There is help for your headaches
HealthWorks’ editorial staff spoke
with Barry Levin, MD,
a neurologist at
Emerson Hospital,
about a troubling and
common condition.
How common are headaches?
Headaches are extremely common; about 80
percent of Americans experience tension headaches
at some point, and about 10 percent of the population
has migraine headaches. Headaches are among
the most common reasons that people seek out a
physician’s care.
How much tension does it take to
produce a tension headache?
Everyone’s tolerance for stress is different, so there
is no specific amount of tension that will produce
a headache.They frequently are related to stress, as
well as depression.The mechanism of these
headaches is complicated by the probable contribution
of chemical changes that affect the lower part
of the brain, similar to what occurs with migraines.
How are tension headaches treated?
After obtaining a detailed history and performing
a full neurological exam, I frequently advise behavioral
changes, including trying to control stress at
work and home, getting regular exercise, eating a
balanced diet and limiting caffeine and alcohol. I
suggest minor analgesics such as Tylenol or ibuprofen,
but no more than four pills a day, no more than
four days a week. Higher doses can lead to analgesic
rebound headaches. Prescription medications, such
as amitriptyline, are sometimes needed.
Can tension headaches be successfully
treated?
Absolutely.The goal is to lessen the frequency of an individual’s headaches and to reduce the impact of
headaches on their ability to work, go to school and
interact with others.
Are migraine headaches different from
tension headaches?
Yes.Tension headaches can occur anywhere on the
head and produce a feeling of pressure or aching.
Migraine headaches frequently occur on one side
of the head and cause severe, throbbing pain, as well
as nausea, vomiting, sensitivity to light and visualdisturbances. Some people experience migraines
with aura—flashing lights, jagged lines or blind
spots—prior to onset of the headache.The majority
of migraine sufferers are women; migraines generally
become less frequent after menopause. Better
treatment is now available, including medications
aimed at prevention, treating the symptoms and
halting the headache soon after symptoms begin.
What are cluster headaches?
These are headaches that occur in groups or clusters—
once or many times a day.They may occur
every day for a period of weeks.Then they disappear,
and the person may not experience them
again for a year or two. Cluster headaches are
among the most painful type of headache and are
more common in men. A severe, sharp pain occurs
around the eye and in the forehead. Patients with
migraines typically want to lie down in a dark
room, whereas individuals with cluster headaches
cannot relax and tend to pace.The good news is
that cluster headaches typically last only one or two
hours, whereas a migraine lasts from several hours
to a day. Similar to migraines, we have medications
for cluster headaches that prevent them, treat
symptoms and often halt the headache.
When does a headache signal a
potentially serious condition?
We get concerned when someone who has never
had headaches starts getting them—especially if
the person is older.We also worry when a familiar
headache pattern changes, such as the individual
who begins to have more frequent or more severe
headaches. Finally, if headaches are associated with
neurological symptoms, such as weakness on one
side, slurring of speech, imbalance, changes in vision
or persistent nausea and vomiting, the person needs
to be evaluated by a physician as soon as possible.
For more information on diagnosis or treatment of headaches at Emerson Hospital, visit our Find a Doctor section or call the Physician Referral Line at 978-287-3456.
