Physical activity and stress: we understand why the headache

Headache is a common ailment that every person faces in life.

Such pain can be throbbing or constant, sharp or dull, transient or prolonged. Sometimes a headache is not dangerous, but in some cases, it can be a symptom of a severe illness.

Let’s talk about the types of headaches that occur most often:

• Why do they occur?
• How to cope with discomfort.
• At what point it is better to see a doctor.

Tension headache

This is the most common type. Usually mild or moderate.

Symptoms. The pain is dull and aching. It feels like a tight bandage around the head – from the forehead to the back of the head. Sometimes causes soreness of the skin on the head, neck, and shoulders.

Episodes of severe tension-type headaches can be confused with migraine. Unlike migraines, tension headaches are bilateral and do not cause nausea or vomiting. But a severe attack can be accompanied by increased sensitivity to light and sound.

According to the frequency of occurrence, tension headaches are divided into three types:

1. Episodic – once or twice a month.
2. Frequent – no more than 15 times a month for several hours.
3. Chronic – occurs more than 15 days a month or maybe almost permanently.

The reasons. Previously, it was thought these pains were associated with tension in the head, neck, and shoulder muscles. Now scientists believe that muscle tension, although important for the onset of tension headaches, the main reason lies in the increased sensitivity of the entire pain system of the body. Susceptibility to tension-type headaches likely depends on genetic factors.

The most common trigger is stress. Provoking an attack can: include alcohol, excess caffeine, poor sleep, dehydration, and fatigue.

Treatment. From episodic pain, rest, and taking non-steroidal anti-inflammatory painkillers – Pentalgin, ibuprofen, and others – help.

Treatment of chronic tension pain requires a visit to a doctor who can prescribe stronger painkillers, muscle relaxants, and antidepressants. Psychotherapeutic treatment is indicated for chronic pain, which helps cope with stress.

Migraine

Migraine is a common neurological disease, the main symptom of which is a throbbing pain on one side of the head. The disease begins at a young age and affects one in five women and one in fifteen men.

Symptoms. The headache is severe and felt on one side of the head. Usually localized near the eye and temple, but can spread to the back of the head and face. Accompanied by an acute sensitivity to sound and light, nausea, and vomiting.

Attacks last from several hours to several days. Often against their background, loss of appetite, chills, or a feeling of heat, dizziness develop.

There are several main types of migraine. The most common is a regular migraine without aura.

In second place is migraine with aura, or complicated. This type of disease accounts for 20% of all cases.

An aura is a group of symptoms that last from 10 minutes to an hour and warn of the approach of a migraine. Migraine aura manifests itself:

• bright flashing dots and lights before the eyes;
• blind spots, up to a complete temporary loss of vision;
• numbness or tingling of the skin;
• ringing in the ears;
• changes in the sense of smell or taste.

There is also a “silent migraine” – without pain. In this case, the aura appears, but the pain does not occur after it.

Doctors consider status migraine the most severe type: a condition with attacks that last longer than three days and are accompanied by severe headaches and vomiting.

There are types of migraine with severe neurological symptoms: hemiplegic, retinal, and migraine with stem aura. But they are rare.

The attack or its aura may be preceded by a prodromal period in any type of migraine. Occurs one to two days before an attack. Characterized by:

• sudden mood changes, sleep problems;
• constipation;
• increased urination or fluid retention;
• neck stiffness;
• unbearable craving for any product;
• frequent yawning.

After the migraine attack, in 80% of cases, a postdrome period lasts a day or two. At this time, a person feels exhausted, quickly irritated, and unable to focus. Most people describe their condition as depression. But some are overwhelmed by euphoria.

The reasons. The exact cause of migraine is unknown. It is assumed that the neurotransmitter serotonin is involved in the development of an attack. It has been established that the tendency to have migraines is determined genetically.

Migraine attacks have triggers: stress, extreme fatigue, and certain foods or drinks, such as coffee, alcohol, and sausages.

Treatment. Usually, non-steroidal anti-inflammatory drugs – ibuprofen, aspirin, and “Pentalgin” are used to stop a migraine attack. Rest in the dark, quiet, cool room helps a lot.

If a person is diagnosed with a migraine, they have been prescribed drugs from the triptan group, such as sumatriptan or zolmitriptan. They affect the functioning of the neurotransmitter serotonin.

Additionally, monoclonal antibodies, antidepressants, anticonvulsants, and hormonal anti-inflammatory drugs may be prescribed depending on the patient’s condition.

Cluster headache

Cluster headaches are one of the most excruciating. People with cluster pain say that the onset of an attack is like sticking a hot poker in the eye.

Despite the terrible pain, cluster seizures are not dangerous but significantly impair the quality of life.

