From 
Del.icio.us
Digg
Reddit
Facebook
StumbleUponSymptom or Underlying Problem?
Here comes the pain again--that familiar throbbing in your temple, or at the base of your skull. Quickly, you pop a couple of over-the-counter pain pills, hope for the best, and go about your day. After all, it's just a headache, right?Not necessarily. It could be a migraine, a potentially serious condition that affects more than 29 million Americans, according to the National Headache Foundation (NHF), a nonprofit education and advocacy group based in Chicago. But I don't get migraines, you think. Don't be so sure: More than half of all migraine sufferers have never been diagnosed by a doctor or were diagnosed incorrectly. "They may have been told that they have sinus or tension headaches because there is overlap between the symptoms. The dilemma is that if they really have migraine, they may not be getting the best treatment," explains NHF board member Lisa Mannix, MD, director of Headache Associates in Cincinnati, Ohio.
Headaches 101
Almost everyone gets headaches, and they can start young. In fact, one study found that among people ages 12 to 29 years old, 91 percent of men and 95 percent of women had experienced one or more headaches. The pain drives 50 million people to doctors each year and is one of the top 10 reasons men and women seek medical care. Anything from the foods you eat to a simple change in your routine can set off an attack.
Some 90 to 95 percent of all headaches are primary. These include tension headaches, migraines and cluster headaches. Secondary headaches, such as those that are caused by brain tumors, head injuries or aneurysms, are far more rare. In these cases, the headache is a symptom, not the underlying problem.
No two people experience a primary headache in exactly the same way, which is why they can be tough to categorize. For example, migraines can be debilitating, life-stopping attacks for some, leaving them bedridden in a dark room with the shades pulled, while others hurt but are still able to go about their business. So how do you know what kind of headache you have? Are they different maladies, or simply different levels of the same problem?
"It's a question we struggle with, to some degree," says Richard Lipton, MD, director of the Montefiore Headache Unit at Montefiore Medical Center in New York.
"There's a lot we still don't know about headaches," agrees Mannix. "Tension headache is so common that we don't fully know what's going on in the brain." A little more is known about migraines and cluster headaches: Migraines affect women three times as often as they do men, and may be triggered by hormonal changes. Attacks typically last from 4 to 72 hours. Cluster headaches are relatively rare and mainly affect men. These attacks are much shorter, from 30 to 90 minutes, and can occur several times in a day. "The pain is behind one eye," Lipton explains, "a stabbing or searing pain often described as feeling like a hot poker in the eye."
The features of a migraine are distinct from those of a tension headache, says Lipton: A migraine is typically one-sided pain; tension headache affects both sides of the head. Migraine pain throbs; tension pain is a steady ache. Migraine pain is moderate to severe; tension tends to be mild to moderate. Migraine is always associated with other symptoms, such as nausea or sensitivity to light, while tension headache is often just that--a headache.
Many people assume that migraines always include aura--flashes of light, zigzag lines or other visual disturbances--but only about 15 percent of attacks have those classic signs. Other symptoms can vary as well, and may include sinus pressure and congestion, which is another reason migraines are often misdiagnosed. In a 2004 study published in the Archives of Internal Medicine, 88 percent of people who believed they had a history of sinus headache actually had been experiencing migraines.
"If an otherwise healthy person comes in to a primary care office and complains of episodic headache for at least six months, the likelihood that it will be migraine is 94 percent," explains Stewart Tepper, MD, director of The New England Center for Headache.
Advertisement 
Your Comments
See all
...
Post your commentCancel