Just because it quacks, doesn’t mean it’s a duck..

Just because your head hurts, doesn’t mean you have a migraine.  A migraine is a very specific type of headache.  According to the brain surgeons, who I suppose would know, there are about 150 different headache diagnoses.  Luckily this blog is YesFive and I will describe, you guessed it, five of them.  Also, just because it isn’t a migraine does not mean that it doesn’t hurt and isn’t interfering with your life.  This should be your criteria for seeing a doctor about your headaches.  Everyone gets an occasional headache but if they are disrupting your life, make an appointment.


1.  Migraines can present in several different ways but most often, migraine pain is on one side of the head, usually in the temple area, accompanied by nausea and/or vomiting and preceded by an aura.  An aura is a sensation that often warns that a migraine is coming.  It can be a change in vision, a smell, a tingling in the arm or other body part.  Sometimes, there is no pain — just the aura.  A migraine can last for hours or days and is brought on by both environmental and physical changes and often make people seek out a dark, quiet spot.  (Triggers are highlighted in yesterday’s blog.)  Migraines are a chronic condition.  The average age of onset is 20, but children and the elderly can also be diagnosed with migraines. Studies show that this type of headache lessens in severity with age.  While not much is known about the cause of migraines, there is probably a hormonal link as women are three times more likely to suffer.  They affect 25% of women and 8% of men in the U.S.  There are treatments and with the large number of patients effected, pharmaceutical companies are very anxious to relieve migraine sufferers of their money, uh-hmm, I mean, relieve them of their pain.  I imagine that the drugs will only continue to improve.

2.  Tension headaches are now know as tension-type headaches.  They feel like a tight band around your whole head with the pain usually starting in the back of the head and neck and moving to the front.  It used to be thought that they were the result of the actual muscles of your head, face and neck getting tighter but we now know that this isn’t the case.  They are estimated to affect almost 80% of the population and can be brought on by all the triggers mentioned yesterday, with stress being the most notorious cause.  They can last from minutes to weeks.

3.  Cluster headaches are thankfully not very common.  I have heard them called suicide headaches because they can be so severe that normally sane people will slam their head against the wall in an effort to end the pain.  They are called “cluster” because they happen in clusters.  For instance, a patient will experience them every day at about the same time for about 4-8 weeks and then they will go away for months or years. They are usually described as an intense pain around and behind one eye.  The eye and nose on that side can become red, inflamed and runny.  Men are affected more than women.  Writing that last sentence, I have the same satisfied feeling I get when, about once a decade, I encounter a longer line at the men’s room than the ladies’ room.  Sorry guys.

4.  Hangover headaches happen when you have had too much alcohol to drink the day and/or night before the onset of the pain.  They are most often described as a sensation of the brain expanding against the skull and can be associated with nausea, vomiting and a general sense of embarrassment or regret.  Unlike other headaches, the cause is very clear and the mechanism for the pain is likely a combination of lack of productive sleep, sulfites and dehydration.  To treat this kind of headache, try water, Gatorade, Advil, french fries with gravy and rest.  Most often, though, the only effective treatment is tomorrow.

5.  Sinus headaches are described as a constant deep ache in the forehead, cheeks and the bridge of the nose.  They often get worse with movement of the head and can be associated with a runny nose, swollen eyes or face, and fever.  The pain is from the congestion and pressure associated with a sinusitis.  I am covering headache treatment tomorrow but for this type of headache, relief is found in decongesting the sinus cavities.  Over the counter decongestants, nasal sprays, use of a netti pot, steam and finally, antibiotics if there is an actual infection, are all very useful in alleviating the pain.

So, it may not be a migraine but it definitely hurts.  Ironically, headaches are a real pain the the other end.  Identifying the type of headache you have and what may have caused it is the first step toward getting some relief.  Tune in for tomorrow for treatment.

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