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What are the different types of headaches?

What are the different types of headaches?

Over 150 distinct kinds of headaches exist. Cluster, sinus, hypnic, migraine, and tension-type headaches are a few of the varieties. Even though headaches can occasionally be excruciating and incapacitating, most of them can be managed with basic painkillers. On the other hand, recurring episodes or particular kinds of headaches might point to a medical issue. Primary and secondary headaches are frequently separated into two major categories. There is no other cause for a primary headache. A secondary headache, on the other hand, has a different underlying cause, like a head injury or abrupt caffeine withdrawal. Eleven of the most prevalent headache types are examined in this article, along with information on their causes, prevention, treatments, and when to consult a physician.

Headaches are a prevalent problem. According to estimates from the World Health Organization (WHO), about 40% of people worldwide suffer from headache disorders. Across all age groups, headaches rank among the top three most prevalent neurological disorders. Intense throbbing pain on one side of the head is a common symptom of a migraine. A person may become more sensitive to smell, sound, and light. Vomiting and nausea are also frequent. About 25% of migraineurs report having an aura either prior to or during their headache.

Aura symptoms can also be signs of stroke or meningitis. These visual and sensory abnormalities usually last 5 to 60 minutes and include: seeing zigzag lines, flickering lights, or spots; partial loss of vision; numbness; tingling; muscle weakness; difficulty speaking or finding words; and more. If someone is experiencing these for the first time, they should get medical help immediately. Each episode of a migraine headache can last anywhere from a few hours to several days, and they are frequently recurrent. It is a chronic condition for many people.

The precise causes of migraines are not entirely understood by medical professionals. Nonetheless, it frequently runs in families and is more prevalent in those who already have certain medical conditions, like epilepsy and depression. Stress, anxiety, disturbed sleep, hormonal changes, missing meals, dehydration, certain foods and medications, bright lights, and loud noises are all possible migraine triggers.

The severity of the symptoms, their frequency, and whether or not the patient experiences nausea and vomiting are some variables that will affect the course of treatment. Treatment options include: antiemetics, like metoclopramide, to control nausea and vomiting; neurostimulation techniques, like transcranial magnetic stimulation (TMS); non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, aspirin, and acetaminophen triptans, like sumatriptan, which need a prescription.

Resting in a quiet, dark area, applying a cold cloth or ice pack to the forehead, and drinking water are other ways to reduce migraine attacks. People who suffer from chronic migraines should consult a healthcare provider about preventive care. If a person experiences an episode for more than 15 days in a month or if symptoms appear at least 8 days a month for three months, they may be diagnosed with chronic migraine. Topiramate (Topamax) and propranolol amitriptyline are medication options for migraine prevention. Acupuncture, stress reduction, and dietary modifications are additional management options to take into account.

Most people experience tension-type headaches occasionally. These primary headaches are the most prevalent kind. According to research, approximately 78% of adults will at some point suffer from a tension-type headache. They start off as a dull, persistent headache on both sides. Additional symptoms may include: headaches lasting 30 minutes to several days; sensitivity to light and sound; a feeling of pressure behind the eyes; and tenderness of the face, head, neck, and shoulders. It’s unclear what specifically causes tension headaches. Nonetheless, common triggers include stress, anxiety, and depression. Dehydration, loud noises, lack of exercise, poor sleep, missing meals, and eye strain are additional possible triggers.

Ibuprofen, acetaminophen, and aspirin are examples of over-the-counter (OTC) painkillers that are typically very effective at halting or reducing pain. People should see a doctor if they have headaches more than 15 days a month, as this could be a sign of chronic headaches. Tension headaches may be avoided with certain treatments and lifestyle modifications. Acupuncture, stress, anxiety, and depression management, regular exercise, stretching, and better sitting and standing posture are a few examples.

Severe and frequent headaches are known as cluster headaches. Males are six times more likely than females to be affected, and they are comparatively rare, affecting 1 in 1000 adults. Cluster headache sufferers report a sharp, piercing pain behind or around one eye. Cluster headaches typically occur suddenly and without warning and last anywhere from 15 minutes to 3 hours. Other symptoms may include watering eyes, swollen eyelids, a runny nose, or sensitivity to light and sound. Up to eight attacks may occur in a single day.

