Headache: what to do?


Headache: what to do?

It is unlikely that among us there are lucky people who have never had a headache. When is a headache a cause for concern and how is it properly treated? We deal with a neurologist.

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Kirill Skorobogatykh
Candidate of Medical Sciences, Neurologist, Director of the “University Headache Clinic”

“Headache is one of the most frequent problems with which patients come to the doctor,” says Kirill Vladimirovich. Indeed, more often you can meet perhaps caries. We used to endure a headache or drink it with medicines, but is this the best way out?

How to understand what is happening

“When a patient comes to me with a headache, the most important thing is to eliminate the possibility that this headache is a symptom of a more threatening condition. We call this pain "secondary", it can be associated with various diseases of the nose, ears or eyes, infection, head injury, and many others. There are “red flags” at the doctor’s disposal that indicate the possible presence of another dangerous disease, ”says the doctor.

Fortunately, secondary pains account for only 5–10%.“Primary” headaches, that ar freelance diseases of the brain itself, ar much more common. The most common ones are tension headaches and migraines.

When it hurts, but not very much

If, after a hard day’s work, a headache begins to hurt, but no additional symptoms (nausea, discomfort from light or sounds) appear, you will most likely have a tension headache.

“Typically, these pains are bilateral, localized in the frontal or occipital region, have a monotonous oppressive character, but in intensity are quite moderate,” Kirill Vladimirovich describes the symptoms.

When it hurts and prevents life

It so happens that recurring headache attacks turn into a real test and take away the opportunity to continue working.

Kirill Vladimirovich explains it this way: “Such pains, as a rule, are one-sided, throbbing, of medium or high intensity, and they increase with physical exertion. If at least two of the four criteria are met and these attacks are also accompanied by unpleasant sensations (nausea or vomiting, hypersensitivity to light or sounds), then the most likely diagnosis is “migraine. ”

When it hurts like never before

Headache, which with its abrupt onset, intensity or character scares you, is a sure sign that it is time to call an ambulance. These are the very “ red flags ” that talk about, perhaps, the secondary nature of the headache.

Yes, it may be the debut of a migraine or other disease, but the key factor in creating an emergency is time, so don't delay your doctor's visit.

When to call an ambulance :

  • Thundering headaches - sharply arisen, intense and growing to a maximum in minutes.

  • A new kind of headache that arose after the age of 50 years.

  • Changes in the nature of headache attacks (more often or stronger than usual, longer or completely new course).

  • Headache, which changes dramatically when you change position.

  • If a headache has occurred in the background of severe chronic disease (HIV, cancer).

  • Headache on the background of high temperature.

  • Sudden nausea, vomiting, confusion, convulsions, impaired speech, or dilated pupil.

  • If headaches are provoked by sneezing, coughing, straining.
Why headache

With secondary headaches, everything is relatively simple: there is a primary disease (sinusitis, otitis), which affects the pain receptors of nearby tissues. The signal goes to the pain center of the cerebral cortex and attracts our attention: there is something wrong!

With independent headaches, it is more difficult to explain the cause: the substance of the brain is deprived of pain receptors, so the brain itself cannot hurt. Studies suggest that in such cases, the person's sensitivity to neurons is impaired and the transmission of pain signals is facilitated. Simplifying, we can say that the balance is disturbed in two systems: the one that perceives pain, and the one that blocks it.

“As a long-term practice shows, most often people explain headache attacks by three reasons: osteochondrosis of the cervical spine, vascular problems or high intracranial pressure. But I must say that in reality these are very rare situations - and then such a headache will be considered secondary, ”the expert says.

Painkillers handfuls - really bad

Painkillers with excessive use have a negative effect on the intestines (cause ulcerative lesions of the gastric mucosa) and kidneys (reduce blood flow in the kidneys, cause disruption of their tubules, resulting in irreversibly reduced ability to filter).

Moreover, overuse of painkillers can trigger a drug-induced, or about use, headache. In this situation, medication only starts a new cycle of pain, a vicious circle is formed.

The most important thing: you need to treat not pain, but illness. The removal of symptoms by pills makes it impossible for the doctor to deal with the original signals that the body gives.

How to treat

You need to start by finding out the reason. The doctor will help you to choose from more than 200 diagnosis options.

If this is not a dangerous secondary headache, but an ordinary attack of a tension headache, you need to rest.

If necessary, you can take simple non-prescription drugs (for example, paracetamol, aspirin, ibuprofen).

Defeating these pains is possible by adjusting the regime: a sufficient amount of sleep, regular exercise, and diet.

If possible, reduce the load at work or school, organize an ergonomic workplace and arrange breaks at work at the computer.

In case of aggravation of pain attacks or their increase (more than 1 time per week), consult a neurologist. 

If you have a migraine, individually selected therapy and regimen will help you to turn frequent attacks into rare ones and ease their flow.

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