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Check Your Health is a web-only feature being offered monthly by The Cheshire Herald. Each month, a professional from MidState Medical Center will offer advice on a different issue pertaining to health.
Headaches are a very common medical complaint, both in emergency rooms and physicians offices. Most of these are not due to any worrisome cause but do require chronic management. There are a number of things patients themselves can do to help keep their headaches in check.
The vast majority of headaches are not due to any life-threatening process. Migraine and tension headaches are by far the most common. Migraines, when at full severity, have disabling throbbing head pain in half the head (the word “migraine” is derived from Latin meaning “half the head”), with severe sensitivity to light, sound, and other stimuli, sometimes causing nausea and vomiting. There can in some people also be bizarre visual auras which precede the migraine. Tension headaches are less severe, pressure and “vice-like,” typically in a headband pattern around the skull.
With a patient in the office complaining of headache, a physician's first job is to sort out which few of these headaches are not just migraines or tension, and require further evaluation. This is done by recognizing certain red flags, which include things such as abrupt onset of the worst headache of life, headaches with certain types of symptoms such as weakness, and onset of headaches older than age fifty.
Once a physician is satisfied that the headaches are not due to any severe process, the next step is treatment to reduce symptoms. This can include a variety of daily and as-needed medications, and a lot of the medical care of headaches revolves around adjusting some of these medications. This is, however, only a part of headache management and the non-medication therapies can be just as important as what pills people take.
There are a variety of lifestyle changes which can be helpful. Regular sleep is important, and while most people would recognize that lack of sleep might be contributing to headaches, is also the case that people with migraines should not oversleep. Similarly skipping meals and particularly getting dehydrated can bring out headaches. All of these things play to the same theme – anything that throws the body’s balances off-kilter can provoke worsening headaches. This is not to say that doing all of these things perfectly would completely prevent headaches, it’s just that not doing them (such as not eating anything or drinking anything all day, and then staying up all night) is just asking for a severe headache.
Stress often plays a large role in headaches, and while we cannot live stress-free lives, having good stress management and relaxation techniques can make a very big difference. Having someone to talk to about problems, whether it is a professional counselor or just a close friend or family member, can be invaluable when faced with stressful circumstances.
With the help of a physician a patient can use medications and other options to help control their headaches. Lifestyle changes and stress management techniques empower the patient to be able to gain some control of the various factors impacting their headaches.
Justin Montanye, MD
MidState Medical Center