These attacks can last for weeks or months and typically happen in clusters every day. Additionally, they frequently begin at regular times, usually a few hours after going to sleep at night. These symptoms, which occasionally mimic hay fever, should be discussed with a healthcare provider by anyone exhibiting them. Cluster headaches are more common in smokers, though their exact cause is unknown. Alcohol should also be avoided when having an attack.

The goal of treatment is to lessen the attacks’ frequency and intensity. Deep brain stimulation and vagus nerve stimulation also show promise in treating cluster headaches that do not respond to medication. Other options include oxygen therapy, sumatriptan, verapamil steroids, melatonin, and lithium.

The following activities can cause exertional headaches: running, jumping, weightlifting, sexual activity, and coughing or sneezing. These headaches are typically very short-lived, but they can occasionally last up to two days. They are more prevalent in people with a family history of migraine and manifest as throbbing pain throughout the head. When exertional headaches occur for the first time, people should consult a healthcare provider because they may indicate a more serious condition.

OTC pain relievers and beta-blockers, like propranolol and indomethacin, are among the treatments for exertional headaches. Cardiovascular problems can occasionally cause exertional headaches. If so, a medical expert might suggest tests to assess a patient’s cardiovascular and brain health.

A rare condition known as a hypnic headache typically first appears in people in their 50s. It may, however, begin earlier. They are also known as “alarm clock” headaches, and they cause people to wake up in the middle of the night. Mild to moderate throbbing pain, typically on both sides of the head, is the hallmark of a hypnic headache. Along with other symptoms like light and sound sensitivity and nausea, it can last for up to three hours. A person may have multiple attacks in a given week. There are no recognized triggers for hypnic headaches, and their exact cause is unknown. Even though hypnic headaches are usually benign, older adults should consult a doctor if they have any unusual headaches for the first time. A medical practitioner might want to rule out cluster headaches and migraines. Hypnic headaches can be treated with caffeine indomethacin lithium.

Medication-overuse headache A common form of secondary headache is medication-overuse headache (MOH), also referred to as a rebound headache. About 1-2 percent of the general population has them. MOH headaches typically affect those who suffer from tension-type headaches or migraines. MOH headaches usually occur as soon as a person wakes up in the morning. Each person experiences the pain and location differently. Additionally, they might feel queasy, agitated, and have trouble focusing.

Taking medication for headache disorders regularly causes these headaches. However, if a person’s pain is not improving, they might take them more frequently or in greater quantities. If a patient has a headache condition and has taken painkillers for at least 15 days in a month, a doctor may diagnose MOH. NSAIDs like aspirin and ibuprofen, opioids, and acetaminophen-triptans, like sumatriptan, can all result in MOH when they wear off.

Stopping the medication that is causing the headaches is the only way to treat MOH. But anyone who wants to stop taking medication should only do so under a doctor’s supervision. To facilitate the withdrawal process, they can offer alternative medication prescriptions and assistance in creating a plan. The following symptoms are likely to occur after stopping the drug: worsened headaches, nausea, vomiting, elevated heart rate, low blood pressure, sleep disturbance, restlessness, anxiety, and nervousness.

A doctor may prescribe antiemetics or other medications to help manage nausea and vomiting. Although they can linger for up to four weeks, the symptoms typically last two to ten days. After a MOH is resolved, a medical expert will provide advice on appropriate painkillers to take. MOH can be avoided by limiting the use of painkillers for headaches, avoiding codeine and opioids, and taking preventive medication for chronic migraines.

Sinus headaches Sinusitis, or inflammation of the sinuses, is the cause of sinus headaches. Usually, an allergy or infection is the cause. A dull, throbbing ache around the eyes, cheeks, and forehead is one of the symptoms. Movement or straining may make the pain worse, and it occasionally spreads to the jaw and teeth. Facial pressure or pain, decreased sense of smell, nasal discharge, a blocked nose, fever, exhaustion, poor breath, coughing, dental pain, and a general feeling of being ill are some additional possible symptoms. Seldom do sinus headaches occur. This type of headache is more likely to be a migraine episode if there are no nasal symptoms.

