Headache Treatment

Headache is one of the most common complaints in the community, occurring in 90% of the population. Most of these headaches are comprised of migraines and tension-type headaches. The International Headache Society has classified headaches into 14 main groups and hundreds of subgroups.

When a patient presents with a headache, the primary issue to differentiate is whether the headache is primary or secondary. To perform this evaluation, sufficient time should be allocated to take a detailed history of the pain from the patient, and a neurological and physical examination should be conducted meticulously.

Classification of Headaches;

1) Primary Headache:

Primary headache refers to situations where the headache itself occurs without an underlying disease or another cause. These types of headaches are classified into specific types such as migraine, tension-type headache, and cluster headache. Primary headaches are generally considered as neurological conditions not associated with structural brain problems or other medical conditions.

• Migraine:
  Migraine is a type of primary headache characterized by recurrent severe headaches. Migraine attacks usually begin with a throbbing pain felt on one side, which can intensify with physical activity. During a migraine attack, symptoms such as nausea, vomiting, sensitivity to light and sound, and aura (visual or sensory changes) may also occur. Migraine can be triggered by a combination of genetic and environmental factors.
• Tension-Type Headache:
  Tension-type headache is a mild to moderate headache felt like a band around the head on both sides. It is associated with factors such as stress, tension, or poor posture.
• Cluster Headache:
  Cluster headaches occur in attacks and usually appear in a specific period (cluster period) followed by a remission period. This type of headache is often accompanied by symptoms such as redness of the eyes, tearing, nasal congestion, and sweating on the face.

2) Secondary Headache:

Secondary headache refers to situations where the headache occurs due to an underlying disease, trauma, or another cause. These types of headaches can occur due to various reasons such as brain tumors, infections, sinusitis, traumatic brain injury, brain hemorrhage, or some systemic diseases.

The treatment of secondary headaches varies depending on the underlying cause. For example, headaches due to sinusitis may require antibiotic treatment, while brain tumors may require surgical intervention or radiotherapy.

Accurate classification and identification of headaches are important for determining appropriate treatment and management strategies.

What are the Causes of Headaches?

There are many potential causes of headaches. These include stress, tension, muscle tension, hormonal changes, sinusitis, eye problems, neck and shoulder problems, insomnia, dietary habits, alcohol consumption, nervous system disorders, brain tumors, infections, abnormalities in blood vessels, and side effects of medications. Additionally, some types of headaches may be related to genetic predisposition.

How is Headache Diagnosed?

The diagnosis of a headache is generally made by a neurologist. The doctor evaluates the patient's symptoms and takes a detailed medical history to determine the type of headache. Physical examination can often help determine the cause of the headache. If necessary, the doctor may also request additional tests such as imaging tests (e.g., magnetic resonance imaging-MRI) or blood tests.

When to See a Doctor for Headaches

Continuous and severe headaches that adversely affect a person's daily life are often sufficient reasons to see a doctor. If;

• If the patient is younger than 10 or older than 50 years old
• If the severity or pattern of a pre-existing headache changes, or if it does not respond to treatment
• If the headache is the most severe the person has ever experienced and it starts during physical activity, increasing in intensity
• If the headache is accompanied by confusion, vision loss, speech impairment, loss of strength, or epileptic seizure (convulsion), immediate medical attention should be sought
  
  

Prevention of Headaches

Some measures can be taken to prevent headaches.

• Pay attention to regular sleep habits
• Manage stress
• Healthy eating
• Drink enough water
• Practice regular rest and relaxation techniques
• Engage in regular exercise
• Maintain proper posture

Additionally, identifying factors that may trigger headaches and avoiding them is important. Keeping a headache diary can help identify the frequency and triggers of headaches.

Some Non-Invasive Treatments Used for Headaches

The treatment of headaches depends on the underlying causes of the headache.

• Medication:
  Medications used for headaches are used to relieve symptoms or prevent headaches. Options commonly used in headache treatment include nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans.
• Rest and sleep:
  Headaches are often associated with factors such as fatigue, stress, or lack of sleep. Therefore, getting regular sleep and rest is important to prevent or alleviate headaches.
• Stress management:
  Stress is one of the triggers for headaches. Practicing stress management techniques such as yoga, meditation, deep breathing, or relaxation techniques can reduce the risk of headaches.
• Healthy eating:
  Some foods and drinks can trigger headaches. Limiting or avoiding consumption of caffeine, alcohol, sugary, and processed foods can reduce headaches. Additionally, maintaining a healthy diet, having regular meals, and drinking enough water can help prevent headaches.
• Physical activity:
  Regular physical activity can be an effective method to prevent or alleviate headaches. Exercise can promote the release of natural pain relievers called endorphins and reduce stress.
• Resting your eyes:
  Prolonged computer use can cause headaches. Taking short breaks every hour to rest your eyes, doing eye exercises, and limiting screen time can be helpful in preventing headaches.
• Hot or cold compresses:
  Hot or cold compresses can be used to alleviate headaches. A hot compress can relieve tension-type headaches by relaxing muscles. A cold compress can reduce migraine pain by constricting blood vessels.
• Muscle relaxation techniques:
  Muscle tension may be one cause of headaches. In this case, using muscle relaxation techniques can help alleviate headaches. You can try methods such as taking a hot shower, neck and shoulder massage, or relaxation exercises.
  
  

Interventional Treatments Used for Headaches:

• Neurotoxin Injections:
  Neurotoxin injection is an option used in the treatment of migraine headaches. In this treatment, neurotoxin is injected into specific muscles. These injections relax the muscles and can help alleviate migraine pain. This treatment is commonly used in the management of chronic migraines.
• Nerve Blocks:
  Nerve blocks involve local anesthetic or corticosteroid injections targeting specific nerves associated with headaches. These injections can reduce headache symptoms by blocking the transmission of pain signals through the nerves. Various nerve blocks are available, such as sphenopalatine ganglion block, occipital nerve block, and trigeminal nerve block.
• Neural Therapy:
  Neural therapy is a treatment method aiming to regulate nerves by injecting local anesthetics into specific areas. It is also an option used for headache treatment. This therapy can assist in restoring normal nerve function and reducing headache pain.
• Acupuncture:
  Acupuncture is a commonly used alternative treatment for headaches. In this method, thin needles are inserted into specific points on the body. Acupuncture is believed to be effective in reducing headache pain, although its effectiveness may vary from person to person.
• Transcranial Magnetic Stimulation (TMS):
  TMS is a non-invasive brain stimulation method used in headache treatment. In this treatment, low-frequency magnetic fields are applied through magnetic coils placed on the head. These magnetic fields can influence the activity of nerve cells in the brain, potentially reducing headache pain.