Types of headaches
Tension headaches, migraines and cluster headaches
The head is buzzing, behind the forehead it is throbbing and you can no longer concentrate. At some point in life, the headache hits everyone. While it is the exception for some, around 40% of people are affected several times a month. Headaches are one of the most common diseases worldwide. They occur as a symptom in many diseases, but often also occur as an independent clinical picture.
Apart from accident- or side-effect-related headaches, the so-called secondary headaches, there are three major groups of primary headaches, which we explain in more detail below.
Tension headache
The most common are tension headaches. A dull press in the head, often behind the entire forehead area. It feels like the skull is clamped in a vice. The pain is mild to moderate and lasts from a few minutes to several days. Physical activity does not affect the severity of pain. Other accompanying symptoms are rare.
The reason for this pain is not necessarily, as often suspected, tension. Stress, lack of sleep or weather sensitivity, often the causes are completely unknown. Everyone has probably experienced this type of headache. They occur from toddlers to the elderly. As a treatment, over-the-counter painkillers with the active ingredients acetylsalicylic acid, paracetamol, ibuprofen or naproxen are suitable. We will introduce them in more detail below.
Since the body has a pain memory and thus becomes more and more sensitive, one should not torture oneself unnecessarily bravely. However, these funds should not be taken too often naively. As a rule of thumb, up to 10 days per month applies. If the headache is more frequent, it is advisable after consultation with the doctor to keep a pain diary to find out about any causes. For prevention, light endurance sports and relaxation methods, e.g. progressive muscle relaxation according to Jacobson, autogenic training, meditation or yoga are suitable.
Migraine & Cluster Headaches
Migraine: sensory disturbances, nausea, booming pain
Severe pain sets in suddenly
In migraine, the usually one-sided headache is much stronger. A migraine attack can last up to several days. Sometimes he announces himself by a migraine aura. During this you suffer from visual disturbances, see flashes and color patterns, everything blurs, you feel numbness or tingling. Due to the visual disturbances, normal participation in public life is no longer possible in this phase of migraine. However, the actual headache appears later.
After a while, maybe an hour, severe and pounding headaches of migraines completely incapacitate the afflicted. Bright light and ambient noise, as well as activities, exacerbate the problem. Silence and darkness are preferred. Concomitant symptoms of migraine are nausea and vomiting.
Applies to all genders and ages
Women are affected more often than men, which is why migraine is often considered a women’s disease or even ridiculed. However, this prejudice is deceptive and does not do justice to the severity of this disease. Every migraine sufferer is limited in his daily life. In the case of acute migraine attacks , quick action is required, because work or driving is out of the question within minutes.
Often the attacks begin with puberty and disappear with menopause. But men, adolescents and even children can also be affected. Since the exact causes are not known, prevention is difficult. Stress plays a major role here, with the attacks often only starting when the stress subsides, e.g. at the weekend or on holiday. Regular sleeping and eating times are also important. It is advisable to maintain the rhythm of the week even on weekends. Headaches on weekends or Mondays are typical.
The therapy is as individual as the pain
In some patients, certain foods such as cheese or red wine are known to be triggers . Tobacco is also frequently discussed as a trigger for various headache disorders. High-frequency flickering or bright light from neon tubes and energy-saving lamps is also suspected of triggering attacks. In order to get to the bottom of the whole thing, it can also help here to keep a migraine diary . In it, migraine attacks (date, duration, course) are noted, but also life circumstances and habits. Occasionally, this can even be used to identify foods that promote or help prevent migraines.
Over-the-counter painkillers are often not strong enough. Special migraine remedies such as triptans may be prescribed by the doctor. Again, no more than 10 days a month applies. It could otherwise come to a so-called drug headache. The body gets used to taking it and reacts with pain as a withdrawal symptom. During a migraine attack, a normal daily routine is hardly possible. Here, too, regular relaxation exercises help preventively.
Cluster headache: comes violently and in waves
How to recognize cluster headache
A rare but severe type of headache is cluster headache. This can last up to several hours . It occurs frequently and sometimes several times a day. Sometimes there are symptom-free months between the individual attacks. The headache is one-sided and the affected side of the face suffers from a watery eye and runny nose. Men around the age of 30 are often affected. It feels like a knife is catching the eye. During a cluster seizure, normal life is practically impossible.
