Know your headaches | The Daily Star
12:00 AM, September 03, 2019 / LAST MODIFIED: 12:00 AM, September 03, 2019

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Know your headaches

This week, Dr Firdous Quader Minu deviates from her usual column and writes on headaches. Something she feel is often neglected and as a result, most people suffer unnecessarily.

Perhaps, there is no persons in the world who has not suffered from headaches once in a while. Frustrating as it may be, patients need not worry as most headaches are manageable, and should not be as physically disruptive as they sometimes turn out to be.


In medical terms, a headache is pain experienced from the region above the eyebrows and the ears, behind the head or at the back of the upper neck. It is divided into two main categories — primarily, one that originates from the head and neck region; and the secondary, one due to some illnesses such as sinusitis, hypertension,  dehydration, caffeine withdrawal, etc.

Irrespective of the cause, all forms of headaches, caused by stress, sinusitis, migraines, cluster headaches, or otherwise can be minimised. The first step would be to identify the cause of the headache. And then find a suitable routine for management and prevention of repeated attacks.


They can be episodic, or consistent — one that can last for an hour, or even more. These usually go away with OTC (over the counter) medication.

They can also be chronic, and if they are more consistent; more of a daily occurrence, they need to be managed properly, or can get prolonged over long periods.

The most common headache is episodic — this can happen to anyone, at any time, and they do not last long. Usually simple things like a bad day at work, hunger, heat, or low temperatures, winter chills, etc. can trigger such forms of headaches. These usually go away with over the counter (OTC) medicines.

Stress related headaches

They are common, especially in adults. These can be discomforting and should be looked into, or they can turn into something chronic. Patients usually complain that there is pain in the back of the head or neck, moving upwards.

It feels very tight around these areas as well as the jaws and shoulder areas. This occurs due to spasm of the muscles around the neck, or the jaws, due to prolonged posture, or physical and psychological stress.

It starts around mid-day and gets stronger as the time progresses. Unlike migraines, with this headache, there are no other symptoms like muscle weakness, blurring of vision, or nausea. The patient does not have to stop regular routine work due to the headaches.

Having chronic fatigue, disrupted sleep and concentration, irritability, slight dizziness, etc. all may start the headache. There is usually some underlying tension, or stress related to these. The cause must be looked into and eliminated. It can be treated by OTC medications and some relaxation techniques along with rest and avoidance of stress factors.

Cluster headaches

These usually affect men more than women, and can occur on a daily basis for a while and then disappear for years. The pain is described as a burning excruciating pain behind one eye, or the face.

Swelling, flushing, redness of the affected eye and congestion on the nostril can occur. The headache can occur more than once in a day and can last up to one to three hours in a day.

Diagnosis is usually from history and treated by OTC medication added with some prescription medication to avoid further attacks. Avoidance of too much alcohol and smoking is advised.


It is an intense throbbing pulsating pain on one side of the head lasting from a few hours to days. It is hereditary, and women are affected more. The patients usually feel nausea, vomiting, increased sensitivity to light and sound. Patients have varying triggering factors like environment, hormones, empty stomach, different smells, or even wet hair. Each case is unique.

Patients can usually feel the headache coming on, also known as an aura, which can be a flash of light, tingling of limbs or face, etc. This helps in the treatment of the headache as it can be prevented by taking medication during the aura.

Taking regular medication and maintaining a regular lifestyle can avoid the onset of migraines. It is very important for these patients to take regular medicine for prevention of the headaches as they can face loss of working ability for a day or two.

The frequency of this type of headache usually reduces with age. Once the patient develops a routine of how to handle headaches, life becomes less disruptive. The doctor will prescribe anti-migraine drugs to be taken regularly as they reduce onset of headaches. Also medications for acute pain are prescribed. Changes in lifestyle to avoid triggering factors is necessary.

Secondary headaches are associated with other illnesses in the body and the headache is just a symptom. It can happen in cases like trauma to the head and the neck, disorders like strokes, infection of sinuses, pneumonia, eye diseases, substance abuse, or withdrawal from narcotics.


This is a common cause of headache, occurring in change of season, allergies, or any other factors affecting the nose or sinuses. There is pain in the front of head and also face, throbbing in nature, with or without rhinitis. If it doesn’t go away with pain medication a visit to doctor will diagnose the case after doing an X-ray of the sinuses. After diagnosis, headaches will subside with proper medication. If there is any predisposing cause for sinusitis, that also needs to be treated to avoid recurrence.

Hormone headaches can occur before, during or after menstruation. It may also occur during the premenopausal time. It will usually subside when hormone fluctuations stop. OTC medication helps during the headache.


This can cause headaches too. The pressure can cause throbbing pain behind the neck/head. If the patient is already being treated for hypertension, then they should check if medication is adequate or not. Correct dose of medicines is very essential in hypertension, as it may lead to strokes or heart attack.

Headaches caused by medication!

Rebound headaches is usually caused by the overuse of pain medication (at least 15 days in a month). The medication overuse must be stopped and counselling is needed.

Please note, overuse or abuse of narcotics and alcohol can also cause headaches. Tumours and aneurysm of the brain and the meninges can also cause headaches. If headaches persist despite OTC medicines, do consult your doctor.

If a headache is not minimised by rest and OTC medicines, then seeking professional medical help should be considered.

Consultation with a physician will help in the correct diagnosis through appropriate tests, and this can ensure an improved quality of life and fewer disruptions in our day to day activities.  

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