Usually, sinusitis goes away on its own in four weeks. OTC pain relievers, salt water nasal sprays or solutions from the pharmacy, antihistamines, steroid nasal sprays, available with a prescription, antibiotics, rest, and fluids, and if there is a bacterial infection, people should consult a healthcare provider if symptoms worsen or do not go away after three weeks. A medical practitioner may recommend a patient to an ear, nose, and throat specialist to determine the underlying cause of sinusitis. To clear the sinuses, minor surgery might be required in certain situations. Avoiding smoking and other known allergens or triggers is one way to prevent sinusitis.

Headaches can occasionally result from consuming four cups of coffee a day, or more than 400 milligrams (mg) of caffeine. Withdrawal symptoms may include migraine-like headaches in those who have consumed more than 200 mg of caffeine per day for more than two weeks. These usually appear 12 to 24 hours following an abrupt cessation of caffeine use. They can last for 2 to 9 days and peak between 20 and 51 hours. The effects of caffeine vary from person to person, but cutting back on intake may lower the risk of headaches. Other potential symptoms include fatigue, difficulty concentrating, decreased mood or irritability, and nausea. Reducing caffeine intake may also benefit those who suffer from persistent migraines.

Headache After a Head Injury Sometimes a person experiences a headache right after or shortly after a head injury. This is frequently resolved by OTC pain relief. However, a person should get medical help right away if their symptoms are severe or get worse over time. In the event of a severe head injury or if any of the following symptoms appear after a head injury: unconsciousness, seizures, vomiting, memory loss, confusion, vision, or hearing issues, always call an ambulance. Post-traumatic headaches can also appear months after the initial head injury, making diagnosis challenging. They can last for up to a year and occasionally happen every day. Traumatic brain injury can occur from even minor head trauma.

Menstrual Headaches: The origin of such headaches is predominantly associated with shifts in hormone levels. During the menstrual cycle, migraines may manifest due to alterations in estrogen levels. In the pre-menstrual and post-menstrual phases, or during ovulation, hormone-related headaches typically manifest, with symptoms akin to migraines without an aura, although these may persist for a prolonged duration.

A throbbing headache the next day or even later that day can result from consuming too much alcohol. Both sides of the head typically experience these migraine-like headaches, which can get worse with movement. Symptoms of a hangover headache include light sensitivity and nausea. Hangovers cannot be cured, but they can be lessened by eating sugary foods and drinking lots of water. Over-the-counter pain relievers may lessen or eliminate headaches. Hangover symptoms usually disappear in 72 hours. Drinking in moderation, avoiding empty stomachs, and drinking water before bed and in between alcoholic beverages are all strategies to lower the chance of getting a hangover.

People with kidney disease, diabetes may develop heart disease 28 years earlier

People with kidney disease, diabetes may develop heart disease 28 years earlier

According to a recent study, individuals who have type 2 diabetes, chronic kidney disease, or both may be at higher risk for cardiovascular disease (CVD) 8–28 years earlier than those who do not have these conditions. Type 2 diabetes and chronic kidney disease are parts of the cardiovascular-kidney-metabolic (CKM) syndrome, which has a major effect on the risk of CVD.

These findings could aid in the early diagnosis of CVD in patients and aid in disease prevention. Chronic kidney disease, type 2 diabetes, or both may increase the risk of cardiovascular disease (CVD) 8 to 28 years earlier than people without these conditions, according to a recent study presented at the American Heart Association’s Scientific Sessions 2024.

To ascertain the relationship between age and risk factors linked to CKM syndrome, researchers employed simulated patient profiles. These findings could guide early detection and intervention strategies in CVD prevention, even though they haven’t been published in a peer-reviewed journal yet. Type 2 diabetes and chronic kidney disease are two of the four components of cardiovascular-kidney-metabolic (CKM) syndrome, which increase this risk.

According to current CVD prevention guidelines, if a person has a 7 5% chance of having a heart attack or stroke within the next ten years, their risk is elevated. CKM syndrome is defined by the American Heart Association as the relationship among metabolic diseases such as type 2 diabetes and obesity, kidney disease, and cardiovascular disease.

