Headaches 101

Dr. Sean Kenniff On The Four Main Types Of Headaches, And How To Ease The Pain

(CBS)  Not all headaches are created equal.

For instance, do you know the difference between a migraine and a cluster headache?

On The Early Show Wednesday, medical contributor Dr. Sean Kenniff explained the differences among the four main types of headaches, and offered tips on how to get some relief from each of them.

TENSION HEADACHES: THE MOST COMMON

Tension headaches affect up to 40 percent of people at some point in their lives. Most describe it as a tightness around the head as though there's a vice or tight band wrapped around their head. The neck and shoulder muscles may also be sore to the touch.

HOW ARE TENSION HEADACHES TREATED?

Most people can be successfully treated with over-the-counter medications such as aspirin, ibuprofen or acetaminophen. But these medications should be limited to no more than a few days per week because, if used more frequently, you can get "rebound" headaches once you stop taking them.

MIGRAINE HEADACHES: HAVE UNIQUE FEATURES

The typical migraine headache is a throbbing or pulsating sensation in the head, usually on one side, but it can affect both. Patients usually report nausea, with or without vomiting, and sensitivity to bright lights and loud noises. The cause is thought to be swelling in the blood vessels and nerves that surround the brain.

WHAT'S THE BEST WAY TO TREAT A MIGRAINE?

Most people with migraines will tell you that the first thing they want to do is find a dark, quiet place to lie down. Treatment is typically two-fold: medications to treat the ongoing attack, and medications to prevent migraines in the future. For an acute attack, over-the-counter medications can help some people. Ibuprofen, aspirin, acetaminophen or combinations that include caffeine can work. However, many people require a prescription medication. Some of the most popular are the triptans, such as Imitrex and Zomig. There are also a number of medications available by prescription to help prevent future migraines -- such as anti-seizure medications, anti-depressants, and blood pressure medications.

IS THERE A LINK BETWEEN A COMMON HEART CONDITION AND MIGRAINE?

Before birth, babies have a hole in their heart that normally closes in childhood. But, in about 25 percent of people, that hole remains open. As it turns out, people who suffer certain types of migraines are more likely to have this hole, and if this hole is surgically repaired, the migraine symptoms often abate.

CLUSTER HEADACHES

Cluster headaches affect about a million people in the United States, and are much more common among men. The pain typically centers around one eye and often causes a runny nose and facial flushing on the affected side. Episodes may last up to a few hours, but tend to recur several times during the same day for several weeks or months -- hence the name "cluster" headaches. Once the headaches end, a patient may not get another episode for months or even years. The cause isn't fully understood.

HOW ARE CLUSTER HEADACHES TREATED?

Unlike the situation with migraines, most people who get cluster headaches feel better if they remain active during the episode. Interestingly, inhaling 100 percent oxygen can help at the first sign of headache. That can be prescribed by a doctor. Otherwise, treatment is generally aimed at preventing attacks, and there are a number of prescription medications available, such as lithium, and a heart medicine called Verapamil.

SINUS HEADACHES

People with sinus headaches usually complain of a pressure or pain in the forehead, cheeks, nasal area, or behind the eyes. These headaches are usually caused by swelling and fluid buildup in the sinuses stemming from hay fever or a cold.

WHAT'S THE BEST TREATMENT FOR A SINUS HEADACHE?

For the pain, people can again take over-the-counter pain medications. But another thing to try is an over-the-counter decongestant, or an antihistamine, which can help relieve the pressure in the sinuses.

WHAT IF YOU HAVE A HEADACHE THAT DOESN'T SEEM TO GO AWAY?

If you ever have a severe headache, such as the worst headache of your life, you need to get to an emergency room immediately. Also, if you have a headache that lasts longer than usual, or you have unusual symptoms, you need to see your doctor to ensure you don't have a serious underlying medical condition causing your headache.

[eerilyodd-2009]

Aura is a feature of classic migraines only, not common migraine.

[lochlan-2009]

I went to the hospital last month for a migraine. I used to get migraines, as a kid, all the time, but this one was weird. It didn''t have the sensitivity to the light and sound, it was really intense pain in my right temple (that lasted for 3 days), and my fingers in my left hand went numb. Fearing a mild stroke or hematobin I went to the hospital (because "no one can give you their opinion over the phone"). They said it was a rare type of head ache that sometimes happens, and they have no idea why. So, I thanked them for the non-diagnosis, got a prescription, and havn''t had one since.

[candyla5]

I am really surprised that the doctor did not even touch on probably THE MOST obvious distinction between a migraine and other headaches, and that is the post-headache symptoms, that tell a person that he or she has a migraine coming on. Those post-symptoms can be any one or more of the following:

1. Aura consisting of at least one of the following, but no muslce weakness or paralysis:
* Fully reversible visual symptoms (e.g., flickering lights, spots, lines, lost of vision).
* Fully reversible sensory symptoms (e.g., pins and needles, numbness).
* Fully reversible dysphasia (speech disturbance).
2. Aura has at least two of the following characteristics:
* Visual symptoms affecting just one side of the field of vision and/or sensory symptoms affecting just one side of the body.
* At least one aura symptom develops gradually over more than 5 minutes and/or different aura symptoms occur one after the other over more than 5 minutes.

The doctors'' statements about sleeping it off is inept advice, because it is not possible to sleep when one is experiencing such pain. This day and age, there are medications specifically for migraines, the triptans mentioned, and other meds, and no person should try to last it out or try to sleep it off - this is ludricous!

He at least could have mentioned the most obvious distinction between migraines and other headaches, and that is, the post-symptoms!

Thank you.

Candice A. LaCroix

[rupertchiro]

Was extremely pleased when you had a Doctor of Chiropractic talk about the cause of back pain(not just the symptom of pain). It''s the same for Tension and most often, Sinus Type headaches. Spinal injuries of the neck(minor or major)are the most common causes of these types of headaches for which people spend millions of dollars each year treating but never fixing.

[model63]

I could not agree more with Mike. I suffered with migraine headaches for over 10 years. Doctors attributed them to dehydration, stress, lack of sleep, incorrect prescription glasses, poor posture among others. Finally, purely by chance i went on the Atkins diet to support my wifes dieting efforts. Suddenly headaches got substantially better. By trial and error discovered over the next year I was "allergic" to wheat, yeast and aspartane. I have altered my diet and rarely get migraines anymore. Only if i "slip up" and get something i shouldn''t, usually at a restaurant. Bottom line, if you suffer migraines try a lamb and rice diet for a week to see if it helps. You have nothing to lose and everything to gain. My life has really been changed, and if i had relied on doctors i would still be medicating my headaches instead of curing them--good luck!

[mikebannon11]

Cluster headaches are rare...and it can take a long time and lots of work to properly diagnose them. It took years for me.

Here is a site with great information...put together by and run by cluster headache sufferers:

www.clusterheadaches.com

Great information for sufferers, doctors and those who know and love people who are affected by these.