Headaches Are a Jerk

~ OR: Dwarves digging for gold in your head need to take a break

Headaches suck.  A lot.

End blog post.

(ok, not end blog post.  that would be too easy)

At some point or another, each and every one of us has likely experienced some form of headache.  Sometimes they are a light ache in the upper left side of the skull.  Other times they adopt the same rhythm as your heart rate and it can be felt top center.  Even other times it feels like someone is trying to push your eyes out of their sockets.  Still yet other times the only way to even try to navigate the day with some types of headaches is to find a dark and silent room and ride it out, praying that it eventually goes away.

It is just not a pleasant way to function, and sometimes it causes all function to cease.

In my own personal experiences, I generally experience once or twice a year what could be potentially categorized as a “light migraine headache.”  The find-a-dark-room, lay-on-a-couch, pray-a-lot kind of headache.

I have friends for whom this is a regular event in their lives and I cannot begin to even fathom what that must be like.

So it’s time to do some homework on headaches.  Regurgitate newly-found information.  You know the drill here by now.  Here we go!

Disclaimer: I do not have the letters M and D after my name.  This blog post is not medical advice; it is information gathering and sharing.  If you are experiencing some of the things noted in this post and it inspires you to consult with a physician, I am the happiest writer alive.  Headaches are not something to be messed with.

What exactly are headaches?

I was today-years-old when I learned that brain tissue does not actually possess pain-sensitive nerves and cannot feel pain as a result.  Seems counterintuitive, given that when there is a headache present, we feel it in – as the name implies – the head.  But it’s not the keto-compatible fatty computer made of meat itself!  The brain proper is not feeling pain in the sense that we would expect.  When you stub your toe, pain receptors send signals to the brain letting it know that toe stubbing has happened.  Our response to that is to say “ouch,” grab the foot, and jump up and down cartoon style making Fred Flintstone-esque ouch sounds.

Headaches are not the stubbing of the brain.  That’s an interesting concept, actually, but not the case.  Usually they are not the stubbing of the head either although head injury and trauma can lead to our topic.  Please see the section on “When should I see a doctor?” below in the event that you have recently experienced a head or neck injury and are living with heretofore not-experienced headaches.

Trigeminal Nerves R Us

The more common explanation for experienced headache has to do with our good friend the trigeminal nerve.  This bad boy is a cranial nerve – one of a family of twelve, which is a lot of mouths to feed no matter how you slice it – and it is responsible for sending information related to touch, pain, temperature, and vibration back to the thalamus.  No, thalamus is not a character from Marvel movies.  The thalamus acts as a transfer hub that receives pain information from all over the body and forwards it on to the parts of the brain that acknowledge the sensation of pain and how to react to it on an emotional level.

Depending on the nature of the pain, signals can be sent to other parts of the brain that will trigger nausea, vomiting, difficulty concentrating, stomach distress, and other neurological reactions.  It’s all connected!  Remember when we talked about Brain #2 a while back?  Cross-signaled reactions at their finest.

The pain-sensitive nerve endings that trigger those signals are called “nociceptors” (будь здоров!) and start the whole cascading process.  Back to the trigeminal nerve.  It is responsible for receiving information from nociceptors related to blood vessels in and around the the skull, the lining surrounding the brain (meninges), and everything related to the face, mouth, neck, ears, eyes, and throat.

That’s quite a bit of responsibility for a single nerve.  Given that knowledge, causes of headaches tend to focus on those areas.  They can be triggered by incidents in any one of those areas.  While it seems very localized, it covers a broad spectrum of things that could trigger a pain event.

The TLDR: headaches are a response to pain in any of the areas under the trigeminal nerve purview.

What are the different categories of headaches?

For the purposes of this specific blah(g) entry, I’m going to divide up the next portion into four sections based on the following categories:

• Migraine
• Tension
• Cluster
• Miscellaneous Primary

There is so much that can be written about each of the four above and I will try to be as brief and informative as possible.  Which, yes, sounds completely impossible given my history of WORD AVALANCHE, but I’m giving it a shot anyway. Here we go.

