage may also alleviate tension headache pain.
Cluster Headaches
The least common of the three, cluster headaches are a bit of a medical mystery. They may be caused by vascular changes in the brain, or by a complex series of activation in certain areas in the brain. Cluster headaches are distinct from both migraines and tension headaches in that they occur in short bursts over a period of time.
Cluster headaches may feel sharp, or like burning. Like migraines, they are neurological. However, their accompanying symptoms are much different. They include:
- Pain felt over or behind one eye
- Watery eyes
- Red or puffy eyes, especially on the painful side of the head
- Droopy eyelids
- Restlessness or agitation
Cluster headaches are short-lived, which means medications are not always effective. Preventative medications include corticosteroids and antiepileptics. Local analgesics such as pain patches may help relieve cluster headache pain, and some physicians use oxygen therapy to ward off tension headaches. Some people find relief with dietary supplements such as melatonin. You should talk to your doctor before using any dietary supplement as is may react with certain prescriptions or cause other complications.
Coping with Chronic Headaches
Medication and alternative treatments can help control chronic headache pain, but like many other conditions chronic headaches can disrupt your daily routine. Many people are forced to make lifestyle changes to accommodate headache pain, which can get to you after awhile.
Coping with chronic headache pain involves finding the best support possible, whether it is your friends and family or a network of peers. Look for support groups either locally or online. Doing some research and keeping up with doctor’s appointments can also help you stay on top of your headache pain, regardless of what type of chronic headache you suffer from.
Sources:
Fumal, Arnaud and Schoenen, Jean. Tension-type Headache: Current Research and Clinical Management. Lancet Neurology, 2008; 7: 70–83.
May, Arne. Cluster headache: Pathogenesis, Diagnosis, and Management. Lancet 2005; 366: 843–55
National Institutes of Health. Medical Encyclopedia: Tension Headache. Accessed April 2, 2009. http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000797.htm
Silberstein, Stephen D. Migraine. The Lancet. Volume 363, January 31, 2004. pp381-391.
