Headache
is said to be the most common of all discomforts felt by people
other than those resulting from severe deprivation. The main
problem with headaches is that they are feared because of their
potential significance. People with backache generally assume
that they have strained their back in some way, not that they
might have cancerous deposits in the spine. Some people with
headaches, however, tend, sooner or later, to worry that they
might have a brain tumour, or a haemorrhage, or meningitis.
The vast majority of headaches are not caused by significant
illness. The only medical condition that commonly causes headache
is migraine (see Migraine), the rest are caused by a wide variety
of circumstances - stress, over-indulgence of almost anything
including alcohol, smoking, too much or too little sleep, poor
environment - stuffy, noisy, bright lights -and, most commonly
of all, no particular reason anyone can think of. Simple headaches
arise in two particular areas, the muscles of the scalp and
neck, and the blood vessels. It is dilatation, stretching, of
blood vessels that gives the headache of migraine. Similar throbbing
headache can arise from alcohol excess, hangover, and the headache
of such infections as the common cold and influenza. The headache
of muscle spasm, sometimes described as a "tight band around the head" is often the result of anxiety, poor posture, staying too long in the same position (hunched over a key-board ,for example) or irritation of the neck muscles arising from the cervical spine ( neck part of the spine). Headache arising from the cervical spine, due to arthritis, is particularly common in the elderly and is often worse first thing in the morning. Early morning headache is something about which a doctor should be consulted. Other significant headaches about which a doctor should be consulted, immediately , are headaches with a fever, with a stiff neck, with photophobia (increased sensitivity to light), with drowsiness, with vomiting - particularly after a head injury - and with any visual disturbance not explained by known migraine. A person should see the doctor if the headache has lasted more than 24 hours - most ordinary headaches go after sleep -or if the headache is recurrent over a week or more. That having been said many headaches with neck ache, with fever, lasting more than 24 hours, do not turn out to be serious, but advice should still be sought. Raised blood pressure (see Hypertension) does not cause headache in normal circumstances. Depression can. Other local conditions, such as sinusitis, often cause headache, usually of a characteristic nature.
Although the cause of a headache is not likely to be serious, if there is any cause for concern (see above), a doctor should be consulted. For the rest, simple painkillers such as paracetamol, are usually sufficient. Non-steroidal anti-inflammatory drugs such as ibuprofen are preferred by some but must not be taken by those with asthma or stomach troubles. Sometimes the painkiller needs to be taken in regular doses through the day (2 paracetamol, 4 times a day, in an adult, for example). Some headaches do not respond well to simple painkillers and in such cases the doctor might prescribe an antidepressant, not because the patient is thought to be depressed, but because such medication , sometimes, seems to work better than anything else. Plenty of fluids, massage, rest, all will tend to make a headache better. |