Migraine Headaches

The category of headache that tends to get the most attention – due to the potential for crippling severity + commonality – is that of the migraine.  Migraine headaches are somewhat elusive in terms of exactly what scientists know about them, their triggers, resulting effects, and treatment.  To say we know more now than we knew a couple decades ago would be an understatement, and research continues into better identifying treatment and preventive measures.

Newer migraine headache research is indicating that they are less solely about blood vessels and more a sensory perceptual disorder.  The number of senses that are altered during the course of a migraine lend to this consideration.  Part of this research has to do with many migraineurs (I was also today-years-old when I first saw this term) experiencing sensitivity to some of the same sensory triggers in between episodes.  Not all, but enough for scientists to be studying a correlation between the two.  To be continued.

Another wild component of migraines: they’re not always accompanied by pain in the head.  Basilar type migraines are experienced most commonly by teenage girls and related to the menstrual cycle, sometimes causing blurry or double vision, dizziness, or – of course – blistering headache.  Ophthalmoplegic and retinal migraines will cause pain, droopy eyes, vision impairment, and other visually-related maladies that can linger on for sometimes weeks after the headache episode.  Younger children can experience abdominal pain and vomiting in some migraine scenarios.

One other thing that is completely unfair about migraine headaches: they are three times more likely to affect women than men.  I can’t add anything else to that other than it’s just plain unfair.  The end.

Common Migraine Headache Triggers

The short version of a migraine headache is an overreaction to different types of stimuli.  The stimuli involved can be traced to both food (internal), environmental (external) , and emotional or musculoskeletal (really internal) triggers.

Side note: I should have mentioned above that discussion of the migraine type is the longest in this post.  If you can get through this hurdle, you’re home free.  Here we go.

Fud

Where food is concerned, it is estimated that 50% of migraine headaches are a result of something om-nom related.

(sometimes you are what you eat.  sometimes what you eat hates you.  which might actually be a recipe for self-loathing.  I think that might be meta but I’m not entirely sure. this requires more effectuitative research)

Some ingested substances that can be attributed to migraine headaches can be cæffeine (or sudden reduction of caffeine), alcohol, excessive sodium intake, aged cheeses, some fruits, fermented or pickled objects, yeast, and cured or processed meats.

That’s …. a lot to take in from a food perspective.

One of the recommended preventive measures that can be taken if consumables are suspected to be a trigger is a food journal.  Once upon a time the idea of keeping a food journal sounded too much like work.  We’ve discussed the work allergy before, and allergies are also probably headache triggers so yeah.  Nowadays with everyone posting everything they eat on Instagram, food journals are not only easy but socially expected.  Go for it!  Make it a social exercise.  Tell everyone you’re tracking a migraine and seeing if it’s food related.  Not only will you have the potential for viral content, it’ll create a support group.  It might even help find the cause!  You don’t know!

The Environment

While not necessarily referring specifically and only to general climate – although changes in weather and pressure can also trigger these things – our environment can contribute greatly to the possibility of a triggered migraine.

Sometimes environmental triggers can be related to loud noises, bright lights, specific scents, changes in sleep pattern, or general exhaustion.

Drawing from my own experience, someone close to me was hit with a very awful, fetal-position-inducing headache when exposed to the smell of mint.  That is something that has thankfully since gone away but there is definitely a direct smell component involved in some cases as a trigger.

Internal

There is quite a bit of study into the symbiotic relationship between some mental or internal health situations and migraine headaches.  Sometimes the one triggers the other and vice versa.  Some internal challenges that are associated to headaches are depression, anxiety, hormonal shifts, neck and shoulder strain due to tension or poor posture*, and stress.

It’s gets complicated when the one feeds the other and it’s difficult to figure out which was the chicken and which was the egg.  As an example, did a severe bout of depression cause for a migraine to kick in or was it the migraine kicking in that caused a severe bout of depression?  That definitely requires a more thorough conversation with a medical professional for better means of tracking what is triggering what.

*how many of you just sat up a little bit straighter upon reading that?  I sure did writing it.  it’s like how yawns are contagious.  yawn contagion is also another interesting blog possibility…

Auras

This part gets a bit weird.  Common migraine headaches are as described above with a variety of different possible triggers.  That in and of itself is plenty to try to sink your teeth into.  Now let’s add the aura component to the whole mix.  This is sometimes referred to as the Classic Migraine.  The visual impacts that we were discussing just a few minutes ago above in the non-stop tsunami of words?  Those fall into the aura category.  Sometimes those visual impairment or enhancement experiences can start ten to sixty minutes prior to the onset of the actual aching of the head.  Or without headache pain at all, also as discussed above.

