Headache is one of the most common health problems experienced by people of all ages. It can range from mild discomfort to severe, disabling pain. Understanding the type of headache is essential for selecting the right treatment. Most headaches are not dangerous, but some may indicate underlying medical conditions.
1. Types of Headaches
Headaches are broadly divided into two categories: primary and secondary.
Primary Headaches
These are not caused by any other medical condition.
- Migraine
- Tension-type headache
- Cluster headache
Secondary Headaches
These occur due to an underlying cause such as infection, injury, or medication overuse.
- Sinusitis
- Fever
- Head injury
- Hypertension
- Medication-overuse headache
2. Migraine
Migraine is a recurring, throbbing headache usually affecting one side of the head. It may last between 4 to 72 hours and is often disabling.
Symptoms
- Pulsating or throbbing pain
- Nausea or vomiting
- Sensitivity to light, sound, or smell
- Aura (flashes of light, blind spots) in some patients
Triggers
- Stress
- Skipping meals
- Hormonal changes
- Lack of sleep
- Certain foods (cheese, chocolate, caffeine)
Treatment
Acute Treatment
- Paracetamol or NSAIDs (Ibuprofen, Naproxen)
- Triptans (Sumatriptan, Rizatriptan)
- Antiemetics (Metoclopramide)
Preventive Treatment
- Beta-blockers: Propranolol
- Antidepressants: Amitriptyline
- Anticonvulsants: Topiramate, Valproate
- CGRP inhibitors in resistant cases
3. Tension-Type Headache
The most common type of headache, often described as a tight band around the head.
Symptoms
- Dull, aching pain
- Tightness or pressure around the forehead or scalp
- No nausea or vomiting
- Pain not worsened by routine activities
Causes
- Stress and anxiety
- Poor posture
- Eye strain
- Lack of sleep
Treatment
- Simple analgesics (Paracetamol, NSAIDs)
- Stress management
- Regular sleep and hydration
- Physical therapy or stretching exercises
4. Cluster Headache
A severe form of headache occurring in cyclical patterns (clusters). It is more common in men.
Symptoms
- Intense pain around one eye
- Redness or watering of the eye
- Nasal congestion
- Episodes lasting 15 minutes to 3 hours
Treatment
- High-flow oxygen therapy
- Sumatriptan injection
- Verapamil for prevention
- Steroids for short-term prevention
5. Red Flag Symptoms (When Headache Is Serious)
Immediate medical care is needed if headache is accompanied by:
- Sudden severe headache (“thunderclap headache”)
- Neck stiffness with fever
- Confusion or altered consciousness
- Weakness or vision loss
- Headache after head injury
- New headache in older adults
6. Non-Pharmacological Management
- Sleep hygiene
- Avoid known triggers
- Stress reduction techniques
- Adequate hydration
- Cold or warm compress on forehead
7. Complications
- Repeated absences from work or school
- Medication-overuse headache
- Depression or anxiety in chronic migraine
8. Role of the Pharmacist
- Assess type of headache through patient history
- Recommend appropriate OTC pain relief
- Educate patients on avoiding triggers
- Identify medication-overuse headache
- Ensure correct use of triptans and preventive therapy
- Refer patients with red flag symptoms
Detailed Notes:
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