Headaches
Headaches are among the most common medical complaints. Headaches are also one of the most common reasons why people miss school or work, or if they do go to work or school, a top reason why they do not perform well in school or at work. For most people, headaches occur only occasionally. The headache usually goes away spontaneously on its own, or is relieved with a single dose or two of a typial headache/pain relief medication. However for others, headaches are a regular and troubling condition.
I see a lot of patients who come into the clinic who are extremely worried that their headaches are due to a serious problem within their brain or skull, but the vast majority of headache sufferers have benign headaches that are not due to a serious cause like a tumor, or a circulatory problem. As many as 90 percent of all benign headaches fall under just a few categories, and these include migraine headaches, tension-type headaches, and a headache category called cluster headaches.
Anyone who suffers from recurring headaches should have a careful and thorough examination. Although most headaches are benign and can usually be classified into one of the major categories, it is important to make sure there are no worrisome features that would demand further investigation. A sudden onset, very severe headache (likened to a thunderclap going off in their head) in someone who does not usually have headaches should be evaluated.
For people who do have recurring headaches there are really two aspects to treatment that should be considered carefully. Acute treatment takes place when the headaches actually occur or come on, and it is this kind of treatment that is what most people think of as standard medical treatment. However, when these headaches occur regularly and so often, then a Preventive Strategy is really what is needed. These days, there are very effective strategies that can prevent the onset and occurrence of these recurring headaches.
I once saw a Japanese woman who had a ten year history of recurring headaches. She would present to medical facilities when she was having the worst of these headaches, and she would receive acute treatment that often gave her relief, but no acute-care or Emergency-Room physician probably ever had the time to sit down with her and take a look into her history so carefully and consider strategies for headache prevention. After evaluating her, we had her begin a fairly standard, migraine headache-preventive medical regimen. Soon after starting this kind of preventive regimen, her headaches completely resolved. Although she has had to take a medication daily, gone were the many hospital/clinic visits for treatment of the most severe headaches, and gone were the many other days when she had headaches to the degree that disturbed her ability to go to work, attend social fucntions, or interact at her best with her family and friends.
A thorough headache history takes in a number of factors. Some examples are age at onset, presence or absence of an aura or prodrome, frequency, intensity and duration of attack, number of headache days per month, time and mode of onset, quality, site, and radiation of pain, associated symptoms and abnormalities, family history of migraine or recurrent headaches, the factors that precipitate and relieving factors, effect of activity on pain, relationship with food/alcohol, response to any previous treatment, any recent change in vision, association with recent trauma, any recent changes in sleep, exercise, weight, or diet, state of general health, change in work or lifestyle, change in method of birth control, possible association with environmental factors, effects of menstrual cycle.
Our doctors at the Stamford Medical Clinic have the expertise to perform a thorough history and examination for patients who present with the complaint of headaches.
Written by Dr. Mark L. Siefring M.D.
Headaches are among the most common medical complaints. Headaches are also one of the most common reasons why people miss school or work, or if they do go to work or school, a top reason why they do not perform well in school or at work. For most people, headaches occur only occasionally. The headache usually goes away spontaneously on its own, or is relieved with a single dose or two of a typial headache/pain relief medication. However for others, headaches are a regular and troubling condition.
I see a lot of patients who come into the clinic who are extremely worried that their headaches are due to a serious problem within their brain or skull, but the vast majority of headache sufferers have benign headaches that are not due to a serious cause like a tumor, or a circulatory problem. As many as 90 percent of all benign headaches fall under just a few categories, and these include migraine headaches, tension-type headaches, and a headache category called cluster headaches.
Anyone who suffers from recurring headaches should have a careful and thorough examination. Although most headaches are benign and can usually be classified into one of the major categories, it is important to make sure there are no worrisome features that would demand further investigation. A sudden onset, very severe headache (likened to a thunderclap going off in their head) in someone who does not usually have headaches should be evaluated.
For people who do have recurring headaches there are really two aspects to treatment that should be considered carefully. Acute treatment takes place when the headaches actually occur or come on, and it is this kind of treatment that is what most people think of as standard medical treatment. However, when these headaches occur regularly and so often, then a Preventive Strategy is really what is needed. These days, there are very effective strategies that can prevent the onset and occurrence of these recurring headaches.
I once saw a Japanese woman who had a ten year history of recurring headaches. She would present to medical facilities when she was having the worst of these headaches, and she would receive acute treatment that often gave her relief, but no acute-care or Emergency-Room physician probably ever had the time to sit down with her and take a look into her history so carefully and consider strategies for headache prevention. After evaluating her, we had her begin a fairly standard, migraine headache-preventive medical regimen. Soon after starting this kind of preventive regimen, her headaches completely resolved. Although she has had to take a medication daily, gone were the many hospital/clinic visits for treatment of the most severe headaches, and gone were the many other days when she had headaches to the degree that disturbed her ability to go to work, attend social fucntions, or interact at her best with her family and friends.
A thorough headache history takes in a number of factors. Some examples are age at onset, presence or absence of an aura or prodrome, frequency, intensity and duration of attack, number of headache days per month, time and mode of onset, quality, site, and radiation of pain, associated symptoms and abnormalities, family history of migraine or recurrent headaches, the factors that precipitate and relieving factors, effect of activity on pain, relationship with food/alcohol, response to any previous treatment, any recent change in vision, association with recent trauma, any recent changes in sleep, exercise, weight, or diet, state of general health, change in work or lifestyle, change in method of birth control, possible association with environmental factors, effects of menstrual cycle.
Our doctors at the Stamford Medical Clinic have the expertise to perform a thorough history and examination for patients who present with the complaint of headaches.
Written by Dr. Mark L. Siefring M.D.