How many times have you heard the phrase, “Stop, you’re giving me a headache!” most often spoken in jest?
But having a headache is no joke, according to Dr. Karin Johnson, a Baystate Medical Center neurologist who treats patients for a wide range of headaches from tension headaches to more severe migraines.
According to the National Headache Foundation, each year some 90% of all men and 95% of all women have at least one headache.
“For some, a headache can be just a minor distraction in their day, but for others who suffer more severe symptoms, a headache can prevent them for carrying out their daily activities,” said Dr. Johnson.
Tension headaches – experienced by over three-quarters of adults at some point in their lives – are the most common type of headache and are caused by tight muscles in the shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety and are common for people who work too long, don’t get enough sleep, and skip meals or drink alcohol.
Other common types of headaches include cluster headaches – chronic repeated headaches which may last for weeks to months with pain-free periods of various lengths, sinus headaches, and the most common of severe headaches – migraines.
The National Headache Foundation has declared June as National Migraine Awareness Month to bring attention to the crippling nature of migraines and to educate the public about their causes, impact and treatment.
A migraine, which is three times more common in women than men, is one of the most painful types of headaches. It is characterized by severe, often pulsating-like pain
on one or both sides of the head. During migraines, people are extremely sensitive to light and sound and may become nauseated and vomit. They may last a day or more and can occur as often as several times a week or only once every few years.
“Some migraine patients may even experience what we call an aura before or during their headache, when their visual field is clouded with sparkles or flashing lights,” said Dr. Johnson.
National attention was cast on complex migraines earlier this year when Los Angeles television reporter Serene Branson suffered a “severe migraine with aura” while speaking gibberish and looking confused and worried during her live coverage of the Grammys.
Also, during what the Baystate Medical Center neurologist described as “complex migraines” similar to that experienced by Branson, people can experience various neurological manifestations such as numbness or tingling sensations, weakness, or speech problems.
While the causes of migraines are not well understood, doctors attribute the headache to the opening and narrowing of blood vessels in the head, involving various nerve pathways and chemicals in the brain.
There are many things that can trigger a migraine including anxiety, stress, lack of food or sleep, certain foods, exposure to light, and hormonal changes in women.
“Also, migraines are genetic and tend to run in families,” said Dr. Johnson. Branson’s mother, for example, has suffered from migraines.
Unfortunately, while there is no cure for migraines – which can be very challenging to prevent and treat – the painful headache can often be effectively managed, noted Dr. Johnson.
“Everyone responds to pain differently. Migraines are unique to each patient whose triggers, severity and frequency of headache differs,” said Dr. Johnson.
“When someone is having frequent migraines, other than working with them to modify triggers and various risk factors, preventive treatment is usually recommended,” said Dr. Johnson.
Drug therapy – including the use of prescription medications such as amitriptyline, topamax or propranol – biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling a migraine.
Once a migraine has begun, acute prescription medications – also referred to as abortive medications – such as ibuprofen and Excedrin are used to treat the pain, noted Dr. Johnson. If over-the-counter medications like ibuprofen or Excedrin are not strong enough, then prescription medications such as sumatriptan (Imitrex) can often be helpful.
In addition to the tremendous personal toll migraines take on the many who suffer from this often debilitating condition, the National Headache Foundation reports that industry loses $31 billion per year due to absenteeism, lost productivity and medical expenses caused by migraine headaches. Also, an estimated 157 million workdays are lost annually because of the pain and associated symptoms of migraines.
Not all headaches require a visit to the doctor’s office, but some can signal a more serious disorder and call for prompt medical care. The National Institute of Neurological Disorders and Stroke, and arm of the National Institutes of Health, recommends that you see your physician immediately or go to your local Emergency Department if:
- You experience a sudden, severe headache or sudden headache associated with a stiff neck.
- Your headache is associated with fever, convulsions, or accompanied by confusion or loss of consciousness.
- You experience a headache following a blow to the head, or it is associated with pain in the eye or ear.
- You were previously headache free and now suffer from persistent headaches.
- Your child has a recurring headache.
When you do make an appointment to see a doctor for possible migraine treatment, Dr. Johnson said it would be helpful in advance to try to identify any patterns to your headaches, including associating any possible triggers to them.
It is well-known in the neurological community that getting too little sleep, sleeping too long, or poor sleeping habits, can trigger migraines. Sleep routines are very important for those who suffer from migraines – including going to bed and getting up at the same time every day. Also, there has been much discussion and research as of late about the link between sleep apnea and migraines, an area of great interest to Dr. Johnson, who treats sleep-challenged patients in the Neurodiagnostics and Sleep Center at Baystate Medical Center, part of the Baystate Regional Sleep Program.
Dr. Johnson recently completed her own research on the subject presented in an abstract at the American Academy of Neurology annual meeting that noted treating obstructive sleep apnea can play a major role in reducing migraines or eliminating them altogether. She found that 78% of headache patients with obstructive sleep apnea (OSA) who used continuous positive airway pressure (CPAP) treatment had improvement in their headaches compared to improvement in headaches in only 53% of patients without OSA and 33% of patients with OSA who did not tolerate CPAP treatment.
For more information on the Neurology Division at Baystate Medical Center, visit baystatehealth.org and click on “Neurology” under the Services tab, or to make an appointment, call (413) 794-7297.