Headache is the most common disease in Germany. More than 60% of adults experience headaches at least once a year, and one in four suffered from severe pain in the last two weeks, according to a study, who needed to take painkillers. This year's German Pain Management Day will help these patients to properly treat their headaches pharmaceutically.
Self-treatment only for mild ailments
For mild complaints, there is nothing wrong with self-treatment with non-prescription painkillers from the pharmacy, but these medicines should not be taken for more than three consecutive days and not more than 10 days a month. If the pain is not controlled, a doctor should be consulted.
Too often in these cases analgesics (painkillers) are taken in too high a dosage. This carries the risk of unwanted side effects, complications and even the emergence of new chronic headache in itself. The Forum Pain in the Green Cross eV therefore calls for sufficient information of the consumer on the effect and use of these funds to prevent such drug abuse.
Do not reach for the tablet immediately, once your head starts to buzz ...
Most people who occasionally experience headache are often helped by a walk in the fresh air. Relaxation exercises or regular endurance training, eg by cycling or jogging, are also a good prophylaxis (prevention) against the pain.
Changing habits such as avoiding so-called "pleasure poisons" such as alcohol, cigarettes, and too much coffee, and having a regular lifestyle with a steady sleep and wakefulness, can help to prevent headache from becoming so severe and frequent. Help can also provide stimulus shielding (darkening of the room), massage (rubbing of the temples) as well as cold and warmth stimulation.
The recognition and avoidance of triggers of the individual headache comes first. Too much stress, too many sports or social activities, irregular food intake, heavy noise and light pollution, family conflicts and fears as well as certain foods such as cured foods, cheese, red wine, chocolate and nuts can cause headaches. Keeping a headache diary can be very helpful in detecting these personal triggers.
Which headache types are there anyway?
According to the International Headache Society, 160 different types of headache can be distinguished. They are divided into primary and secondary headaches. If the pain represents the disease itself, it is counted among the primary types of headache; if it is the result of an underlying disease, it is a secondary form of headache. Such underlying diseases can include tumors, high blood pressure, head injuries, infections (flu), inflammation.
Although the doctor's diagnosis excludes these types of headache, only 1.6% of younger patients report any of these serious illnesses. Primary headaches are basically harmless. Nevertheless, they are diseases that can have a significant negative impact on the lives of those affected.
By far the most common type of pain is tension-type headache. More than half of all pain patients complained of headaches of this kind. In 1988, the International Headache Society agreed that headaches should not be classified according to their cause, but rather according to their symptoms, since the cause research in this area has not yet been satisfactory.
Terms previously used for tension-type headache, such as "muscle tension headache, " "stress headache, " or "psychogenic headache, " merely stated that the cause of the headache was known. Therefore, the term "tension headache" a number of headache types of different origins. It is divided into episodic and the much rarer chronic tension-type headache, which occurs at least 15 days per month.
Symptoms and Causes of Tension Headache
Tension headache is characterized by the following symptoms:
- bilateral headache with mild to moderate intensity
- Headache is perceived as oppressive and pulling rather than pulsating
- no increase in headache during physical activity
- normal performance is limited but not sustainably hindered
- the headache can last from half an hour to a week if left untreated
- Hypersensitivity to noise or light
- no vomiting and no nausea.
The tension headache can have a purely psychological cause, if under heavy load, exhaustion or fatigue the "nerves lie bare". Depression and anxiety can also lead to tension-type headache.
Often, however, the tension headache is also associated with tension or cramps in the neck or neck area, as the head muscles can be increasingly tense and sensitive to pain.
A special form of tension-type headache is the drug-induced headache. Constant use of analgesics for months can cause this headache. They may occur several times a week, but more often as a persistent headache.
Migraine: Women are affected more often
This is related to the female hormone estrogen, which is why birth control pills and menstruation can cause migraine. In the course of pregnancy or after menopause occurs in these cases, an improvement in headache attacks. There are about 16 different types of migraine, of which the most common is the "migraine without aura". The following symptoms are characteristic of this migraine:
- The pain is one-sided, pulsating and moderate to severe
- The headache is felt as oppressive to pulling
- Enhancement of headache during physical activity
- The normal performance is permanently disabled or completely limited
- Migraines occur like an attack
- It can cause vomiting and nausea
- There is a hypersensitivity to noise and light
- Left untreated, the headache lasts 4 to 72 hours
Various migraine forms
The description of the migraine has a history, because it was already mentioned in ancient times by the Egyptians and Greeks. Their manifestations are as varied as they are characteristic. For every third affected person, the day before or hours before the attack, signs of fatigue, diminished performance and, in particular, female cravings for sweets or fatty foods are observed. The pain can affect both sides of the head and change sides.
At the beginning of a migraine attack, the pain is often localized in the neck and the back of the head. When it reaches its peak, the pain is most intense in the area of the temple, forehead and eye area.
Migraine with aura
It was formerly called "classic migraine". Here, sometimes less severe or even very slight headaches are preceded by neurological disorders, usually visual disturbances. The aura develops slowly and can last up to an hour, sometimes also a number of aura symptoms (visual, sensory and speech disorders) can occur one after the other.
For the occurrence of a migraine, there is an innate willingness to react. However, whether a migraine disease really does happen or not depends on many other factors such as stress, emotional conflicts or hormonal status.
The first migraine attack is usually between the age of 10 and 20 years. By the age of 40, nine out of ten migraine sufferers have already had their first attack. Although the frequency of migraine can be reduced by avoiding the individual trigger factors, but not heal. In old age, however, migraine can often disappear completely.
Which medications help with headaches?
Ergotamine (the ingredient of ergot) has been the standard preparation for migraine therapy since the 1920s. They have recently been replaced by the more potent triptans. It is interesting that in the treatment of migraine in general the placebo effect plays a major role, which is consistently estimated by many authors in the order of 40%. According to the German Migraines and Headache Society (DMKG), a combination preparation of acetylsalicylic acid (ASA), paracetamol and caffeine is the most suitable analgesic for headaches in general. Combination preparations have a broader effect profile, act faster and are more compatible, as the active ingredients can be used as a combination in a lower dose.
Individual substances from ASA, ibuprofen or paracetamol can also help. Chronic headaches should not be treated with analgesics because of the risk of drug abuse. Here a treatment by an experienced doctor is required. In drug-induced headache, the therapy of choice is drug withdrawal, which may take place on an outpatient or inpatient basis.