Headache

When to consult a  physician?

Although most headaches are harmless, sometimes they can be caused by a serious illness.

So, although it is always good to consult a physician, in some cases it is absolutely necessary:

An urgent neurological examination is needed in the case of a sudden headache accompanied by nausea, consciousness impairment or other neurological symptoms.  These symptoms may be caused by bleeding.

An urgent examination at the infectious diseases service in the case of a headache accompanied by fever, nausea, impaired consciousness and neck stiffness. These symptoms may be caused by meningitis.

A neurological examination is also needed in other situations, such as: Headache accompanied by neurological symptoms, e.g. muscle weakness, sensory symptoms, mental changes.

Headache without a clear cause in a person with no prior history of headaches.

Increased frequency, worsening or significant change in headache associated symptoms in people with a history of migraine or tension headache.

How common are headaches?

Headaches are a very common health problem.  Epidemiological studies show that nearly 50% of people have at least one headache episode per year.

The most common is the tension-type headache, which appears in about 40% of cases. Migraine is the second most common, which is present in 10% of cases. Approximately 3% of people suffer from chronic headaches, which is defined so if the headache is prevalent for more than 15 days a month.

What is the difference between the migraine and tension-type headache?

An attack of tension-type headache may last from 30 minutes to a couple of days. Patients usually describe it as pressure or tightness, often like a band around the head, and sometimes spreading into or from the neck. In addition to the headache, some people are sensitive to pressure in the area of ​​pain. It can be light do moderate in intensity, but with such a headache usually a person can perform normal daily activities. Tension headache is not accompanied by vomiting or any other symptoms.

An episode of a migraine headache can last from 4 to 72 hours. The characteristics of migraine include pulsing and throbbing head pain, pain on the left or right side of the head, increased sensitivity to light and sound, nausea and vomiting. The symptoms can aggravate by simple routine physical activity, such as walking or climbing stairs. Before the onset of the painful phase, some people experience transient visual symptoms such as blind or coloured spots, zigzag lines, etc. Such symptoms are called the visual aura.

What triggers migraine?

A migraine can be triggered by various environmental, dietary or physiologic factors. In some people, outbreaks of headache are associated with changes in weather, which obviously cannot be avoided. However, it is very important to identify those triggers that can be avoided. Some people are sensitive to the consumption of even small quantities of red wine, some types of cheese or foods with certain additives. Headaches can also be triggered by changes in sleeping patterns, which can provoke headaches at weekends. Each person should, therefore, identify her/his triggers, and in consultation with a neurologist create a personalised plan to avoid them.

More about migraine triggers can be found on the page

When to consider preventive medication?

Prophylactic drug therapy should be considered if migraine attacks occur several times per month, lasting more than 24 hours and cannot be suppressed with medication taken during the migraine attack. When preventive therapy is agreed with the neurologist, the pills should be taken even on days with no symptoms. This approach will probably not eliminate headaches, but the frequency and intensity will probably decrease significantly. Different types of medication can be suitable for preventive therapy. In addition to migraine prevention, some of these medicines are also used for treating epilepsy, heart disease and some psychiatric disorders. When considering which drug would be the most appropriate, the neurologist assesses various factors, including gender, age, possible concomitant diseases and therapies.

Can acupuncture help with migraines?

Although the mechanism of action is only partially known, modern medicine has accepted acupuncture as a therapeutic method in treating various painful conditions, including migraines. There is a large body of evidence to suggest that acupuncture is effective for treating migraine.  Several clinical studies have shown that acupuncture is as effective as preventative pharmacological therapy. Moreover, according to these studies acupuncture had the advantage of having fewer undesirable side effects.

How does biofeedback help with headaches?

In addition to acupuncture and some relaxation techniques, biofeedback therapy has proven effective in migraine and tension-type headaches.  Biofeedback technique uses an electronic device to help teach the body to control certain physiological functions, which normally are not under conscious control. An example of such a function is a degree of muscle tension. Once a person learns to control this function, it can be used for the treatment of tension-type headache. When it comes to migraine, by using biofeedback techniques one tries to learn how to influence the degree of muscle tension in blood vessels of the head and thus control the headache.