Q&A: Have a headache or a migraine? A doctor offers advice
Most of us have had headaches. They may be mild and resolved with over-the-counter medication or more severe like a migraine.
How do you know when that headache might be signaling another medical issue?
Dr. José Casanova, a neurologist with the Summa Health Neuroscience Institute, is the expert for this month's Healthy Actions, a look at a medical topic of interest with a local expert.
More:Betty Lin-Fisher: Links to Healthy Actions columns
This is an edited version of our interview. There also is a podcast available of our interview.
What causes a headache?
There are two types of headaches: primary and secondary. Primary headaches are migraine and tension headaches. Secondary headaches are due to underlying diseases like tumors or inflammatory diseases. Most of our practice focuses on primary headaches, or migraines.
Why do people get headaches that may go away with over-the-counter medications?
Those are called tension headaches and are the most common. They usually are caused by stress, lack of sleep or dehydration. They're mild, go away with Tylenol, only last a few hours and usually people can work through them. Rest, sleep and relaxation can also help. If you are using the computer for many hours, take a break.
What is the difference between a headache and a migraine?
Normal tension headaches are global. You can’t really point to where the pain is. You just feel it all over the head. They are mild and sometimes are associated with tension in the neck and shoulders.
Migraines for most is on one side or the other. They usually start at the back of the head and move behind your eyes. Sensitivity to light and noise is very typical. They can last between four hours to a couple of days. Tylenol or aspirin don't do much to relieve pain.
What causes a migraine?
Migraines run heavily in families. About 20% of women get migraines and about 10% of men.
Stress, weather changes, food and lack of sleep are the main triggers when you have the right genetic background for a migraine. Then as you get under stressful situations or you are exposed to bright light for long periods of time, that could trigger the migraine.
Can children have headaches?
Yes, they are as common in children as adults, but they manifest in a different way. It can be repetitive vomiting and you don’t get as much of a headache, but gastrointestinal symptoms. Some children as young as 2 to 3 can have headaches.
The typical age for headaches or migraines is usually in the teens and going up to 50 years old. Normally, if someone is getting heavy headaches after 50, that is one of the red flags that you have to rule out other things before calling it a migraine.
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When should go to a doctor?
If you are having one migraine or migraine-like headache a month or every other month, your internist or family doctor can take care of you. If you are starting to have four to five migraines a month, you should see a specialist.
What are medical issues or diagnoses that can come from headaches or migraines?
Even if you think you have only migraines, you need to make sure nothing else is going on. For example, brain aneurysms at the beginning can present very similar. They respond at the beginning to the same medications as a migraine, but as time goes on, they get worse and can be fatal.
A neurological exam is normal before diagnosing someone with a migraine. Many times, we do an MRI to make sure we don’t miss anything.
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People often worry about a brain tumor. Can headaches be a sign of a tumor?
Yes, but normally with brain tumors, there is more than a headache. They don’t look like a migraine with light or noise sensitivity. They start developing cognitive problems like memory issues or motor symptoms like weakness in one arm or leg or you have problems swallowing.
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Can you prevent migraines?
For mild cases, diet is important. There are special diets for migraines. Normally, things that are low in tyramine. People with migraines shouldn’t eat cheeses or lunch meats. If you imagine whatever is in a pizza — they shouldn’t eat any of that. Alcohol is also bad and too much caffeine can also trigger migraines.
Lifestyle modifications is probably the best way to go to start — things like exercise, diet and hydration. If that doesn’t work, then start with your family doctor and if the headaches become more chronic or heavy, you can be referred to a headache clinic.
We have pretty good treatments and people with really bad migraines can do very well.
To read previous Healthy Actions topics, go to www.tinyurl.com/BettyHealthyActions
Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com.
This article originally appeared on Akron Beacon Journal: Advice from a doctor on resolving your headache or migraine
