Headaches: When Should You Seek Help?

LEXINGTON, Ky. (Dec. 23, 2014) -- Headaches are a common ailment; the World Health Organization estimates that almost half of us have a headache at least once a year.  Unfortunately, because headaches are so common, they are often dismissed as insignificant. That's a pity, since many new options are available for the treatment of headaches, including medications and other therapies, lifestyle changes, and/or homeopathic remedies.

There are many different types of headache. Some examples include sinus headaches (usually associated with sinus infections), cluster headaches (tend to happen in groups, or clusters, with periods of relief between clusters), and tension headaches (the most common type, usually characterized by non-specific head pain). 

Perhaps the most misunderstood is the migraine. Migraines are severe, pounding headaches made worse by routine activities and associated with nausea and sensitivity to light and sound. A migraine usually begins above the eyes, typically affects one side of the head, and tends to throb intensely, especially when you become more physically active and/or bend over. Some migraines have associated neurologic symptoms, known as aura, which cause disturbances in vision, language, and sensation.

Many patients find it helpful to keep a diary to identify possible headache triggers, such as cheese, red wine or foods with MSG. Too much caffeine from coffee or soda or over-the-counter pain treatments might actually increase headache frequency.  Eating regular meals and getting plenty of sleep may also help.

Not all headaches should be regarded as a temporary nuisance. In fact, headache can sometimes be the only symptom of a more serious medical emergency, such as meningitis, stroke, or aneurysm.  Learn to “SNOOP” out the cause of a headache to determine whether it requires immediate attention:

·      Symptoms in addition to headache. Do you have fever, recent weight loss or other risk factors like HIV or cancer?  Are you taking medicines that affect the immune system?

·      Neurologic symptoms. Are you experiencing confusion, decreased alertness, vision changes, dizziness, numbness, or weakness?

·      Onset. Did your headache arrive suddenly or abruptly?

·      Older. New headaches in middle age, especially 50 years or older, can be a troubling sign.

·      Previous headaches. Is this your first headache? Or is this headache different from your previous headaches (change in frequency, severity or associated symptoms)?

If you answer "yes" to one or more of the above, seek immediate medical attention. 

Do not be embarrassed or afraid to seek help if you suffer from headaches. A physician who specializes in treatment of headaches can help you manage your pain.  If your headache is a symptom of something more serious, the good news is that many of these conditions are treatable, especially if caught early.  SNOOPing in this case is a good thing.

Dr. Paul Gadient is a neurologist at the UK HealthCare's Kentucky Neuroscience Institute

This column appeared in the December 21, 2014, edition of the Lexington Herald-Leader.