A headache is defined as pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes. Dr. John Gahima working at Kanombe Military hospital says that because so many people suffer from headaches, and because treatment is sometimes difficult, the new classification system recognised by the World Health Organisation allows healthcare practitioners to understand a specific diagnosis more completely so as to provide better and more effective treatment regimes. The doctor says that the most common classified headaches are migraine headaches and tension headaches. Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache. Tension headaches are the most common type of primary headache; as many as 90 per cent of adults have had or will have tension headache. The headaches are more common among women than men. Migraine headaches are the second most common type of primary headaches. they affect children as well as adults. Before puberty, boys and girls are affected equally, but after puberty, again more women than men are affected. Tension and migraine headaches are not life-threatening. Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis. The doctor points out that headache begin suddenly and produce severe pain from the onset which worsens over a very short time. While this may not be a type of migraine, it should be checked. It may be caused by a serious problem such as rupture of the vessel or aneurysm. He adds that a person should always contact a physician in case the headache is accompanied by fever or a feeling of illness. Headaches in children is potentially more serious as compared to adults. Children under the age of 2 years cannot be safely given any nonprescription pain product without a physician recommendation. Even in children over two years, a visit to the doctor is the best course of action. Some analgesics (painkillers) should not be given to children under the age of 12 or 16 years. The most common causes of headache in children are viral illness, sinusitis, migraine, and trauma. A patient who has hit his or her head and is suffering from a headache should be taken immediately to an emergency room to assess possible injury to the brain. Gahima John explains that migraine is a common and more severe type of headache which can be debilitating without adequate treatment. It occurs on one side of the head, tends to produce a pulsating pain, and can be accompanied by nausea, vomiting and painful reaction to light or sound. Another type of headache to mention is muscle contraction headache or acute tension type of headache occurs in about 50 per cent of the population on a monthly basis but is usually low impact which is why it is not seen a lot in primary care. The exact causes of tension headache are not known but stress and tension play a part. Typically the tension headache is mild to moderate only, non-pulsating and bilateral. Sensory sensitivity to noise or light is more likely to be associated with migraine. Difficulties arise when patients who are suffering from migraine are misdiagnosed as having tension headaches. They then do not receive appropriate pain management. Patients often describe their head pain as a “feeling of tightness or squeezing’. There is a sinusitis headache; sinusitis is caused by infection of one or more of the cranial (skull) sinuses. These are the bony inner structures of the skull. Acute sinusitis lasts for days to up to three weeks. Purulent discharge and acute febrile illness is indicative of acute sinusitis. The site of the pain varies according to the location of the infection. Maxillary sinusitis pain is mostly in the cheek, gums, teeth and upper jaw. When pain is presented between and around the eyes this is referred to as ethmoidal sinusitis. Frontal sinusitis pain is seen in the forehead and sphenoidal sinusitis presents with pain at the crown of the head. The head pain often has a dull aching quality which is worsened by bending. Very rarely complications can occur such as meningitis or abscesses. Management In case one suspects that he or she has migraine headaches, a doctor’s intervention is important for evaluation and discusses treatment. Fortunately, migraine headache may be prevented, at least some of the time, if one can identify the factors that cause an attack. For example, some are induced by oral contraceptives. The physician can help the patient choose an alternate product. The doctor also advises that if migraine is triggered by too little or too much sleep, try to maintain regular times for going to sleep and arising. If stress, anger, excitement or emotional upset cause migraine, try to modify these emotions as much as possible. Avoid fluorescent lights if they seem to trigger an attack, and be especially wary of flashing or strobe lights. Avoid smoking or second hand smoke, strong odors such as perfume and cleaning solutions should be avoided. Alcohol, caffeine, chocolate, strongly sugared foods, aged cheeses, nitrates in meats, fruits, dairy products, pickled foods, and artificial sweeteners can trigger migraine and should be avoided in most cases. Doctor also points out that headache can be helped by many nonprescription ingredients. If the headache is not serious, the patient may try aspirin, acetaminophen, ibuprofen, naproxen or ketoprofen. However, the dosing and directions on the labels must be followed exactly. If the directions are unclear or if one need further information, a nearby pharmacist should be consulted. Ends
