The impacts of chronic headaches are far reaching and can be debilitating. Those who suffer from them may develop depression and anxiety. The pains of headaches can even affect your relationships and your finances.
Patients, particularly those with migraines, often miss work and cancel plans when headache symptoms are severe. Friends, family and coworkers experience the impact, and the headache patient often feels a sense of guilt.
The financial burden of missing work and medical evaluation costs can weigh on individuals with recurrent severe headaches. Patients who don’t get better after treatment and those who experience side effects can become frustrated. The lack of definitive answers contributes to lost hope for many.
Many people visit their family doctors to seek help for their headaches. If the headache doesn’t respond to the recommended treatment, the patient is typically referred to a headache specialist or a neurologist who specializes in headaches.
To best treat your recurring headaches, your specialist will need an accurate description of the symptoms, onset, patterns and triggers. This will help determine if the headache is the primary ailment or if it is a secondary problem related to another issue. Sometimes diagnosis requires testing, including neuro imaging such as MRI and CT scan.
A great deal of my time is spent helping people with very severe migraine headaches or very frequent migraine headaches – headaches that haven’t really responded to the typical treatments.
Symptom logs can be very helpful in finding the most effective treatment. In general, people tend to underestimate the frequency of their headache attacks. Questionnaires help the doctor assess the level of distress. The logs establish the baseline for treatment.
Headache patients are asked to try to identify dietary, environmental, hormonal or lifestyle triggers. Fermented, processed and aged foods are the most common culprits. It is best to eat fresh foods, minimally processed, and to not skip meals. It is also important to stay hydrated.
Lack of sleep, weather fronts, odors and drinking alcohol are also common triggers. Stress, travel and fatigue affect many in a negative way as well.
It is critical that patients learn how to help themselves.
The most effective programs to decrease headache frequency and related disability combine pharmacologic and complementary treatment. Drugs can be used to prevent and stop headaches. Injections and blocks are sometimes necessary. But medication is not the only way to fight recurring headaches. Exercise, healthy eating, lifestyle changes, sleep management and physical therapy play an important role.
Dr. Francis O’Donnell is with NHRMC Physician Group – Neurology and is New Hanover Regional Medical Center’s first headache specialist.