Dr. Tariq Jagnarine
Family Medicine, Endocrinology/ Diabetes

HEADACHES are a common health problem — most people experience them at some time. Frequent or severe headaches can affect a person’s quality of life. Knowing how to recognize the cause of a headache can help a person take appropriate action.

A headache can affect any part of the head, and pain may be present in one or several locations. Headaches can cause various types of pain, and classifying the pain can help doctors reach a diagnosis. Doctors also categorize headaches based on whether an underlying health condition is responsible for the pain. Based on this classification, a headache may be primary or secondary as suggested by the International Headache Society.

A primary headache is not a symptom of an underlying illness. Instead, these headaches result from problems involving the structures of the head and neck. A primary headache may be due to over activity of:

• Specific areas of the brain
• Blood vessels
• Muscles
• Nerves
• Brain chemicals
Common types of primary headaches include cluster, migraines and tension headaches.
Also, headaches can result from using medication for pain too often. In this case, a person has a medication overuse headache or rebound headache, and this is another type of primary headache.

These are symptoms of underlying medical conditions. The cause of a secondary headache may be:
• Pregnancy
• Systemic conditions, such as an infection
• Hypothyroidism
• Giant cell arteritis
• A stroke
• A brain tumor
Secondary headaches can result from serious health issues. It is important to seek medical advice if any headache displays the following:
• Severe, sudden or disruptive
• Persistent
• Gradually worsening or change in pattern
• Does not improve with medication
• Occurs alongside other symptoms, such as confusion, a fever, sensory changes, or stiffness in the neck
• Headaches that first develop after age 50
• Head pain that increases with coughing or movement
• Changes in personality or mental function
• Headaches that are accompanied by a painful red eye
• Headaches that are accompanied by pain and tenderness near the temples
• Headaches after a blow to the head
• Headaches that prevent normal daily activities
• Headaches in patients with cancer or impaired immune systems
Factors that lead to headaches may be:
• Emotional, such as stress, depression, or anxiety
• Medical, such as migraine or high blood pressure
• Physical, such as an injury
• Environmental, such as the weather

The characteristics of a headache and the effects on daily life can vary. A headache may:
• Affect one or both sides of the head
• Radiate from a central point
• Involve sharp, throbbing, or dull pain
• Have a vise-like quality
• Come on gradually or suddenly
• Last from under an hour to several days
The features of the pain depend, to some extent, on the type of headache.

• Tension-type headache
This is a common form of primary headache. The pain usually arises gradually, in the middle of the day. A person may feel:
• A tight band around their head
• A constant, dull ache on both sides of the head
• Pain spreading to or from the neck
Tension-type headaches may be:

Episodic: These attacks usually last for a few hours, though they can last for several days.
Chronic: This involves tension-type headaches occurring on 15 or more days per month for at least 3 months.