Increased sensory sensitivity, nausea, and/or loss of appetite can accompany the aura experience.  Speech impairment, muscle weakness in one side, and tingling in hands are a more severe version of the aura and can be confused with stroke.  More consultation with a physician is in order if you experience that more severe version.

Tension Headaches

Tension headaches are going to be an experience of more consistent pain rather than something with a beat to it.  Which is probably good, since nobody wants to dance to or during the beat of a headache.  They also tend to be much more mild in comparison to their migraine cousins.  Also unlike their cousins, they often are felt on both sides of the head at the same time.

There are some commonalities among many of the headache types in terms of triggers.  Tension headaches can be triggered by stress, jaw clenching, neck and shoulder tightness, depression, anxiety, and missed meals among others.

Sleep apnea can also be a trigger for tension headaches.  Poor neck support during sleep can cause for a tension headache to manifest in the morning.  When was the last time you checked the structural integrity of your pillow, anyway?  If you can hold it up and it flies in the wind like a flag, perhaps it’s time for some new stᵫffing.

Depression and anxiety as tension headache triggers are an interesting study in and of themselves.  Sometimes an event that triggers a depressive or anxiety episode can cause for an instant onset of a tension headache.  Our bodies are very interesting machines and sometimes try to betray us at every turn.

They can be episodic in nature (10-15 occurrences per month, lasting 30 minutes to several days) or chronic (lasting days or months).  Current studies indicate that tension headaches will start as episodic prior to evolving into chronic experiences.

Cluster Headaches

The much more fun term for the cluster headache is Trigeminal Autonomic Cephalalgias.  And by fun I mean tongue-twistery.  Like “left hand: blue!” kind of twistery.

Except tongues don’t have hands.  So it would be more like “tongue: blue!”  And given that hands and feet normally go on blue, proceed at your own risk.

Have I mentioned recently how much I love medical narration?

ANYWAY.

Cluster headaches are straight up awful.  They are absolutely the most severe of the categories.  Seasonal and occurring one-eight times a day in a cluster period, the are described as being intense burning or stabbing behind one eye or eye area. This headache will not switch from one side of the head to the other and can be either throbbing or constant.  You know, just to make it more difficult to describe when in the throes of an episode.

Miscellaneous Primary Headaches

There are a whole bunch of these.  Let’s bullet-point these goons with short descriptions:

• Hemicrania continua – causes presently unknown, always happens on the same side of the head or face. Can appear like an allergy attack with red and tearing eyes, sweating, stuffy or runny nose, or swollen or drooping eye lids.  Lasts between minutes and days.
• New daily persistent headache (NDPH) – constant daily pain, mild to severe.  Can occur for 3 months – or even years – without lessening of severity.  Nausea or vomiting, lightheadedness, pressing or tightening pain on both sides of the head, and abnormal sensitivity to light or sound can accompany this.  This one sometimes goes away on its own, other times lingers and is difficult to treat.
• Primary stabbing headache – sometimes called the “ice pick” headache.  Generally felt near the eye, lasts anywhere from 1-10 seconds with a frequency between once a year to multiple times a day.  Very difficult to identify causes of and treat due to the short duration.
• Primary exertional headache – can be triggered by coughing, sneezing, sports, and other physical exertions.  This headache will begin at the onset of the activity and will generally not last long but could linger for a couple days.
• Hypnic headache – once called the “alarm clock” headache.  Onset happens during the night time causing wakefulness.  There is no known cause for this headache but possibly associated with rapid eye movement during dreaming.
• Ice cream headache – Also called brain freeze.  Pain can last for up to 5 minutes and is more common among migraineurs.  Around 2012, anecdotal information suggested inducing brain freeze to stop a migraine headache in its tracks.  No official link between the two has been found but I’m sure someone on TikTok swears by it and it’ll be the new craze.

