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Health Matters | Is it Pollution, Stress, Sleep Cycle or a Tumour? Here’s When to Fret Over Your Niggling Headache

Do you often find yourself complaining about a faint headache that you wake up with or the one you experience eventually as the day goes along?

I do that, quite often. And end up offering my mind multiple reasons — all based on sheer assumptions. Starting from lack of sleep and work stress to less water intake and increasing air pollution, I blame everything for my headache.

However, I rarely pop any medicine to fix it unless it is too intriguing and niggling. I tried checking if it was just me complaining of a regular headache and found many colleagues and friends responding with “me too”.

The conversations made one thing clear — with hectic lifestyles and overwhelming daily schedules, nearly everyone has a headache but none of us takes it seriously.

So, why do we ignore this common irritant? Before we crack that, here is a quick guide to de-cluttering headaches and when you should seek medical advice.

What is a headache?

A headache is a common disorder and it is normal to get them due to fasting, missing sleep, stress or during extreme weather conditions.

However, Dr Praveen Gupta, principal director of the neurology department at Fortis, Gurugram, told me that there is nothing called a “normal headache”.

He divided the headache into two categories — primary and secondary. Primary is the group in which the headache and associated features are the disorder itself; for example, migraine, cluster headaches, and tension headaches.

The secondary is the group in which the headache is due to some other underlying disorder, for example, systemic infections, meningitis, head injury, vascular disorders, subarachnoid haemorrhage, and brain tumours.

Sometimes, the headache may be related to the eyes; for example, a refractory error requiring a change in the number of glasses or glaucoma.

Headaches can also occur due to colds and sinusitis. If minor, it can be alleviated by an over-the-counter pain reliever, rest, coffee, or some food. In case it is due to a migraine, it will require specific medicines.

What your headache location tells you

If your head aches at the back or travels to the neck, it could be a signal of a headache due to tension or migraine. Rarely, it can also be due to arthritis in the upper spine.

A headache in the hairband area or forehead signals tension or migraine. However, migraine pain could be differentiated by nausea and visual changes and the intensity of pain should be moderate to severe if it’s a migraine.

The pain generated due to sinus is behind the brow bone or cheeks, whereas cluster pain is behind or in one eye or side of the head. If the pain generates behind the ear and travels to the head, it can be due to an ear infection or dental problems.

Pain in the temples may reflect problems with your jaw and the muscles in your face, which is known as temporomandibular disorders (TMD) or it can be simply due to stress. Among the elderly, it can be due to arthritis as well.

The other common headache is a muscle tension headache, which is a dull headache accompanied by stiffness in the bilateral temple.

The other common headache is cluster headache, which is one-sided and short-lasting, accompanied by lacerations and redness of the eyes. It is more common in males. It occurs in cyclical patterns and generally awakens you in the middle of the night with intense pain.

There is another variety of primary headache disorders which are short-lasting and may be accompanied by symptoms on the face.

How to deal with a mild headache?

In case of a mild headache that can be dealt with without consulting a doctor, you can try the following tricks:

• Stay hydrated and manage stress

• It is important to regularise your sleep cycle with consistent bed-time and wake-up time

• Doctors suggest regular exercise as it releases endorphins, which are natural painkillers. This can be achieved by moderate-intensity exercises, including biking, jogging, swimming and walking.

• Experts also suggest drinking caffeine below 150 milligrams per day.

“Take a break from your mobile phone, laptop screen, computer screen, or tablet screen as just scrolling up and down or constantly being glued to such screens can trigger a headache,” Dr Hyacinth Peninnah Paljor told me. Paljor works at the department of internal medicine of Faridabad-based Amrita hospital.

When to seek medical advice

There are warning signs when one should be concerned about headaches and you need to reach out for medical advice, immediately.

When a headache comes along with an agonising red eye, you need to consult your doctor. If it’s unusually severe and occurs for the first time, the pain should not be avoided.

When a headache comes with pain and tenderness near the temples, you need medical advice. A headache that intensifies with coughing or bodily movement such as bending and lifting should be concerning.

If a headache develops swiftly and is accompanied by severe pain that lasts for at least 24 hours or persists for days or even months, you must seek medical attention.

Clubbed with slurred speech, confusion, change in vision, loss of balance, memory loss, difficulty in moving one’s arms or legs, stiff neck, numbness, fever, and vomiting among other symptoms, a headache could be a cause of concern.

Red flags in headaches are those with fever or other bodily symptoms, Gupta from Fortis summed up.

Some headaches can be a sign of a brain tumour, cancer, severe dehydration, heat stroke, brain haemorrhage or brain infection and high blood pressure.

In patients who have seizures or weakness in one part of the body, memory loss or visual difficulty headaches may be a sign of a brain tumour.

Serious disorders like meningitis, subarachnoid haemorrhage, brain tumour or hydrocephalus usually are visible on brain MRI. “If there is a sudden change in severity type and frequency of headache in a previous migraine patient, a reconsideration of diagnosis for the development of a more serious disorder should be done,” Dr Paljor said.

It is quite clear that headaches can be caused by a variety of disorders and it’s possible to differentiate benign from serious conditions.

Match your symptoms and if all is well, don’t stress out to make your headache, even further. Else, seek medical advice.

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