Oh That Terrible Headache Again:

Headaches are a common phenomenon. Everyone encounters a headache at some time or the other. Some individuals get them occasionally and others frequently. Then, there are those who are debilitated by them. Summertime seems to bring them on more frequently. Women are affected twice as frequently as men. Imagine a jackhammer drilling through your brain causing an unrelenting severe throbbing pain. That’s the most common way patients describe a headache. Can we do something about them; yes we can.

Tension Headaches: This is the most common type of headache that most individuals experience. You can blame stress or fatigue which causes stiffness in the muscles of the shoulders, face, neck, forehead and/or scalp. This then in turn irritates the nerve endings in the brain which initiates the headache. Tension headaches are easy to treat; generally three to four Motrin tablets combined with two extra strength Tylenol tablets is effective. Individuals rarely need a prescription. Sometimes a relaxing massage or acupuncture helps treat the tension. Preventing this type of headache is the main goal. Exercising regularly and meditation are two of the best solutions.

Sinus Headaches: When an individual has a sinus infection, the sinuses get so inflamed that the pressure in them feels like an exploding balloon. These cause an intense pain in the brow area causing the patient to feel miserable. It can often lead to dizziness and doing your daily routine feels like a drag. Motrin and Tylenol with over the counter nasal decongestants may relieve the discomfort. Most patients with severe symptoms however, end up in their doctor’s office. The patient will likely receive a prescription for an antibiotic to control the sinus infection, a nasal steroid decongestant and/or prednisone tablets for the inflammation. Patients who are prone to chronic sinus infections should try using a neti pot to irrigate the sinuses and change the hepa filters frequently on their air conditioners.

Migraines: This is the worst kind of headache. They are quite debilitating in some, lasting anywhere from a few hours to a few days. Most patients experience severe nausea and vomiting. These patients are usually unable to carry on their daily routine and end up lying in bed with the lights off. Light is a sensitive trigger. A variety of etiologies come into play from hormonal changes, stress, lack of sleep, dehydration, and hunger. Women usually suffer from migraines and there has been a genetic theory proposed. At this time, forget taking over the counter medication as they rarely help. Most patients have their prescription medication with them or end up in the E.R., or their doctor’s office. There are a number of different medications available and they have to be titrated to see which works best for that individual. Medication should be taken by mouth early on to work effectively, otherwise patients end up in the doctor’s office getting I.V. fluids and IV medications as their condition has deteriorated from the persistent nausea, vomiting and intractable pain.

Other remedies that one may try are Acupuncture and Botox. Lately there have been a number of studies showing Botox to be quite effective in decreasing the intensity and frequency of migraine attacks. Here at Medical Care San Diego we have a dedicated recovery room for IV fluids and IV medications, where the patient can be monitored and treated effectively to alleviate these terrible symptoms.

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