I am definitely a fully signed up member of the Christmas lovin’ club. I adore pretty much everything about this time of year and never seem to lose my childlike excitement about it (much to my husband’s amusement!). Yet despite being a total
Christmas-o-phile it does not come without its stresses.
I don’t know how you divvy up Christmas chores in your family, but for us it remains a fairly female activity. This, I hasten to add, is probably as much my doing as my husbands. We both have fairly large families, plus godchildren and so on, so just buying all the presents is a fairly epic task! That is before I’ve even thought about all the food, clearly one of THE most important aspect of this time of year, plus all the little extras bits and bobs to make Christmas extra magical …. Phew! Since sprog3 is officially due on the 25th December things have been pared down a bit this year, but there is still plenty to do, so I can really see why for many people Christmas just becomes one big headache.
In this spirit of this I thought I’d do a quick run down on common causes of headache (festivity-induced headaches don’t feature I’m afraid!). Headaches account for a huge number of GP appointments and around 96% of the population will experience a headache at some point in their life. The vast majority of headaches will settle down on their own, but we all worry about the more serious causes. I’ve put together a bit of information about common causes of headaches and then a list of my top ‘when to see a Doctor’ signs to be aware of.
As with many things in life headaches often don’t neatly fit into precise categories and many people suffer with different types of headaches over the course of their life. Your doctor will usually ask lots of questions and then examine you to work out the cause of your particular type of headache. CT or MRI scans are occasionally used to help make the diagnosis, but for most people they don’t shed much more light on the issue and can even confuse the situation.
Tension Type Headaches
This is the commonest type of headache affecting millions of us up and down the country. They tend to affect women more than men and are commonest between the ages of 20-50 years. The classical description of tension headaches which I remember studiously learning at medical school was of a pressure or tightness, like a vice or tight band around the head. Often people feel this sort of headache in their neck or shoulders. It tends to come on gradually and will often ease a little with simple painkillers.
When doctors talk about tension headaches people often think we are referring to them being emotionally ‘tense’ or stressed. Although tension headaches do have a relationship to stress and anxiety, in many patients the ‘tension’ is of the muscle variety and more related to poor posture or sitting at the laptop endlessly.
Treatment usually involves simple painkillers – ideally anti-inflammatories such as ibuprofen or stronger ones available on prescription. For people who have more persistent problems there are longer term medications which can be offered.
Sometimes looking more holistically at the underlying cause of the headache can be of most use e.g. if stress or depression are adding to your headaches then tackling this may help, or if the headache is posture related taking up yoga or pilates can make all the difference. Our computer based age has a lot to answer for in terms of tension headaches, so making sure your work space isn’t placing more strain on your back and neck muscles is also really important.
The topic of migraines is massive! So rather than risk you nodding off whilst reading this I will try to be concise. There are plenty of descriptions of migraines out there but, as always, many people don’t quite fit in neat categories.
The typical symptoms of migraine are of a one-sided headache which gets worse over several hours and can last several days. It can cause nausea, vomiting or sensitivity to light.
Typically migraines fall into 2 groups: with aura or without aura. Aura is the name given to warning signs that come on before the headache starts. They are often things such as seeing flashing lights or zigzags, or feeling pins-and-needles or numbness down one side of your face. The auras can be quite dramatic and I’ve known people attend hospital thinking they were having a stroke when in fact it was a nasty migraine with aura.
Sometimes people only get the aura and no headache, which is known as an ocular migraine. There are also a plethora of other subgroups of migraine such as menstrual, abdominal, basilar, hemiplegic, vertiginous….. I told you it was a complicated subject!
Once your doctor has made a diagnosis of migraine then comes the decision what to do about it? Sometimes a trigger for the headache is obvious, such as coffee, in which case cutting out the offending item is a fairly sensible step. Next up come the ‘rescue’ treatments that try to stop the migraine once it has started. These sort of treatments range from simple ibuprofen to more specialist treatments.
If you are experiencing very frequent migraines, once a week or more, then considering a daily preventative medication might be suitable. There is a range of different options and it can be a bit trial and error to start with to find out what suits you best. For a run through of all these treatments this leaflet is pretty comprehensive.
You may not have come across the term Cluster headache, but they are extremely painful and quite common. They classically cause a severe pain around one eye or temple. The pain comes on rapidly and lasts approximately 15–90 minutes. Often they are associated with redness or watering of the affected eye.
Typically people experience a number of cluster headaches over a short space of time (hence their name), and then they disappear all together for months or even years.
Simple painkillers are not usually very effective for cluster headaches so more specialist treatments are required. Nasal sprays are one of the most popular types of treatment to help stop attacks. Sometimes preventative treatments are required similar to migraine medications. Avoiding alcohol during the cluster has also been shown to be of help in reducing the number of attacks.
Ouch is a UK-based charity with a very informative website – so if you want to know more, take a look.
Rebound headaches are also known as painkiller headaches or medication-overuse headaches. This is also a lesser-known cause for persistent headaches, but something GP’s and neurologists see a fair bit of.
It is thought that around 5-10% of all headaches are due to people taking too much medication. A vicious cycle starts where more and more painkillers are taken to help combat the headaches, but unfortunately they are only making the headaches
worse. Somewhat bizarrely this phenomenon only seems to occur when the painkillers were started for headaches in the first place – usually tension type headaches.
Taking painkillers more than twice weekly, for over 3 months can put you at risk of developing rebound headaches. It is thought that the headache occurs when the effects of the painkiller wear off, leaving your body craving the next dose and experiencing a ‘withdrawal’ headache.
The commonest culprits for this are codeine, paracetamol, aspirin and ibuprofen.
Clearly the answer to this problem is to stop the offending painkiller. This can be done ‘cold turkey’, but if you’ve been taking medication for a long time then a gradual reduction can be more appropriate. This would be something to discuss with your GP, to see which approach would best suit you.
There are loads of other causes of headache, the majority of which are innocent e.g. sinusitis or a common viral infection. However here are a few top tips for when to see a Doctor urgently about your headaches;
– If you develop a very sudden onset headache, like being hit on the head with a heavy object.
– If your headache is associated with weakness in your limbs/face, a change in your vision or it is making you confused or muddled.
– If your headache is associated with vomiting or light sensitivity – and this is not something you’ve experienced before.
– If the headache is worse in the morning, or when bending over/coughing/exerting yourself.
– If you have neck stiffness, a fever or a rash.