Everyone gets headaches from time to time. In fact, they are so common that drug manufacturers spend billions each year to try and get you to buy their products that treat them. But what are they? It is rare in this world to have something so common that is so misunderstood by many people.
To begin, our brain itself is not sensitive to pain; it has no pain receptors. However, many of the surrounding structures of the brain like the arteries, muscles and brainstem are lined with pain receptors. Most prominent to pain are the meninges that line the inside of the skull. I think of the meninges as several sheets of plastic wrap that encase our brain and protect it from the inside of the skull.
Traction or irritation to the meninges and surrounding blood vessels are often responsible for the pain that we most often associate with headaches. One notable exception to this cause of pain is migraines. They, along with tension and cluster headaches, are not fully understood. The current thought is that migraines are primarily caused by some problem with the nerves inside the brain as opposed to older thinking that the irritated blood vessels caused the pain.
Generally speaking, major headaches can be divided into three categories: tension, cluster and migraines. Tension headaches are characterized by a mild to moderately dull, achy pain across the entire head that lasts 30 minutes to several hours. This patient does not report light sensitivity or visual disturbances. Cluster headaches last about the same length of time as a tension headache, but the pain is often reported as sharp and focused on the eye or temple. Sometimes, cluster headaches can cause a runny nose, tears or a drooping eyelid.
Finally, migraine headaches are the worst of the worst. These often cause severe pain that lasts for several days with a pulsating, throbbing pain to one or both sides of the head. Suffers often report nausea, sensitivity to light and noise, and, possibly, visual disturbances such as auras.
Over-the-counter pain medications such as acetaminophen, ibuprofen and aspirin can usually relieve the pain associated with tension headaches. Cluster and migraine headaches often require prescription medications such as Imitrex and Zomig to target specific areas of the brain and change the way neurotransmitters are released. Newer medications that contain ergotamine constrict smooth muscles in arterial walls to ease pressure. It is also interesting that new research has shown a link between certain foods and migraines. Lunchmeats with nitrates and red wine are thought to trigger migraine headaches. No matter the type of a headache, remember there are certain symptoms that require immediate medical attention. Thunderclap headaches (fast onset), headache after a head injury, headache with fever or stiff neck or a headache that wakes you up are often signs of a larger problem. If you experience these symptoms, get to your physician or the emergency room for evaluation. Don’t let a minor annoyance become a major headache.
If there is a topic that you would like me to explore, please drop me a line at eric.williams@jcjc.edu. Stay safe out there.
M. Eric Williams, MS, NR-P is a syndicated columnist and the Assistant Director of Emergency Medical Education at Jones County Junior College. He is a current Doctoral Researcher at Delta State University and has 15 years’ experience in Emergency Medicine.
