Words by Corina Tan
The throbbing, pulsating sensation that we are all well acquainted with usually strikes when we least expect it. Often emerging at inconvenient times, the painful and debilitating symptoms of a headache make getting through the day difficult and sometimes impossible. Most people reach for some kind of painkiller or an icepack to soothe symptoms when they occur. Although more than 300 types of headaches exist, the most common ones are tension, migraine and cluster headaches. The good news is that besides learning how to prevent and minimise symptoms, some new promising treatments are also underway.
This type of headache is probably the most common one affecting almost 30 per cent of the population at any one time. Characterized by pressure or dull pain around the forehead as well as throbbing on one or both sides of the skull, tension headaches which are typically caused by stressful situations, tight neck muscles, or sitting in one position for too long, easily subside with over-the-counter pain medication. They can be prevented by keeping adequately hydrated throughout the day, using breathing and calming techniques to alleviate stress, being mindful of being in the same work or sitting position for too long, taking short breaks in between work deadlines, and maintaining a good work-life balance. Tension headaches can be brought on by taking on too much in a short span of time, dealing with difficult situations and people, and forgetting to drink, eat or rest. Some people have reported to have good results using essential oils like Peppermint around the temples and neck stem, as well as inhalation with deep breaths straight from the palm. Diffusing essential oils are also a popular way to promote a calm and peaceful environment, while encouraging a positive atmosphere that eliminates stress.
Often running in families and triggered also by stress, lack of sleep or changes in barometric pressure, these neurological disturbances can lead to throbbing on one side of the head, nausea and vomiting. Other debilitating symptoms include sensitivity to light, sounds and smells. Migraines affect many women during their reproductive years, as well as a smaller percentage of men. They can last for hours and severe cases may even go on for days, with symptoms that precede and follow the attack. Sufferers of migraines may be so severely affected that they are unable to work or be productive during an episode. Good migraine prevention habits include getting sufficient rest and exercise, eating regular meals, and skipping alcohol and caffeine. When a migraine strikes, instead of reaching for over-the-counter drugs which can make migraines worse in the long run, consider other prescription medications such as triptans or ergots. These of course require a visit to the doctor but may be a better alternative as they are less damaging to internal organs. New preventive medications called calcitonin gene-related peptide inhibitors (CGRP) have also emerged which target the protein that causes migraines. Taken monthly, these injectable drugs have demonstrated a 50 per cent reduction in the frequency of migraines in regular sufferrers. Patients who have extremely frequent attacks may consider speaking to their doctors about the availability, suitability and costs of this new medication.
These severe painful bouts have been referred to as suicide headaches, as they can come on suddenly and intensely. They are characterised by extreme discomfort that starts around the same time every day and increases for a few minutes and lasting up to an hour and a half. Attacks can reoccur multiple times a day, causing extreme distress in patients. Treatments have so far been limited to oxygen masks, triptan injections, or a synthetic version of the brain hormone somatostatin. In some cases, local anaesthetics such as lidocaine is administered through the nose. Currently, CGRP inhibitors (as in the case of migraine headaches explained above), are being studied and evaluated as a possible treatment for cluster headaches as well. Other brain stimulating therapies such as occipital nerve stimulation and non-invasive vagus nerve stimulation are also being explored. The vagus nerve is made up of the main nerves of the parasympathetic nervous system that controls specific body functions such as digestion, heart rate and the immune system which are involuntary. Vagus nerve stimulation is a type of neuromodulation that alters nerve activity by implanting a device that sends regular, mild pulses of electrical energy to the brainstem through the vagus nerve in the neck.
In general, headaches which become more frequent or worse over time may warrant further investigation. If you notice symptoms such as chills, fever, weight loss, vision changes, mobility or balance issues, these need to be examined in order to rule out other serious conditions like an aneurysm or a brain tumour. It is important to get the right diagnosis so that you can be treated accurately. When in doubt, always seek medical attention and advice from a doctor or a neurologist.