Developing cardiovascular risk profiles
To represent men and women aged 30 to 79 with and without type 2 diabetes and/or chronic kidney disease, researchers created risk profiles. They estimated the age at which each profile would probably reach elevated CVD risk using the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) calculator from the American Heart Association. Data from the 2011–2020 National Health and Nutrition Examination Survey was used to create the risk profiles.

An estimated glomerular filtration rate (eGFR) of 44.5, which denotes stage 3 kidney disease, was used to categorize chronic kidney disease. A “yes” answer to the PREVENT calculator question, Any history of diabetes, indicated type 2 diabetes. According to the American Heart Association, almost half of all U.S One in three adults has at least three risk factors linked to CKM syndrome, and all adults suffer from cardiovascular disease (CVD) in some capacity. Early identification of high-risk individuals can enhance primary prevention initiatives and reduce the likelihood of early death from CVD.

According to our research, a person’s age and other medical conditions have a substantial impact on their risk of cardiovascular disease. In particular, people with diabetes or kidney disease have a significantly increased risk of heart disease, even in their 30s, which can now be determined using the PREVENT equations. According to Krishnan, the Pooled Cohort Equations, which began at age 40 and excluded kidney function, could not previously be used to evaluate this.

A better understanding of cardiovascular disease risk, which includes heart attacks, heart failures, and strokes, should be made possible by the study, she continued. Even in the absence of a formal diagnosis, people with borderline high blood pressure, glucose, or kidney function may be at risk for unidentified health issues.

For people with CKM (Cardiovascular-Kidney-Metabolic) disorders like diabetes or kidney disease, these risks manifest earlier. For instance, elevated cardiovascular risk can manifest decades earlier in individuals with CKM, particularly when combined with other conditions, whereas it begins around age 68 for women and 63 for men without CKM.

References:
https://www.medicalnewstoday.com/articles/chronic-kidney-disease-type-2-diabetes-may-develop-heart-disease-28-years-earlier#Developing-cardiovascular-risk-profiles


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In Conversation: How to understand chronic pain

In Conversation: How to understand chronic pain

In recent years, chronic pain has gained recognition as a medical condition in and of itself. This is because chronic pain is a disease process that is so complicated that we are only now beginning to understand what triggers it. However, what is it like to live with chronic pain, and how do the body and brain cope with it?

People often describe their pain as aching, dull, gnawing, burning, sharp, shooting, and piercing. Imagine having to deal with some of this every day until you have no idea what it’s like to go about your day without this constant pain that gradually saps your physical and mental stamina. For many people who suffer from chronic pain, that is their reality.

It could be an internal struggle concealed behind gritted teeth and fake smiles, and some days might be fantastic and some days awful. However, how does chronic pain become, well, chronic? In the most recent episode of our Pain Awareness Month-themed In Conversation podcast, Medical News Today delves into the science of chronic pain with Drs. Tony L. and Hilary Guite. As Joel Nelson, a longtime patient and advocate for psoriatic disease and arthritis, Yaksh, a professor of anesthesiology and pharmacology at the University of California, San Diego, talks about his experience with pain.

Because chronic pain is not life-threatening, it is frequently disregarded as merely a symptom of a more serious issue or not given the attention it deserves. Chronic pain, however, has a social as well as a personal cost. According to studies (), individuals who experience chronic pain may find it difficult to carry out daily tasks and activities and may also have worse general health. Chronic pain sufferers may also experience unemployment or unstable employment.

Chronic pain was not recognized or diagnosed until 2018 when the International Classification of Diseases (ICD) assigned it a code in the draft version of the new ICD-11 coding system. The two types of chronic pain currently recognized by the World Health Organization (WHO) are chronic primary pain and chronic secondary pain.

According to this classification, primary pain is defined as pain that cannot be attributed to or explained by another medical condition. Fibromyalgia and persistent primary low back pain are a couple of examples. A widespread pain disorder that affects at least four to five body parts and lasts for at least three months, but typically longer, fibromyalgia varies from person to person. Since there is no other explanation for the pain, Dr. Dot Guite clarified that it is a form of primary chronic pain.

