Headache and Migraine Treatment In Maryland, Pennsylvania and Virginia

Different types of migraines and headaches

Headaches vary greatly in location, type of headache, pain level, and how often they occur. While the brain does not have pain signals and cannot feel pain (hence why patients do not feel anything when having brain surgery), other facets of the head can lead to you feeling pain from a headache.

Some of these parts are the many nerves in the head and face, the head, neck, and shoulders muscles, and blood vessels. Most people may not be aware, but there are over 150 ways to describe a headache or migraine. It is the most common form of pain. Frequently experienced primary headaches include:

Tension Headaches:

The most common type of headache people experience is a tension headache, which occur in three of every four adults. Tension headaches can occur from muscles tightening in your shoulders, neck, scalp, or jaw, and they are often related to stress, depression, or anxiety.

Those with severe tension headaches can have them up to three to four times a week, but most only have mild, occasional headaches. Tension headaches are typically characterized by pain on both sides of the head (bilateral), pain that is dull or even feels like a band or vice around the head, possible sensitivity to light, along with nausea/vomiting. Most tension headaches last about 20 minutes to two hours.

Migraines:

Migraines are the second most common type of headache and are often more intense than tension headaches, described as a pounding/throbbing pain. Migraines are often accompanied by other physical symptoms, including nausea/vomiting, lightheadedness, sensitivity to light, and blurred or otherwise messed up vision. Migraines can last anywhere from four hours to three days and are two to three times more common in women than men.

Types of migraines and symptoms

Migraines have different phases, although not everyone goes through each phase. The first phase is the premonition or prodromal phase and involves a change in mood or behavior before the actual headache. The next phase is the aura, which involves visual, sensory, and motor symptoms such as numbness, tingling, and vision changes.

The headache phase is next and is when the pounding/throbbing pain and other physical symptoms occur. Lastly, the resolution phase is when the pain starts to subside, and people can feel fatigued or irritable after having the headache.

How To Treat Complex Migraines

Complex migraines, also known as complicated migraines, are a subset of migraines that are characterized by debilitating neurological symptoms. Complicated migraine symptoms include prolonged auras, temporary vision loss, or even difficulties with speech and motor skills. Unlike traditional migraines, complex migraines symptoms may linger long after the headache phase has passed, causing a significant impact on the patient's daily activities and quality of life.

Cluster Headaches:

These headaches are not as common as tension headaches or migraines but are the most severe type of primary headache. Cluster headaches occur five times more often in men than in women, and the usual person dealing with cluster headaches is middle-aged men with a history of smoking.

Cluster headaches are called that because the head pain tends to come in groups or clusters. They generally occur one to eight times in a single day (hence the clustering aspect) during a period from two weeks to possibly three months (often during the same time of year). Individual headaches can last from 30 to 60 minutes, and the headaches can completely disappear (what doctors refer to as remission) for months or even years, only to come back again.

Cluster headaches always start on one side of the head, usually behind one eye, and can be throbbing and constant. The eye where the pain is located can become red and water, with a drooping eyelid and small pupil. There can also be swelling of the eyelid, a runny nose or congestion, and swelling of the forehead. Many people suffering from cluster headaches experience intense pain that they cannot sit still and will start to pace or jog in place, which can lead to agitation.

Other types of headaches include:

• Sinus Headaches
• Allergy Headaches
• Caffeine-Withdrawal Headaches
• Fasting Headaches
• Hangover Headaches
• Hunger Headaches
• Hypertension Headaches
• Menstrual Headaches

Not all headaches require a doctor’s attention and most people can alleviate some of these pains by improving their diets, relaxing and sleeping habits, and taking over-the-counter pain relievers.

Frequent headaches, however, can be a symptom of a more significant issue. Tell your doctor about frequent, sudden, or severe headaches. They will be able to determine if more medical attention is necessary.

Causes for chronic headaches and Migraines

Headaches are one of the top reasons why people miss work or school. It is not fully known what causes most headaches, but the pain does derive from blood vessels, muscles, brain chemicals, and nerves. The unknown part about the root cause of migraines and headaches is what triggers these parts to cause pain.

Migraines (and headaches in general) have been shown to run in families, and it is thought that they result from nerve cells reacting to specific triggers. Those nerve cells send impulses to blood vessels, which then cause pain. Some migraine triggers can be lighting, noise, alcohol, bad sleeping habits, depression, stress, and changes in the weather.

Preventing Headaches and Migraines

The biggest way to be able to prevent headaches is to learn what triggers them for you and avoid those triggers as best as possible. What triggers headaches in you may not trigger them in someone else, so you must pay attention to what is happening before a headache starts. For example, if you notice that you tend to get a headache from inconsistent or lack of sleep, you should create a better-sleeping routine.

Living with chronic headaches: When To Worry

A minor headache is generally not caused for concern and can be treated with over-the-counter medication, drinking more water, and getting some sleep. However, headaches do range in severity, and if you believe that your headache is not usual or the pain is too intense, you should seek out medical assistance to ensure nothing more serious or an underlying problem is occurring.

