Over 40 million Americans experience chronic headaches. For at least half of these people, the problem is severe and sometimes disabling. It can also be costly as headache sufferers make over 8 million visits a year to doctor's offices. Migraine victims alone lose over 150 million workdays because of headache pain.

Source Of The Pain

Where is the pain coming from when you have a headache? Several areas of the head can hurt, involving a network of nerves that extend over the scalp, which also includes certain nerves in the face, mouth and even the throat. Also sensitive to pain are the muscles of the head and blood vessels, found along the surface and at the base of the brain, which are rich in delicate nerve fibers. Surprisingly, the bones of the skull and tissues of the brain itself don't hurt, since they lack pain-sensing nerves.

At the ends of these pain-sensitive nerves are structures called nociceptors. They can be stimulated by stress, muscular tension, dilated blood vessels as well as other triggers mechanism for headaches. Once stimulated, a nociceptor sends a message up the length of the nerve to the nerve cells in the brain, thus signaling that a part of the body hurts.

A number of chemicals help transmit pain-related information to the brain. Some of these chemicals are natural pain killing proteins called endorphins. One theory suggests that people who suffer from severe headache and other types of chronic pain have lower levels of endorphins than people who are generally pain free.

When To Seek Medical Attention

Not all headaches require medical attention. Some result from overused neck muscles, for example or occasional muscle tension and are easily remedied. But some types of headache are signals of more serious disorders and call for prompt medical attention. These include:

Diagnostic Tests

The diagnostic work-up for headaches most often begins with a detailed question-and-answer session with the patient. This can often produce enough information for a diagnosis. Many types of headaches have clear-cut symptoms which fall into an easily recognizable pattern. Most physicians will also obtain a full medical history from the patient, inquiring about past head trauma or surgery and about the use of medications. Physicians may also suggest that a patient undergo a computer tomographic (CT) scan and/or magnetic resonance imaging (MRI). The CT scan produces images of the brain that show structures or variations in the density of different types of tissues. The scan enables the physician to distinguish, for example, between a bleeding blood vessel in the brain or a brain tumor and is an important diagnostic tool in cases of headache associated with brain lesions or other serious diseases. Physicians then analyze the results of all these diagnostic tests along with a patient's medical history to arrive at a diagnosis.

Headaches are classified as one of the following types:

Muscle contraction (tension) Vascular Traction Inflammatory

Vascular headaches--a group that includes the well-known migraine--are so named because they are thought to involve abnormal function of the brain's blood vessels or vascular system. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Some people have more than one type of headache.

Finding the solution to your headache problems is usually a lengthy and involved process, especially since making an accurate diagnosis of the type and cause of the headaches must come before the proper treatment regimen can be found. Read Part 2 to learn more about the different types of headaches and how they're treated.

 

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