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Headache Treatments from the Drexel Center for Women's Health

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About Headaches

A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are extremely rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and occasionally by taking medications.

The most common headaches are probably caused by tight, contracted muscles in your shoulders, neck, scalp, and jaw. These are called tension headaches. They are often related to stress, depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to them. Headaches can be triggered by chocolate, cheese, and monosodium glutamate (MSG). People who drink caffeine can have headaches when they don't get their usual daily amount.

Common Causes of Headache

Common causes of headache include:

  • Holding your head in one position for a long time, like at a computer
  • Poor sleep position
  • Overexerting yourself
  • Clenching or grinding your teeth
  • Poor posture

Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vise. Your shoulders, neck, or jaw may feel tight and sore. The pain is usually persistent, but does not get worse with activity.

Migraine headaches are severe headaches that usually occur with other symptoms such as visual changes or nausea. The pain may be described as throbbing, pounding, or pulsating. It tends to begin on one side of your head, although it may spread to both sides. You may have an "aura" (a group of warning symptoms that start before your headache). The pain usually gets worse as you try to move around.

Migraine headaches can be associated with hormonal changes, such those due to menstruation, use of birth control pills, or during menopause.

Rare causes of headache include:

  • Brain aneurysm—a weakening of the wall of a blood vessel that can rupture and bleed into the brain
  • Brain tumor
  • Stroke or TIA
  • Brain infection like meningitis or encephalitis

Other Types of Headaches

Cluster headaches are sharp, extremely painful headaches that tend to occur several times per day for months and then go away for a similar period. They are far less common.

Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches.

Headaches may also occur if you have a cold, the flu, fever, or premenstrual syndrome.

Home Care

Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches. When a headache occurs, write down the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern.

A headache may be relieved by resting with your eyes closed and head supported. Relaxation techniques can help. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches.

  • Try acetaminophen, aspirin, or ibuprofen for tension headaches.
  • Migraine headaches may respond to aspirin, naproxen, or combination migraine medications.

If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications. Sometimes medications to relieve nausea and vomiting are helpful for other migraine symptoms. If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. If you are using pain medications more than two days a week, you may be having headaches due to overuse or misuse of your medication. Medication overuse headaches, or rebound headaches, are caused by a cycle of using pain medications for short-term relief, followed by the headache pain returning for increasingly longer periods of time despite taking more pain medications. All types of pain pills (including over-the-counter drugs), muscle relaxants, some decongestants, and caffeine can cause this pattern. If you think this may be a problem for you, talk to your health care provider.

When to Call the Doctor

Take the following symptoms seriously. If you cannot see your health care provider immediately, go to the emergency room or call 911 if:

  • This is the first headache you have ever had in your life and it interferes with your daily activities
  • Your headache comes on suddenly and is explosive or violent
  • You would describe your headache as "your worst ever" even if you are prone to headaches
  • Your headache is associated with slurred speech, change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss
  • Your headache gets progressively worse over a 24-hour period
  • Your headache is accompanied by fever, stiff neck, nausea, and vomiting
  • Your headache occurs with a head injury
  • Your headache is severe and localized to one eye with redness in that eye
  • You are over age 50 and your headaches just began, especially with impaired vision and pain while chewing

See the doctor soon if:

  • Your headaches wake you up from sleep
  • A headache lasts more than a few days
  • Headaches are worse in the morning
  • You have a history of headaches but they have changed in pattern or intensity
  • You have headaches frequently, and there is no known cause

Read more about headaches.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

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