Headaches and Migraines

Headaches

There are many kinds of headache and many possible causes. A headache can be a warning of a serious health problem, it can be a recurring and debilitating problem for an individual, or, in others, a one-off that seldom recurs. Headaches can occur in different parts of the head ad can occur with or without other symptoms such as vomiting, fever or difficulty with bright light. The nature of the headache helps doctors to determine whether something serious could be going on. Could the headache be a symptoms of high blood pressure, for example?

New and severe headaches, especially when associated with fever and vomiting are taken more seriously by doctors because they could indicate a life-threatening condition such a a brain infection or haemorrhage. Most headaches have far less serious origins.

Students commonly get "tension" headaches which may be due to musculoskeletal problems in the neck and shoulders relating to poor study posture. Always have your headache assessed promptly if it is:

  • new to you and severe

  • recurring frequently (several times a week) and getting worse over time

  • associated with any other symptoms, such as fever, vomiting, tingling in hands or feet, weakness, dizziness or loss of balance, speech difficulty, altered vision/taste/smell/hearing/sensation

  • waking you up at night or always there when you wake up

  • not improved by simple analgesics such as ibuprofen or paracetamol

Migraines

Migraines are a very particular kind of headache that, because of their recurring nature and long duration, can have a very negative impact on sufferers' lives. They often " run in families" or have a genetic component, and once diagnosed, a sufferer will recognise their pattern and must learn to manage them. Not all migraines cause headache, occasionally a person will get only visual or speech changes. 

Migraine is a common condition that affects millions of Australians. Women are more prone to migraines than men. They can occur in all age groups but tend to be less troublesome as the person ages. A migraine is characterised by a localised, throbbing pain, usually on one side of the head or face, that can last between four and 72 hours, and is often combined with  nausea, vomiting and a heightened sensitivity to light. Some migraine sufferers experience an "aura", a warning sign that a migraine attack is likely to follow. The most common auras are visual disturbances, such as flashing lights or blurred vision. 

There are many "triggers" which can cause the onset of a migraine for some individuals. How these triggers result in a migraine is still unknown. Common triggers include:

  • ​Stress

  • Fatigue

  • Sensitivity to certain chemicals found in food (e.g. caffeine, alcohol, food additives such as nitrates.)

  • Changes in hormones, such as at the time of a woman's menstrual cycle or with use of hormonal birth control methods

  • Exposure to excessive heat, light, noise or chemical fumes

  • Changes in the normal sleep pattern

  • Changes in the weather

While the exact cause of migraine has not yet been determined, current thinking suggests that migraines are caused by inherited abnormalities of neurotransmitter chemicals and their effect on the blood vessels within the brain. 

Treatment for migraine

While there is no magic cure for migraine, there are a variety of drug and non-drug treatments and prevention strategies available that may reduce their frequency and severity. Consult your GP to discuss which treatment and/or prevention strategies may benefit you. 

Treatment and prevention strategies include:

  • Reducing exposure to trigger factors to prevent a migraine 

  • Treating the symptoms of your migraine through use of medications such as simple anti-inflammatory analgesics and/or migraine specific medications. Triptans are are a specific class of migraine medication that, if successful for the individual sufferer, can make a dramatic difference to their quality of life. They come as tablets, nasal sprays or injections and can stop a migraine "attack" if used early. There is increasing evidence, however, that overuse of both codeine-containing analgesics and triptans can result in increased headache frequency.

  • Taking migraine prevention medications is sometimes indicated as well as avoiding other drugs which may be worsening the condition eg the contraceptive pill.

  • Making lifestyle changes to reduce stress and anxiety

 

How We Care

Severe and recurring headaches should always be investigated by your doctor. While migraines are not life threatening, and there is no test to diagnose them, it is important to rule out other reasons for the headache. Occasionally this will involve brain imaging and/or referral to a neurologist.  If migraine is the diagnosis then your doctor can work with you to identify possible triggers and the most effective treatment options available to you. Our doctors may ask you to keep a "headache diary", where you document the timing, location, duration of your headaches, activities (e.g. work, exercise, menstrual cycle etc.), any medications taken and other symptoms experienced (e.g. vomiting). By recording details of your headaches, you and your doctor may see a pattern emerge. This will greatly assist in assessing the effectiveness of prescribed medication as well as helping you to recognise triggers and warning signs that lead to your kind of headache. Once the kind of headache has been identified, our doctors may share your management with other health professionals. There are, for example, specialised physiotherapists expert in the management of cervicogenic headaches which have their origins in the structures of the neck. 

Our doctors will investigate headaches further when they are concerned that there might be an underlying diagnosis which has not yet been found. Our doctors understand the debilitating impact that migraines and other recurring headaches can have on your life and overall wellbeing. Our doctors will provide an individualised and tailored approach to the management and treatment of your headaches.

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