Types of Headaches
Tension type headaches are the most common type of headache and affect about 75% of all headache sufferers. Tension type headaches typically are a steady ache that affects one or both sides of the head. Some people get tension type headaches in response to stressful situations. Tension type headaches may also be chronic, occuring frequently or even everyday.
Migraine headaches are less common than tension headaches. Nevertheless, they afflict 25-30 million people in the US. Up to 80% of women experience a migraine headache at some time and roughly 2 out of 3 migraine sufferers are female. The distinguishing feature is a potential disability accompanying the headaches is a warning sign or symptom prior to the headache pain of the migraine. Migraines are felt on one side of the head in about 60% of migraine sufferers. The pain is typically throbbing in nature. Nausea, with or without vomiting, as well as sensitivity to light and sound, may accompany migraines. An aura, a group of telltale neurological symptoms, sometimes occurs before the headache pain begins. Typically an aura involves a disturbance in vision and may consist of bright lights or flickering lights in a pattern that moves across the field of vision. About 1 in 5 migraine sufferers experience an aura. The Migraine attacks are occasional and sometimes as often as once or twice a week, but are not usually daily.
Cluster headaches are relatively rare, effecting 1% of the population. They are distinct from migraine headaches and tension type headaches. Most cluster headache sufferers are male (85%). Cluster headaches come in groups or clusters lasting for weeks or months. The pain is extremely severe but the attack is brief lasting no more than an hour or two. The pain centers around one eye which may be inflamed or watery. There may also be nasal congestion on the effected side of the face. These "alarm clock" headaches may strike in the middle of the night and often occur about the same time each day during the course of a cluster. A history of heavy smoking and drinking is common. Alcohol often triggers the attacks.
Rebound headaches may occur among people with tension type headaches as well as those with migraine headaches. They most often result from the overuse of prescription or non-prescription pain reliever to treat a headache. The headache then rebounds as the last dose wears off leading one to take more and more pills.
Headache medications are available that offer several different kinds of delivery methods and formulations. Sometimes patients are able to choose the type of derivative they prefer for themselves in consultation with their physician. Medications are available in oral tablets, disintegrating tablets, nasal sprays, injections under the skin, and rectal suppositories.
Acute (or abortive) medications for headaches are used to stop a headache attack in progress. If you have frequent disabling headaches, you may be a candidate for preventive medications which can reduce both the frequency of headaches and make any breakthrough headaches less severe and easier to treat. If you are using medications more than one or two times a week on an average or any of the following apply to you, you may benefit from preventative medications for migraines.
Preventive headache therapies proven in clinical trials:
- Anti-epileptics (anti-convulsants): Depakote or Topamax
- Anti-depressants: Amitriptyline, Nortriptyline, Desapramine
- Beta Blockers: Inderal, Atenolol
- Anti-inflammatories: Naprosyn, Ibuprofen
- Triptans such as Imitrex, Relpax, Amerge, Maxalt, Zomig, Axert
- Combination medications such as Midrin, Fioricet
- Injections such as Tordol, IV Depakote, steroids, or narcotics
Our clinic also has extensive experience offering Botox injections for chronic migraines (>15 migraines per month).