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headpainmigraine · 11 months

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Migraine isn't a Headache Part Four: but what if a headache is all I get?

I was reading through the notes on some other posts and realised that a lot of people are looking for answers re: what their headache could be.

Migraine is underdiagnosed and grossly misunderstood as 'headache' when it isn't a headache, but likewise, some people might dismiss their headache as migrane when they're dealing with a different beast entirely.

If you're bothered by persistent headaches, frequent (weekly/daily) headaches, but don't really experience the myriad of other symptoms that form a migraine, there are a host of differential diagnoses that should be investigated.

It might be worth taking some small measures first before going through the hassle of seeing a doctor. Headaches can be caused by:

Dehydration (I know 'have you had water' is a common thing to be asked when you say you've had a headache, but make sure that you are actually consuming enough fluids - dehydration can absolutely cause bastard headaches, and it's REALLY EASY to be dehydrated if you're busy working and don't look up to drink something)

Eye strain (It might be easier for you to see an optician/optomertrist than a doctor, plus if there ARE any issues, they're usually easier to sort out with glasses, a new prescription, or different types of lenses. Even if you have 20/20 vision, they can at least a) rule out eyestrain)

Hunger (Food is a touchy topic, so I'm not going to linger on it, but eating something small when you have a headache might help. Sometimes I don't feel hungry, but make myself eat a banana or a cracker or something, just to appease the beast)

Bad Sleep (Not enough sleep, too much sleep, poor quality sleep, sleep apnea, so many sleep things can cause headaches that it's a topic of it's own; you can help by practiscing good sleep hygeine, but a routine bedtime/waketime factoring in sufficient hours is really helpful with this)

Stress (This one isn't something you can easily fix at home, especially if your stress is, you know, the cost of living, working your job and every other thing life can throw at us, but noting that you get headaches when you experience stress can make you more aware of when you might need to pamper yourself a little, or to tell a doctor if you're seeking diagnosis)

Caffeine (the whole thing about 'caffeine addiction' is medically disputed, but you can definitely get headaches from stopping drinking caffeine, but also from drinking too much. A lot of people with migraine find relief when drinking caffeine, and it's included in a lot of painkillers, but if you suspect caffeine might be something to do with your headaches, maybe avoid those. It's easy to tell, you just need to stop caffeine for maybe a week or two and see if your headaches improve.)

I'm going to mention Medication Overuse/Rebound Headache here, because it can be eased without medical treatment, but there are all sorts of issues around that.

This apparently doesn't happen if you're taking painkillers for something other than headache, because why not make life harder for people with them. If you take the same painkillers for, eg, back pain, neck pain, arthritis, etc, you don't tend to get rebound headaches.

If you have headaches usually migraine or tension type) and are taking painkillers too frequently (more than 10 days per month) for too long (more than 3 months) you can develop headaches caused by taking too many painkillers.

Messed up, right?

I've had these headaches alongside migraine and they are EVIL. I can only describe them as seething.

Overuse of opioids and triptans are most likely to provoke rebound headache (yeah, the ones migraineurs take, can't catch a break)

Paracetamol and aspirin are the next culprits, with NSAIDs like ibupfrofen and naproxen having less likelihood, but still very much there.

Medication overuse headaches can be resolved by not taking pain medication.

That sounds simple, but in reality, living it, it's hell. For the first few days after you stop taking painkillers, the headaches are… spectactular. Intense, crunchy, sparkling pain, acid in your blood pain. Not to mention that you have no treatment for whatever you were taking painkillers to cope with in the first place.

Coming off everything for 2-3 weeks does seem to beat MOH, and the relief when they stop happening is as great as the pain is in those first few days, but you can always redevelop it if you go back to taking more painkillers.

So, what do you do to prevent medication overuse headache while not leaving yourself untreated for the headache you were taking the painkillers for?

Medical advice is to limit the usage of headache medications, no more than 2-3 days a week, or less than 10 days a month, and to avoid opioids and triptans as much as possible.

That doesn't really help if you're getting a headache every other day of the month. This is where preventative treatments are supposed to be utilised, to treat the headache instead of just dulling the pain. I don't have to tell anyone who's already a spoonie that trying to get this treatment is difficult, and that's assuming the preventative measures work for you.

But honestly, personally, I'd rather have a migraine than medication overuse headaches, seriously.

There are so many different types of headache, and other illnesses where headache is a symptom and not the illness itself, that I can't list them all.

You shouldn't diagnose headache disorders over the internet.

I'm not going to pretend that seeing a doctor isn't a financial/energetic/emotional/time scale difficulty for a lot of people, but a) headache can be a sign of something serious, b) even if it's not there may be "easy" treatments for it and c) there are treatments for headache that you can't buy over the counter.

It's one thing to go to a doctor and say you have XYZ symptoms, so you suspect you have headaches/migraines, but treating for, example, migraine when you have another type of headache is just going to waste your money and possibly harm you.

Other types of headaches can include:

Tension Headache - usually felt like a tight band around the head, not necessarily caused by tense muscles, but often triggered by stress, among other things; very commonly confused with migraine, they don't present with other symptoms of migraine like nausea, aura, etc; there's a LOT of information about tension headaches online, and is one of the most common causes of persistent or chronic headache complaints

Cluster Headache - also called 'suicide headache', the pain is so bad that sufferers often can't sit still, rocking, pacing or banging their head into a wall. this is a 'something in one side of my face pulling my cheek away from the skull' pain, that also usually presents with a red/watering eye, sinus disruption on that side, drooping eyelid. onset is fast, with headache lasting 15 minutes to 3 hours and occuring 1-8 times a day. they usually appear in bouts, followed by remission and then reappearance.

Thunderclap headache - sudden onset, reaches intensity in less than a minute, extremely severe pain; if you have one of these for the first time, you should seek immediate medical attention; they can be benign, but they can be a sign of brain injury, stroke, blood vessel tears/ruptures/bloackages

As well as:

hemicrania continua

ice pick headache

sinus headache/other sinus disorders (not a headache disorder in and of itself)

hormone/menstrual headache

hypertension headache

post-traumatic headache

chiari malformations (not a headache disorder, rather where the brain starts to slip into the spinal canal; headache can be a symptom for some people; it's not often talked about, so I thought I'd put it here)

This isn't everything, they all have different diagnosis paths, different symptoms that come along with them, different experiences between people who have them.

Headache is a massive area of differential diagnoses, it's always worth seeing a doctor for diagnosis and proper treatment, if you can.

Back to Migraines in the next part

#headache #headache awareness #migraine awareness month #migraine #chronic headache #chronic migraine #spoonies #chronic pain #migraine isn't a headache

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