Oh My Aching Head

Each year, millions of Americans suffer from the painful symptoms of headaches. With more than 150 different diagnostic categories, headaches can vary in cause, location, duration and level of intensity. In rare cases, a headache can be a sign of a more serious condition.

So what causes the pain? Amin Valliani, MD, internal medicine specialist on staff at Des Peres Hospital, gave me an overview.

“Headaches result from signals interacting between the brain, blood vessels and surrounding nerves,” said Dr. Valliani. “At the onset, specific blood vessels and head muscles nerves are activated and send signals to the brain. Scientists are still unsure what causes this activation.”

He listed the following forms of headaches.

• The most common form is tension headaches. These chronic daily headaches cause mild to moderate pain and, in some cases, result from the under or over treatment of a previous headache.

• A more intense, location-specific headache is a migraine. Usually developed on one side of the forehead, migraines can cause increased sensitivity to light and noise and can last up to three days. These headaches begin when hyperactive nerve cells send out impulses to the blood vessels, causing constriction, followed by the dilation of these vessels and the releases of inflammatory substances that cause the pulsation to be painful.  

• Sinus headaches are associated with a deep and constant pain in the face, mainly the cheekbones, forehead or top of the nose. These usually occur with other sinus symptoms, including running nose, watery eyes and scratchy throat.

• The least common and most severe type is cluster headaches. The pain is so intense that it often leaves sufferers unable to sit still. These typically occur one to three times a day during a cluster period, which may last two weeks to three months.

“Headaches can also be triggered by environmental factors, such as second-hand smoke, strong odors, pollution and allergens,” said Dr. Valliani. “Stress, lighting, weather changes, poor posture and increased physical activity are other factors that can trigger headaches as well.”

Understanding your triggers can help you avoid and manage headaches. Dr. Valliani suggests keeping a “headache diary” can help you identify the types of headaches you suffer from and understand what causes them. When you feel the pain coming on, write down notes about the time of day, what you ate in the past 24 hours, your sleeping habits, stress and any other relevant information. When the headache stops, be sure to include when and why. If your headaches persist, make an appointment with your doctor and bring along your headache diary.

Dr Valliani cautioned that if you experience any of the following headache symptoms, you need to seek immediate medical care:

• Pain creates the “worst headache of your life”
• Any problems with speech, vision, walking or loss of balance
• Headache becomes more severe when lying down
• Very sudden onset of pain

Talk to your doctor if you notice that your pattern of headaches changes or if the treatments are no longer working. If your doctor has prescribed medications for your headaches, be sure and discuss any side effects that you may experience. Women who are pregnant or breastfeeding should check with their physicians before taking medications for headaches. 

Visit Des Peres Hospital's online health resources for more information on headaches and treatment.