Cause and treatment of cluster headache
The causes are not recognized. However, since this headache usually occurs at a certain time of day or year, it is assumed that there is a disturbance in the biological rhythm . Heredity is also possible. Again, it is helpful to keep a headache diary to identify any causes. The exact diagnosis is made by a doctor after extensive examinations using CT and MRI to rule out other diseases. The usual painkillers are often ineffective. With special medications prescribed by the doctor, such as triptans or even opioids, seizures can be reduced in severity and frequency.
Medication for headaches
Everyday painkillers can help
These remedies can be found in almost every medicine cabinet: acetylsalicylic acid (ASA), paracetamol, ibuprofen or naproxen. For tension headaches, they all usually work very well. They relieve the pain from just one tablet. This ensures that a short period of pain is survived without significant loss of quality of life.
These remedies can also provide slight relief for migraines or cluster headaches. Some of them also have a blood-thinning or anti-inflammatory effect, which can also have a positive effect on the course of headaches.
| Active substance | Positive | Negative |
|---|---|---|
| Aspirin | +Pain-relieving +Antipyretic +Blood thinning | -increases bleeding tendency -not suitable for children -poor stomach tolerance** |
| Acetaminophen | +Pain-relieving +Antipyretic +for children and pregnant women* | -burdens the liver -hardly anti-inflammatory |
| Ibuprofen | +Pain-relieving +Anti-inflammatory +suitable for children* | -cardiovascular damage* -damage to the digestive tract* |
| Naproxen | +Pain-relieving +Antipyretic +Anti-inflammatory +long duration of action | -unsuitable for children under 12 years |
Side effect blood thinning / anticoagulant
A common application of ASA (acetylsalicylic acid) is protection against infarcts and thrombosis. Especially elderly and pre-sick patients take a low daily dose of 100 mg ASA. As a result, the surface of the platelets changes, the blood becomes more fluid.
The blood-thinning effect of ASA is non-reversible, as platelets are directly damaged by ASA. This effect thus lasts for several days and only subsides when the body has formed new platelets. The same applies to the up to 10x higher, pain-relieving doses.
The other painkillers mentioned above also have an effect – albeit to a lesser extent – on blood clotting. They all increase the risk of bleeding to some extent, even if this is no longer particularly relevant for Acetaminophen (Paracetamol). Therefore, at least people with coagulation disorder or when taking oral anticoagulants at the same time should be careful with over-the-counter painkillers and consult their previous family doctor.
Basically, always read the package leaflet carefully, pay attention to interactions and side effects and start with low dosage. Because incorrect use, dosage and regular intake can do more harm than good.
*) Observe dosage and duration of application
**) Observe the instructions for use
Special painkillers
In severe cases of migraine or cluster headache , the headache diary and the above-mentioned everyday painkillers and opiates do not provide sufficient relief, or their side effects allow its use only at night. In these cases, the resort remains to special painkillers, the triptans. Triptans not only fight the pain, but are meant to fight the cause, which many doctors see in dilated and inflammatory vessels in the brain. Triptans ensure that inflammatory reactions return and the vessels shrink to a healthy level.
These funds are the last Notanker for patients with severe headaches. The success of therapy for triptans is strongly dependent on the patient and whether the agent is tolerated. In the best case, the pain disappears immediately after its occurrence. In worse cases, triptans can cause nausea and sensory disturbances .
There are different triptans available, so that the path to a tolerable triptan can also cause failures. Your family doctor usually has sample copies at hand.
Alternative therapies and remedies for headaches
There are a variety of traditional home remedies and alternative healing methods that are worth trying for headaches. The following measures are often recommended:
- A cold compress on the forehead or neck sometimes works wonders.
- Peppermint oil applied to the temples has been shown to partially replace the painkiller for tension headaches.
- Preventive regular acupuncture has proven effective in migraines.
- Those who drink a strong black coffee with lemon juice right at the beginning of the headache sometimes succeed.
- So-called acupressure mats are also popular. Their plastic tips promote blood circulation in the fascia.
- In herbal medicine , there are many herbs that are suitable, such as willow bark (the natural aspirin), lavender, lemon balm and many more.
- Kneipp treatments or foot baths are also justified in pain therapy.
- Many sufferers swear by CBD oil, but the effect has not been proven.
- Regular meals, plenty of exercise in the fresh air, the renunciation of nicotine, less alcohol and sufficient sleep and relaxation are generally recommended.
In the case of sudden, unusually severe pain or worsening of symptoms as well as uncertainties, it is advisable in any case to have a headache clarified by a doctor . Because often headaches are symptom of a disease, the treatment of which also makes the headache disappear. If headaches occur together with speech disorders, paralysis or loss of consciousness (“black-out”), an emergency doctor should be informed immediately.