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If you've ever missed work, a night out with friends, or a special occasion because of a headache, then you know first-hand just how debilitating they can be.
While people may think they know whether they're experiencing a tension headache or migraine, experts warn that headaches can be complicated and people often misdiagnose themselves.
That’s why they encourage anyone who frequently gets severe headaches to contact a specialist.
What are the most common types of headaches?
According to the Cleveland Clinic, tension headaches are the most common type of headache, followed by migraines and cluster headaches, which are the most extreme.
All three of these headaches fall under the same category of primary headaches, which means the headache is the true health issue and is not caused by another condition.
What is the difference between tension, cluster headaches and migraines?
A tension-type headache produces a mild to moderate pain and a pressure across the forehead, sort of like you have a “tight band around your head.” Tension headaches can get confused with migraines as they produce similar symptoms, but there are key differences you should look out for.
Unlike migraines, tension headaches don’t usually produce a sensitivity to light or nausea. The exact cause behind tension headaches is unknown, but environment and genetics may play a factor.
A migraine is a neurological condition and the third most common disease in the world, according to Migraine Canada. This category of headache often produces throbbing and pulsing on one side of the head, feelings of nausea or vomiting, as well as sensitivity to light and sound that can last between four hours to a few days.
Migraines are often hereditary, meaning if one of your parents also suffered from migraines, there's a 50 per cent chance you'll get them as well. Aside from genetics, gender also plays a role. Women are three times more likely to get a migraine than men, likely because of hormones.
Of the three kinds of headaches, cluster headaches produce the most intense pain.
Dr. Tasjeel Ansari, a neurologist and assistant clinical professor at McMaster University, says the pain is so extreme that cluster headaches have become known as “suicidal headaches” because people may have thoughts of self-harm during an episode.
Someone with a cluster headache may also experience tearing up in one eye, eyelid swelling or drooping, a runny nose and nasal congestion. Cluster headaches typically last anywhere from 15 minutes to three hours and can happen up to eight times a day.
What are common headache triggers?
Headache triggers can vary from person to person. The most common triggers for tension headaches and migraines range from alcohol to certain foods, changes in eating or sleeping patterns, stress and or a change in weather.
It's not as easy to distinguish triggers when it comes to cluster headaches, but there are several risks, including age (most people are between 20 and 50), smoking, alcohol use and family history. Unlike with migraines, cluster headaches are more common in men than in women.
What are the best ways to treat a headache?
While there is no cure for headaches, symptoms can be managed with certain medications.
As a headache medicine specialist, Ansari says he typically doesn’t see patients who suffer from tension headaches because those are commonly treated with over-the-counter medications like Advil and Tylenol.
How do you treat a migraine or cluster headache?
Unfortunately, those medications don't provide the same kind of relief for migraines. Most of the treatments for migraines need to be prescribed by a doctor.
For an episodic migraine, defined as 0 to 14 headache days per month, a doctor may prescribe an acute treatment like a triptan, which treats the attack as they're happening. As for a chronic migraines (more than 15 headache days a month) a patient would be prescribed a preventive medication like the anti-depressant Amitriptyline.
A physician can also suggest procedures such as calcitonin gene-related peptide nerve blocks (CGRP therapy) and Botox to help with the neurological condition.
“In an ideal world I would go to Botox and the CGRP therapy [triptans] first, but a lot of times without coverage [it’s unaffordable],” Ansari tells Yahoo Canada. “If you were to do a year of injections at around $3,000 - $4,000, it’s not really affordable paying out of pocket.”
A more affordable course of action is adding certain supplements to your daily routine such as vitamin B2, coenzyme Q10 and magnesium to prevent migraines.
When it comes to treating cluster headaches, Ansari says it’s a “completely different treatment paradigm” because the medication needs to act quicker than with tension headaches and migraines.
A first line of therapy is an injectable medication like Sumatriptan, which takes effect within 15 to 30 minutes or Zomig, a nasal spray that works just as fast. Recent studies have shown that high-flow oxygen therapy can also be used to abort a cluster headache within 15 minutes.
Ansari says other medications that are known to help include Lithium and Topiramate.
“Topiramate is kind of a jack of all trades of neurological medications used for seizures, used for migraines and it can be used as a preventative therapy for cluster headaches,” Ansari adds.
How can you prevent migraines?
Making certain lifestyle changes can help manage or help prevent migraines, such as limiting the amount of caffeine you consume a day.
While some people say caffeine helps with their migraines, others count it as a trigger. Experts recommend limiting your caffeine intake to 200 milligrams a day and stop drinking it after 2 p.m. so it doesn’t affect your ability to fall asleep. While there's a limit with caffeine, experts recommend upping your daily water intake and drinking between 1.5 to two litres of water a day to reduce the frequency and severity of headaches.
Altering your diet can also play a big part when it comes to preventing and managing headaches and migraines. Ansari recommends eating 12 to 15 grams of protein within the first hour of waking up and says skipping meals “lowers your threshold” to getting a headache.
“We think carbs are a quick in and out. So, if you eat cereal, your body gobbles it up inefficiently so it's and out quicker. Whereas protein lasts longer for your brain to use as a source of fuel," he says.
The American Migraine Foundation has an entire list of foods that should be avoided, including artificial sweeteners like aspartame, preservatives like MSG, artificial food colourings, deli meats, and red wine.
While diet is important, preventive measures for headaches and migraines go beyond what you put into your body.
Getting a decent amount of sleep and maintaining a sleep schedule is vital for people who have issues with headaches. That means going to bed and waking up at the same time every day, including on weekends.
“Sleep is where we get a lot of our neuron repair and there’s actually been studies where patients with migraines have [shown] different sleep architecture," Ansari explains. "They actually have poor sleep architecture, so they have more sleep related disorders such as insomnia, TMJ, sleep apnea and restless leg syndrome,” Ansari explains.
Unlike with migraines, these lifestyle changes won't have as much effect for someone with cluster headaches.
When should you see a specialist for your headaches?
If these symptoms, triggers and patterns sound familiar then the best thing you can is to find a specialist as soon as possible.
Ansari says he spends at least an hour with his patients going over their family and medical history to pinpoint what they’re dealing with and develop a course of treatment.
It's also recommended to keep a headache diary, where you can keep track of certain details like how often you get a headache and what you ate before the attack. Ansari says that will help a doctor to better understand your condition and what you're dealing with.
Ansari likes to remind everyone suffering from headaches that they're not alone and seeking help is the first step to feeling better.