Symptoms. Attacks are painful and develop quickly. Often begin without warning, in a dream.

The pain is localized in one eye or behind it. It May radiate to other areas of the face, head, and neck on the same side of the body as the affected eye.

On the side affected by pain, pallor or redness of the skin, nasal congestion, swelling, lacrimation, and omission of the eyelid may be noted.

Sometimes the attack is accompanied by increased sensitivity to sounds and light.

The attack lasts from 15 minutes to several hours. The most severe pain lasts no longer than two hours. It goes away as quickly and suddenly as it begins.

A distinctive feature of cluster pain is the occurrence in series or clusters. A single attack takes several hours. Then the pain goes away but returns after a few hours. A person can experience up to four attacks per day, which form one cluster.

A few hours after the cluster has ended, the next one begins. Usually, the number of attacks in each cluster is the same, beginning at approximately the same time.

Cluster pains are episodic and chronic. Episodic regularly comes in the period from one week to a year. This is followed by a break of at least three months. Often, cycles of episodic cluster pain occur in spring and autumn. Breaks between cycles can be up to several years.

In chronic pain, the cycle of clusters lasts from several weeks to a year. And then, less than a month later, the next one begins.

The reasons. Cluster pain is associated with expanding blood vessels that pressure the trigeminal nerve. Because of what the vessels dilate, it is not exactly established. This may be due to changes in the work of the hypothalamus and neurotransmitters, mainly serotonin.

Cluster pain is more common in men between the ages of 20 and 50. Genetic predisposition plays a role.

Treatment. Drugs from the triptan group are used to alleviate seizures, affecting serotonin receptors’ functioning.

For severe cluster pain, steroidal anti-inflammatory drugs, blood pressure medications, and anticonvulsants are prescribed to prevent attacks.

In extremely severe cases of chronic pain, an operation is performed to turn off the trigeminal nerve.

Chronic hemicrania

Chronic hemicrania is a constant moderate to severe headache in one side of the head.

Symptoms. In chronic hemicrania, the pain does not go away. Within 3-6 months, one-half of the head constantly hurts. Several times a day, the pain becomes stronger, then returns to its previous level.

On the half of the head affected by pain, redness of the eye, lacrimation, nasal congestion, and drooping of the eyelid are noted. Sometimes the pain is migraine-like and is accompanied by throbbing, nausea, and sensitivity to light and sound.

The reasons have not been established. It is only known that women suffer from chronic hemicrania twice as often as men. And exercise and alcohol increase the pain.

Treatment. Non-steroidal anti-inflammatory drug indomethacin helps with chronic hemicrania. It is taken continuously for an indefinite period. Since indomethacin is harmful to gastric mucosa, it is prescribed with antacids. Other anti-inflammatory pain relievers are less effective for this type of pain.

Usually, after 3-6 months from the onset, the pain disappears but may return. Tricyclic antidepressants are sometimes prescribed to prevent relapse.

Primary stabbing headache

Primary stabbing headache is also known as “ice stick” pain. Scientists argue about the prevalence of this type of headache. Some researchers believe that no more than 2% of the world’s population suffers from primary stabbing pains. Others believe that every third adult has experienced such pain at least once in their life.

Symptoms. The pain is extremely sharp. Occurs suddenly during sleep or wakefulness. Lasts from 10 seconds to 2 minutes. It affects different parts of the head. During the day, it can be repeated up to 50 times. And it can occur once, but usually for several days in a row.

Sometimes the primary stabbing pain resembles a short-term cluster. But it is never accompanied by the omission of the eyelid, lacrimation, or redness of the face.

The reasons have not been established. It is assumed that pain is caused by fleeting disturbances in the brain’s central mechanisms of pain control.

Primary stabbing headache affects people of all ages and both sexes. But a special risk group comprises women prone to migraines and patients with cluster headaches.

Triggers – stress, disruption of the usual daily routine, alcohol, hormonal changes.

Treatment. Since the primary stabbing pains last only a few seconds, no pain medication is taken for them. But if “ice shots” occur frequently, prophylactic agents are prescribed. These are usually the non-steroidal anti-inflammatory drug indomethacin and the sleep hormone melatonin. In rare cases, anticonvulsant drugs are indicated.

People prone to primary stabbing pains are advised:

• observe the daily routine, get enough sleep;
• limit alcohol and caffeine intake;
• learn to manage stress – master the skills of muscle relaxation and meditation.

Primary exercise headache

Pain occurs during or after intense exercise. Not associated with any disease.

Symptoms. The pain is bilateral or on one side of the head, given to the neck. Often pulsating. It occurs quickly, lasting from several minutes to several hours. Sometimes it resembles a migraine and is accompanied by increased sensitivity to light and sound.

