By Dr. Femi Ogunyemi

Any pain in the head is…er ….a headache. The WHO says nearly half of the world’s population would have had a headache in the last year. Headaches can be totally unrelated to anything, symptomatic of something else, or announcing the onset of something else.

The International Headache Society classifies headache into primary and secondary. But first, a disclaimer. In this article I will speak very little on signs and symptoms associated with headaches and only broadly, non specifically, about the various treatments. This is intentional. 50 percent of people having headaches self-treat rather than see a doctor. It is easy for readers to identify with generic clinical features in the media, and forget, or refuse to see their healthcare provider.

Please see your healthcare provider for any concerns. Neurologists are specialist trained and equipped to manage headaches. Primary headaches are due to overactivity or problems with things in the head and neck that have pain fibres. The brain itself and the spinal cord cannot feel “pain”.

There are 3 types: tension, migraine and cluster headaches. Tension headaches are by far the commonest type. They can be episodic or chronic. Migraines are the 7th highest cause of disability worldwide. They are often accompanied by blurred vision, nausea, sensory changes and lightheadedness.

The third type of primary headache is the relatively uncommon cluster headache. It is suffered by 1 in 1000 adults. Temperature, external pressure, pain on the scalp (for example over-tight braids or a tight fitting cap) and exertion can also cause primary headache.

The most common cause of secondary headache is the rebound headache associated with (pain) medication overuse. Dehydration, certain foods, drinks, alcohol, drugs and allergies can also cause headaches. Sadly (pardon the pun) depression is 3x more likely in people with severe headache who are otherwise healthy.

When you visit your doctor, particular attention will be directed towards your history: the type of pain, timing and pattern of attacks, what triggers, worsens or improves your pain. Keeping a diary of these observations before your visit or after your first visit, will be helpful to you and your doctor.

The doctor may request blood tests, xrays, CT or MRI scans of the brain. Recent guidelines actually advise doctors NOT to order these scans for ordinary, simple headache; but 12 percent of patients still get this. Treatment: In most cases we recommend rest and over-the-counter analgesics (usually nonsteroidal antiinflammatory drugs), tricyclic antidepressants, antiseizure medicines and beta blockers.

Self care is important. This is a good meal and exercise regime, or heat/ice packs applied to the head and neck. Alternative treatment is also helpful (please note “alternative” is not “TRADITIONAL/NATIVE” ). These are therapies like acupuncture, chiropractic care, cognitive treatment, hypnosis and meditation. Sometimes the treatment for your acute headache may be….to eat!

The National Institute of Health Care and Excellence (NICE) UK now says magnetic stimulation devices appear to be effective in migraines. And, in the US, the FDA has approved the Cerena Transcranial Magnetic Stimulator for true migraines (preceded by aura).

Recent research also show (confirm) that high stress levels “increase frequency of headaches”. Duh! Talk about the obvious. Although we move our heads in enjoyment of afropop and highlife, the “headbanging” pleasure of rock music fans has been called into question.

In 2013, a 50yr. old heavy metal music fan was admitted in Germany after 2 weeks of a severe constant headache. He was found to have a slow, chronic bleed (subdural) in the brain from the “headbanging” appreciation of his favorite music. Doctors believed this complication is probably grossly underreported!

If true that 50 percent of headaches are self treated, it follows that 50 percent are not well treated. There is now a Global Campaign against Headache to raise awareness of headache disorders, improve access and standards of care worldwide.

My take away point in today’s article is to refer back to last week’s article on “why people die suddenly”: any severe headache that starts suddenly and can be described as “the worst ever”, must be presented to a hospital as quickly as possible.



Comments expressed here do not reflect the opinions of vanguard newspapers or any employee thereof.