Hereditary considerations

Headaches – like some illnesses, senses of humor, and even fruit cakes – can be handed down from generation to generation.  It turns out that children who have even one parent who experiences migraine headaches are statistically four-times more likely to themselves experience that malady.  The National Institute of Health has a very thorough study into the subject that goes into great detail about those likelihoods.

Knowing this doesn’t make it any easier when a child experiences a debilitating headache, but perhaps perception of the possibility would permit parents to prepare for the propensity toward this pounding, pain-in-the-neck predicament.

(why did I need that many p words?  i dunno.  i got on a run and i couldn’t stop.  being a sitting thesaurus isn’t always a good thing.  neither is sitting all the time.  I should probably get up, stretch, and go take a walk)

When should I see a doctor?

I am copying and pasting directly from the National Institute of Health website on this subject.  No interpretation: this one comes to you as is.

• Sudden, severe headache that may be accompanied by a stiff neck.
• Severe headache accompanied by fever, nausea, or vomiting that is not related to another illness.
• “First” or “worst” headache, often accompanied by confusion, weakness, double vision, or loss of consciousness.
• Headache that worsens over days or weeks or has changed in pattern or behavior.
• Recurring headache in children.
• Headache following a head injury.
• Headache and a loss of sensation or weakness in any part of the body, which could be a sign of a stroke.
• Headache associated with convulsions and/or shortness of breath.
• Two or more headaches a week.
• Persistent headache in someone who has been previously headache-free, particularly in someone over the age of 50.
• New headaches in someone with a history of cancer or HIV/AIDS.

There’s nothing else to add other than to please take that list seriously and consult with a physician if you experience any of the above. Please adhere to Rule #1: don’t death.

What are some remedies for headaches that I can do at home or away?

Depending on the category and severity, there are things that can be done as both preventive and reactive measures.

Following up on things mentioned above, finding out what the headache triggers are for a person are can be key to prevention. Just a few examples here.  If an Instagram food journal identifies a common theme, cutting that food out is probably a good place to start.  Not as tasty but certainly effective.  If certain scents cause immediate headache reactions, avoiding those scents as much as possible is a strategy.  Posture considerations or neck and shoulder tension?  Exercises to help improve posture or regular stretching of the neck and shoulders can assist.

It’s not always possible to prevent some of the triggers unfortunately so that leads to remedies for those that have already moved in and camped out.  In the absence of specific recommendations from a physician, there are some things that can be tried based on the type of headache and symptoms.

Heat or cold packs on the head or neck can sometimes alleviate some symptoms.  A sinus spray to relieve pressure during a sinus infection is a possibility.  Stretching exercises are always an effectual plan in general but also have the potential to assist with headache pain.  Massaging head, neck, back, or shoulders – either yourself with a roller or with a licensed masseuse – could relax tense muscles.  A quiet and dark room is another thing that we probably need more of in general practice, but also a good thing to try when a headache hits.  If the headache source isn’t due to exertion, taking a walk seems too simple but is worth trying.

If caffeine happens to not be the trigger, Excedrin as a medication has a caffeine punch to it in addition to the base acetaminophen dose that could provide pain alleviation.  In the middle of trying to cut back on caffeine and your headache is based on this cutback?  Proceed with careful.  You might be undoing your progress.

Closing the floodgates on rising tide of words

As weird as it sounds, there are VOLUMES of effluence that could be written about headaches based on things I learned while reading a metric boatload of papers on the subject.

This is the short version.

If I had an editor, I’d be fired.

This seemed like a good topic to tackle given prevalence of headaches in our lives and society.  And either you the reader or a close friend of yours have been through this.  Definitely people who are dear to me.

As research continues, there is always hope of better treatments coming up that can alleviate symptoms with greater ease.  Even further research with the hopes that they can be prevented with greater efficacy.

We’re not there yet but there’s always tomorrow.  And every day after that.  Support your local medical research scientist.  Their work will continue to improve our daily lives as time goes on.

As a final reminder: if headaches are a regular thing for you or there is new onset of severe headache, please for the love of all that is sacred consult with a physician.  Let the old school “tough it out” mentality stay in the past and approach our modern medical world with an open mind and potentially squinted eyes.  Because the future is bright and if you have light sensitivity, that could be complicated.

Until next week.

-= george =-