The reasons. The attack begins due to the expansion of the blood vessels of the brain during intense physical exertion. However, it is not known why physiologically normal vasodilation causes pain in some people and not in others. It has been observed that pain from exercise is more likely to affect those who suffer from migraines or have close relatives with this disease.

Attack triggers are any activity that accompanies physical exertion: running, aerobics, swimming, sex, and coughing. Exercising at altitude, in heat or cold, increases the risk of an attack.

Treatment. Non-steroidal anti-inflammatory drugs are taken to relieve pain. Indomethacin works best. Some people benefit from taking beta-blockers such as propranolol.

Sinus headache

Sinus headaches are caused by sinusitis, an inflammation of the lining of the paranasal sinuses and nasal cavity.

Symptoms. Pain, pressure, and distension in the region of the eyebrows, upper teeth, forehead, and under the eyes. The malaise is accompanied by thick discharge from the nose and deterioration of the sense of smell. Other symptoms of inflammation of the sinuses may be noted:

• General poor health
• A slight rise in temperature
• Redness of the nasal passages

Sinus pain is aggravated by tilting the head, moving to a horizontal position in the morning after waking up, and going out into the cold from a warm room.

Sinus headache is sometimes confused with migraine with nasal symptoms, which also present with nasal congestion and facial pressure. But sinus pain has several differences from migraine. Such pain is not accompanied by nausea and vomiting and is not aggravated by noise or bright light. And the discharge from the nose is thicker than with a migraine.

The reasons. Sinus headaches are caused by the accumulation of mucus and swelling in the sinuses, which can be caused by:

• colds, acute respiratory viral diseases;
• allergy;
• neoplasms, such as polyps;
• deviated nasal septum.

Treatment. To eliminate sinus headaches, the disease that has led to the accumulation of mucus in the sinuses is treated.

For allergies, take antihistamines. Polyps are removed surgically. With a viral infection, wait until it goes away on its own, and vasoconstrictor nasal sprays are used to relieve symptoms. Antibiotics may be recommended by a doctor for bacterial illnesses.

Pain from drug abuse

This type of pain is otherwise called ricochet. Associated with overuse of headache medications.

Symptoms. The manifestations of rebound pain depend on the type of pain treated with pain medications and the type of these drugs. General signs:

• high frequency of occurrence – almost every day;
• a good effect from painkillers, which disappears as soon as the effect of the drug ends;
• increased anxiety and irritability.

The reasons. Frequent use of any drugs that are used for headaches. It can be aspirin, ibuprofen, “Sumatriptan”, “Ergotamine” and others.

Which application is “too frequent” is impossible to say unequivocally. It depends on the type of drug and its combination with other drugs.

Treatment. To eliminate rebound headaches, you need to reduce the number of pain medications you take. Reducing the frequency of admission is carried out according to the scheme developed by the doctor and only under his control. In extreme circumstances, a hospital stay can be necessary.

Hormonal headache

This type of headache occurs only in women and is associated with changes in hormonal status. Often such pains are called menstrual. But they can also be triggered by other hormonal changes.

Symptoms. A hormonal headache manifests itself as a usual migraine. Usually no aura.

Pain intensity is moderate to severe. Pulsating in one part of the head. Accompanied by increased sensitivity to light and sounds, nausea, dizziness, chills, or sweating.

The reasons. Hormonal pain begins when the levels of female sex hormones, mainly estrogen, fall. This happens before menstruation, pregnancy, oral contraceptives, and menopause.

Why some women have a normal level of lowering sex hormones causes a headache while others do not – has not been established. Probably a genetic predisposition matters.

Treatment. To alleviate the attack, non-steroidal anti-inflammatory drugs are used – ibuprofen and Pentalgin. The doctor may prescribe medications of the triptan group – “Sumatriptan,” “Zolmitriptan” – or hormone replacement therapy.

Thunderous headache

A thunder-like headache is a severe headache that starts suddenly, like a bolt from the blue.

Symptoms. People often describe this pain as the most severe in their lives. It starts suddenly and instantly reaches a maximum. It lasts from minutes to several hours and sometimes days. Covers the entire head and gives to the neck.

Thunderous pain is often accompanied by nausea, vomiting, fainting, numbness, speech problems, and confusion.

The reasons. Thunder-like pain is primary, that is, not associated with serious illnesses. In this case, its cause usually remains unknown. But often, a sudden and extremely severe headache is a sign of a serious brain injury, such as bleeding.

Treatment. Since thunderclap pain can be associated with life-threatening illnesses, medical attention should be sought immediately if it occurs.

Treatment is prescribed depending on the cause. If the cause is not established and there are no serious health problems, non-steroidal anti-inflammatory drugs are prescribed.