Dealing with pain areal headache

Headaches are a common ailment — so common, perhaps, that many of us just accept them as part of life.

“When I do routine physicals, I’ll ask about headaches,” says Michael Munger, a physician in Overland Park, Kan., adding many of his patients report frequent headaches when asked but never bring them up otherwise.

Tension headaches, sinus headaches and migraine headaches are among the most common varieties.

Tension headaches affect 30 to 70 per cent of the population, says Nauman Tariq, director of the Headache Center at Johns Hopkins Medicine in Baltimore. These are usually mild and require non-prescription pain relievers.

Migraine headaches affect 12 to 27 per cent of people, Tariq says. These range in severity and frequency, “from two headaches a year to daily headaches,” he says. Over-the-counter drugs are used for migraines, as are prescription drugs.

Sinus headaches are a result of excess mucus in nasal passages and are typically associated with allergies, colds or flu. Antihistamines or decongestants can relieve pressure and pain.

So, should you see a doctor for your headaches?

It depends, of course, on frequency and severity — how much they interfere with your life and whether you can manage them through self-care or by taking over-the-counter analgesics such as aspirin, ibuprofen, acetaminophen or naproxen. These drugs come with their own risks: aspirin and ibuprofen can cause gastrointestinal bleeding, ulcers and kidney problems with long-term use; Tylenol can cause liver damage with high doses.

When to see a doctor? Munger advises the rule of twos: “More than two headaches a week for more than two weeks.”

A doctor’s visit is likely to include questions about the headaches — when they happen, what they feel like and what triggers them.

The location of pain on a patient’s head gives clues as to the type of headache. Tension headaches derive from muscle tension, and they “start at the back of the head, then radiate up and over the crown,” Munger says. Sinus headaches tend to affect people on the face, commonly above or below the eyes. Migraine or vascular headaches often are localized to one side of the head and can be accompanied by nausea and visual oddities such as flashes and blind spots.

Doctors will look for red flags, too, asking about numbness or tingling, nausea, speech disturbances or memory problems that may indicate — or rule out — a more serious condition.

Your doctor may suggest a prescription medicine, such as a muscle relaxant for tension headaches or one of the migraine drugs. Steroid or antihistamine nasal sprays may be recommended for sinus headaches.