Conversely, secondary pain results from or is a result of an underlying medical condition. This would include pain from ulcerative colitis, cancer, or arthritis. I began experiencing chronic pain when I was ten years old. And ever since, Joel Nelson told MNT’s In Conversation, “Chronic pain has kind of been an intermittent part of my life right up until the present day. Joel, who is currently 38 years old, has experienced chronic pain for several decades.

I experienced pain for the first time when I had a gravel-like burning sensation in my hip. And the more I used the joint, the worse it got; at one point, he claimed, I was losing some of my mobility. He decided to seek help at that point, just like the majority of people do. Joel asserted that the best way to describe his persistent pain is noise. I have always referred to it as noise because, on the days when the pain is severe, I simply lose the capacity to take in additional information and manage several tasks at once, he said.

In light of my current condition, I believe that the experience’s fluidity is its most significant lesson. In the end, my mobility and limits can vary from anything to the point where I can do more than just walk, and I might be able to run and cycle a little bit like I do now, to possibly needing crutches again the following week. Pain dictates a lot of that. I get a lot of stiffness in the mornings from arthritis, but the pain is what keeps me from doing things. Joel said it’s difficult to predict what will happen next with his chronic pain, likening it to a series of chapters. Researchers have discovered that a gateway receptor known as Toll-like receptor 4(TLR4) may be a governing factor behind the development of chronic pain from acute pain.

We are aware that signaling that is typically linked to what is known as innate immunity can be activated in response to various types of tissue or nerve damage. And the toll-like receptor is one of the mediators of that. It turns out that although those receptors are typically present to detect the presence of foreign bugs, like E. coli, those insects contain a substance known as lipopolysaccharide, or LPS, in their cell membrane. According to Dr. Dot Yaksh, bacteria are the source of that, which is not typically present in our system.

You don’t need to acquire it; you are born with it. It is constantly present. Over the past few years, we’ve discovered that your body releases a variety of substances that will activate those same toll-like receptors, he continued. The central immune system may be primed for elevated pain states by toll-like receptors. The body begins to release products from inflammatory cells in response to damaging stimuli, stressors, or tissue damage, particularly in the gastrointestinal tract or microbiome.

According to him, when this occurs, the products that are expelled from our bodies can activate toll-like receptors. One such receptor is called TLR4, and it is found on both sensory neurons and inflammatory cells. Dr. According to Yaksh, TLR4 activation makes the nervous system more reactive but doesn’t actually cause as much pain.

In addition to this priming, Dr. Dot Guite noted that if additional stressors are present at the time, such as poor diet or psychological distress, this can trigger a series of events that can accelerate the transition to chronic pain. TLR4 activation initiates a cascade, a series of events that will result in increased expression of numerous receptors and channels capable of enhancing the system’s response. When this occurs, the initial tissue damage is followed by this improved response. It only makes the system more reactive; it doesn’t really cause the pain condition. According to him, Joel’s circumstances are consistent with the idea that people can experience different kinds of pain.

That can be made worse by “psychological” stressors, which can intensify a pain state that may actually have a physiological component that we don’t fully comprehend, he continued. Dr. Yaksh, for instance, proposed that Joel’s condition was likely made worse by the stress (and joy) of becoming a father and all the other factors involved, making it more difficult to manage the pain. He emphasized that this did not lessen the reality of the pain.

I believe that Joel’s situation was likely associated with a very strong, emotional component. He explained that the pain condition and the events related to the psoriatic diagnosis and other aspects may have actually established the transition from one state to another, which we call an acute to chronic or chronification of the pain state. According to current theories, pain occurs where the body and brain meet.

The way you mentioned that pain is in the brain is exactly right; Dr. Dot Yaksh stated that everything’s output function originates from the higher centers. It all comes down to how tissue damage affects how the brain perceives pain. Our bodies use pain as a warning system to notify us when there is damage or illness, which is why it is so important to our survival. Following a disease or injury, the surrounding nerves begin communicating with the brain via the spinal cord, urging us to seek medical attention and prevent additional harm.

Following an injury, the body’s organs and tissues suffer damage, which sets off an acute inflammatory response involving blood vessels, immune cells, and other mediators. But occasionally, the nervous system may continue to be distressed or reactive even after the body has healed from the initial injury phase. The body may become overly sensitive to pain as a result. Peripheral sensitization is the term used to describe this increased sensitivity to touch or heat near the injured area.

