by Nesreen Suwan, M.D. 

 

Confusion abounds when headaches have so many different names: “tension,” “migraine,” “cluster,” “cervicogenic,” “ice pack,” “sinus,” “occipital neuralgia,” and “trigeminal neuralgia.” It’s enough to give you a headache. How do you know what type of headache you have and when you should seek help?

 

About three to five percent of adults worldwide are estimated to suffer from chronic daily headaches. These are headaches that occur three or more times a week with the patient reaching for pain relievers almost daily. In general, chronic headaches are divided into four subtypes.

 

Chronic migraine--Affects only one side of the head and causes pulsating or throbbing pain, moderate to severe intensity, aggravated by physical activity and may include nausea, vomiting,  and sensitivity to light or sound.

 

Chronic tension-type headache--Hurts on both sides of the head, causing mild to moderate pain, often described as pressing or tightening, and may include mild nausea or sensitivity to light or sound.

 

New daily persistent headache--Sudden onset and occurs daily for three days with tightening or pressing sensation on both sides of the head--not throbbing--with mild to moderate intensity.

 

Hermicrania continua--Headache on one side of the head and pain never shifts sides; includes daily and continuous pain-free periods and can be moderate to severe and also affects the eye or nose with tearing, swelling, or congestion.

 

Diagnosis

 

Because headaches are so frequently misdiagnosed and mistreated, it is essential to seek diagnosis through a headache specialist. Too often, headaches are not accurately evaluated and patients unwittingly make their headache symptoms worse. For example, patients often treat their migraine headaches with over the counter analgesics.

Unfortunately, the overuse of analgesics to treat migraines may actually result in more resistant rebound headaches and more intense future migraines. The wrong treatment can make the nervous system even more sensitive, rendering more frequent, more severe, harder-to-treat migraine headaches.

 

A headache specialist can determine if the patient has underlying health conditions contributing to the headaches and may order diagnostic tests ranging from blood work to X-ray, CT scan, or MRI to thoroughly pinpoint the cause of the problem headache.

 

Sometimes the actual cause of chronic headaches is found to be in the neck not the head. Called cervicogenic headache, this type of headache originates in the cervical spine with injuries such as whiplash or bulging disks contributing to the pain. Patients may have headaches in the back of the head, or referred pain in the forehead or near the eyes. Again, a headache specialist is critical in accurately diagnosing the problem.

 

A variety of treatment options is available.

 

 

 

 

Dr Nesreen Suwan is a board certified neurologist who specializes in the treatment of headaches and fibromyalgia. She is board certified in pain medicine with extra certification in headache medicine. She operates a specialty Headache and Fibromyalgia Clinic that is affiliated with Adventist Hinsdale Hospital Pain Center of Excellence. She is highly recognized for her knowledge in headache and fibromyalgia. She is also a nationally known speaker in her specialty.

 

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