The Nation's Health

Health Tips: Headaches: Treatment depends on your symptoms

Do you take aspirin or acetaminophen for all your headaches? For some types of headaches, that's not the best approach. Here's why.

Your head hurts. Again. The first step in developing a plan to combat your recurring headaches is to determine what type of headaches you have. Sometimes headaches are a symptom of another disease or condition. In other cases, no clear cause can be found. To better understand your headaches, take a closer look at your signs and symptoms.

Are the headaches dull and achy?

Tension headaches — the most common variety of headache — often feel like a tight band around your head. Sometimes triggered by neck strain or eyestrain, tension headaches can last from 30 minutes to an entire week.

Nearly 90 percent of women and about 70 percent of men experience tension headaches at some point. Most tension headaches are easily treated with over-the-counter medications, including aspirin, ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others).

Are the headaches throbbing and severe?

Migraines often are accompanied by nausea, vomiting, or sensitivity to light or sound. In six out of 10 cases, migraines affect only one side of your head. The pain may worsen with routine activity. A migraine typically lasts from four to 72 hours.

Migraines are more common in women. Prescription medications are often needed to treat migraines. When a migraine strikes, rest in a quiet, dark room if possible. Hot or cold compresses to your head or neck can be soothing. Massage and small amounts of caffeine may help, too.

Do the headaches recur for weeks at a time?

Cluster headaches, as the name implies, are repetitive — occurring off and on for weeks at a time. The pain typically begins quickly without warning and reaches maximum intensity within minutes. These headaches always affect just one side of your head, and they often are accompanied by a teary eye and stuffed nose.

During a cluster period, which can last for several months, you may experience one or more cluster headaches a day. A typical cluster headache lasts from 15 minutes to three hours. Most people feel restless during a cluster headache, preferring to pace or rock rather than lie quietly in a dark room.

Cluster headaches are rare, affecting less than 1 percent of adults. Because the pain of a cluster headache strikes suddenly and may subside quickly, over-the-counter pain relievers aren't effective. Preventive medications are typically prescribed instead. During a cluster headache, injecting medication or inhaling 100 percent oxygen through a mask may help.

Do you have headaches nearly every day?

Headaches that occur more than 15 days a month are considered chronic daily headaches. You may feel steady pain on one or both sides of your head. Sometimes the pain is described as a dull ache or a tight band of pressure around the head. The signs, symptoms and time frame vary depending on the specific type of chronic daily headache.

Chronic daily headaches affect up to 5 percent of adults. Treatment for any underlying diseases or conditions often stops chronic daily headaches. When no underlying diseases or conditions are present, treatment focuses on preventive medication.

Do you take pain medication more than two or three days a week?

If you've been taking pain medication often, the headaches may be caused by medication overuse. These are known as rebound headaches. The pain may be dull, achy, throbbing or pounding. A rebound headache may awaken you early in the morning and continue throughout the day. The pain may be most severe at first, when the medication begins to wear off.

Anyone who has migraines, tension-type headaches or other chronic headaches is at risk of developing rebound headaches from the overuse of pain relievers. The only way to stop rebound headaches is to reduce or stop taking the medication that's causing the headaches.

Do the headaches follow a specific activity?

Sometimes exercise, sex, bouts of coughing or other activities trigger headaches. An exercise-induced headache may last from five minutes to 48 hours. Most sex headaches last a few minutes, but others may linger for a few hours. Primary cough headaches typically last a few seconds to a few minutes.

These types of headaches are unusual. They're usually short-lived, making treatment unnecessary. When acute treatment is needed, nonsteroidal anti-inflammatory drugs — such as aspirin and ibuprofen — may be effective. Your doctor may recommend various tests to help detect any underlying conditions.

Recognize emergency symptoms

Sometimes a headache signals a serious underlying condition. Seek emergency evaluation if any of the features below are present.

* Sudden onset of severe headache * Fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking * Onset after a head injury, fall or bump * Pain worsens despite rest and over-the-counter pain medication

Take control

Most headaches are nothing to worry about. But if headaches are disrupting your daily activities, work or personal life, it's time to take action. Headaches can't always be prevented, but your doctor can help you manage the signs and symptoms.

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