Dr. Yaksh explained that if I were to jam my finger or if I were to experience something that causes a local autoinflammation of the joint, as Joel did, then that inflammation actually causes the release of factors that make the innervation of that joint more sensitive. Dr. According to Yaksh, everyone goes through this, even if they don’t have chronic pain. He clarified that an otherwise harmless activity, like wriggling one’s finger, can become extremely unpleasant following an injury.

He defined this as a sensitization brought on by inflammation and injury to the periphery, which is subsequently transmitted to the brain via the spinal cord. The brain is now perceiving what would otherwise be a harmless occurrence, producing a signal that suggests, as we say, that bad news is on the horizon. On the other hand, this prolonged reaction to the initial injury can occasionally result in persistent pain that is not restricted to the injured area. Central sensitization is the term for this ().

Joel’s situation is intriguing because it is evident that he has a peripheral problem, whether it be skin inflammation, joint inflammation, or abnormalities in peripheral nerve function. Therefore, Dr. Yaksh explained, that in addition to changes in joint morphology and other similar things, you also get changes that alter how information enters the spinal cord and then travels to higher centers. Additionally, you’ve activated particular populations of sensory fibers that are typically only activated by severe injury.

The spinal cord, which is currently, in a sense, organizing the input-output function from the periphery to the brain, may become reorganized. This would be similar to turning up the volume on a radio; the signal would remain the same, but the volume would increase. The spinal cord can therefore be thought of as a volume regulator.

Additionally, it states that there is bad news. However, we now know that some of the input that travels through the same pathway actually goes to parts of the brain that are unrelated to the source of the pain just that it is severe,” he said. The brain receives information about the location and severity of the pain from these outputs that ascend the spinal cord. According to Dr. Yaksh, the limbic system, also known as the smell brain, is one region where these are processed. He continued by saying that these are brain regions that are actually linked to emotionality in humans.

In addition to causing muscles to tense or spasm, this stress can also alter how the body perceives pain and raise cortisol levels of the hormone. Over time, this could result in pain and inflammation. Over time, this can worsen the pain by contributing to an already stressed nervous system and causing sleep issues, irritability, exhaustion, and depression. Even though acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids are frequently used to treat acute pain, there are relatively few options for managing chronic pain.

We began by stating that pain originates in the brain. Additionally, your views of the world have a direct impact on you and alter how your brain functions in ways that can be defined experimentally. Therefore, I am not implying that pain is any less real in any manner, shape, or form when I say that it is in the brain. Dr. Yaksh asserted that it is a reality. We now instruct medical students that, you know, a patient may have a condition other than a swollen joint, even if that isn’t the primary diagnosis, he said.

According to Dr. Dot Yaksh, fibromyalgia is frequently treated or managed with mindfulness in therapy. According to him, this does not imply that fibromyalgia lacks a physiological component, and in fact, new research indicates that it is most likely an autoimmune disease, just as real as the presence of antibodies that indicate the existence of an arthritic joint.

Although it’s not something you could become mindful enough to say have surgery done, mindfulness can help the person respond to the type of afferent traffic that’s coming up the spinal cord. However, it may lessen the intensity of some of the factors that are actually causing this heightened reaction. A prime example is fibromyalgia. According to him, mindfulness shows that altering your perspective on your pain condition can help you manage it, but it doesn’t make the pain state any less real.

Joel continued by saying that, from the viewpoint of someone who has chronic pain, it is a journey to see how the body and brain cooperate to maintain pain: Talking about pain and how it resides in the brain is a really delicate conversation, and as someone who has gone through the entire process of being appalled when it was first suggested to undergo pain management, I have also had to understand it to better process it. For me, it completely altered everything.

It’s still unclear what the future of chronic pain treatment will bring. Nonetheless, there is hope that medications will be created to affect receptors like TLR4 in a way that might prevent acute pain from turning into chronic pain and that as time goes on, we will learn more about how psychological processes interact with the neuro-immune interface.

References:
https://www.medicalnewstoday.com/articles/in-conversation-how-to-understand-chronic-pain?utm_source=ReadNext#Mindfulness-and-the-neuroscience-of-pain
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