If you start to have any of the following chronic headache symptoms, then it is best to get medical assistance immediately:

• A sudden, new, and unusually severe headache.
• Headaches that appear for the first time over the age of 50.
• Headaches that start after a head injury or accident.
• A significant shift in patterns to your headaches.
• Headaches continue to worsen over time.
• Headaches are accompanied by neurological symptoms, such as weakness, dizziness, numbness or tingling, imbalance, difficulties with speech, mental confusion, memory issues, confusion or decreased alertness, and seizures. Fever, shortness of breath, rash, and stiff neck can also occur.
• An inability to complete daily activities because of head pain.
• Headache pain that wakes you up or causes pain and tenderness near your temples.

For any of the following issues, you should make an appointment with a medical professional relatively soon:

• The migraine keeps coming back three or more times a week.
• Persistent headaches that will not go away, even after taking over-the-counter medication and resting.
• Needing to take general pain relievers for most, if not all, days of the week.
• Headaches that occur after physical activity or strenuous work.

How to Diagnose Migraines and Headaches

If you are suffering from frequent headaches, our physicians are dedicated to giving you a comprehensive exam that will aid in diagnosing the different types of migraine headaches. Using advanced diagnostic techniques, our headache doctors will find out the reason for your pain and then get you on the road to better health right away. Here is the chronic migraine diagnostic criteria our physicians use when completing their comprehensive exams:

• We take your complete medical history to identify or rule out possible causes of your pain.
• We conduct a thorough physical exam.
• We carefully review your symptoms, including how you describe the pain (burning, achy, sharp, etc.).
• We may order diagnostic tests, including an X-ray, MRI, or CT scan, to help us diagnose your headache pain.

Once we have an accurate diagnosis, we will work with you to create a treatment plan to address your chronic headaches effectively.

Headache and Migraine Treatment Methods

At Pain and Spine Specialists, we understand the debilitating effects of headaches and migraines. Your journey to finding relief may involve exploring traditional treatments, interventional methods, and alternative approaches. Here are a few different treatment options that we offer:

Traditional Treatments

Traditional treatments for headaches and migraines often involve medication-based interventions. Alongside medication, lifestyle modifications like stress management, maintaining a regular sleep schedule, and dietary changes also form part of traditional treatment approaches:

• Over-the-counter (OTC) Medications: For many people experiencing headaches or migraines, OTC medications such as ibuprofen, aspirin, or acetaminophen can provide temporary relief. However, it's essential to follow the recommended dosages and consult your healthcare provider if you find yourself relying on these medications frequently.
• Medication Management Programs: In cases where OTC medications aren't effective, your healthcare provider may prescribe stronger medications to alleviate headache or migraine symptoms. These may include triptans, ergotamines, or anti-inflammatory drugs. It's important to discuss any potential side effects or drug interactions with your healthcare provider before starting a new medication.

While traditional treatments can provide relief for some migraine suffererers, they may not be suitable for everyone. Overuse of OTC or prescription medications can lead to medication overuse headaches (MOH), also known as rebound headaches. Furthermore, some medications may cause side effects, including dizziness, nausea, or even increased headache frequency.

Interventional Methods

Interventional treatment methods are often employed when traditional treatments fail to provide adequate relief to individuals experiencing chronic headaches or migraines. These methods aim to directly intervene in the pain pathway to disrupt the transmission of pain signals. Some common interventional treatments include:

• Facet Joint Injection: This procedure involves injecting a combination of a local anesthetic and a corticosteroid into the facet joints of the spine. This can help reduce inflammation and provide pain relief for certain types of headaches.
• Epidural Steroid Injection: By injecting a corticosteroid into the epidural space of the spine, this treatment aims to reduce inflammation and alleviate pain caused by nerve irritation.
• Stellate Ganglion Block: This procedure involves injecting a local anesthetic near the stellate ganglion, a group of nerves in the neck. It can help alleviate pain in specific headache and migraine conditions.
• Radiofrequency Ablation: This treatment uses radiofrequency energy to disrupt nerve function, providing long-lasting pain relief for certain types of headaches.
• Trigger Point Injection: By injecting a local anesthetic into specific trigger points (knots) in the muscles, this procedure can help reduce pain and muscle tension contributing to headaches or migraines.
• Occipital Nerve Blocks: This treatment involves injecting a local anesthetic and corticosteroid near the occipital nerves, which can help provide relief for occipital neuralgia and other headache types.

Alternative Migraine Treatment

Alternative treatments have gained popularity in the management of migraines and headaches as they often have fewer side effects than traditional treatments. They aim at promoting overall wellness and relieving stress, which can be a trigger for headaches and migraines.

• Acupuncture and Migraines Treatment: An ancient Chinese practice, acupuncture involves inserting thin needles into specific points on the body to balance the flow of energy and alleviate pain.
• Massage: Massage therapy can help relieve muscle tension, improve circulation, and promote relaxation, which may be beneficial for those experiencing headaches or migraines.
• Stress Management: Incorporating stress-reducing techniques, such as meditation, deep breathing exercises, or yoga, can help decrease the frequency and intensity of headaches and migraines.
• Migraine Self Care: Maintaining a healthy diet, staying hydrated, getting regular exercise, and establishing a consistent sleep schedule can all contribute to reducing headache and migraine frequency.

Remember, finding the right treatment method for your headaches or migraines may involve trial and error. It's essential to work closely with your healthcare provider or a headache and migraine specialist to develop a personalized plan tailored to your specific needs.