A violent throbbing in the head, pressure behind the temples, sensitivity to light or nausea – headaches come in many forms. Well over 200 syndromes are known today and almost everyone suffers from headaches occasionally or more frequently. Simple measures are often enough to get the pain and its causes under control. Sometimes, however, drug or inpatient therapy is required. As chief physician of the neurology clinic at the AMEOS Klinikum St. Clemens Oberhausen, Dr. Angelika Görtzen the various treatment options. In an interview, the experienced doctor explains how to best react to headaches.
Miss Dr. Görtzen, when are headaches harmless and when are they dangerous?
Most of those affected suffer from rather harmless tension headaches. As the name suggests, these are often caused by tension and stress. Migraines are also very common, but are less common. Both forms are not uncommon or dangerous, but can significantly reduce the quality of life. If headaches occur every other day, it may be a chronic disease that needs long-term treatment. If the pain and accompanying symptoms such as dizziness, nausea or blurred vision occur frequently and for a long time, you should consult a specialist, for example a neurologist or neurologist. And if an unfamiliar headache occurs all of a sudden or the pain becomes so severe that it is almost unbearable, you should have it checked out immediately. Meningitis, a tumor or bleeding can be the trigger.
Can headaches be prevented or relieved?
Partly yes. Headaches are not usually a cause for concern, but they are almost always indicative of another problem. Tension headaches improve, for example, if those affected regularly do endurance sports such as jogging, swimming or cycling. In general, everything that leads to relaxation is helpful here, for example meditation, autogenic training or progressive muscle relaxation exercises according to Jacobson. Sometimes a visit to a jaw specialist is the solution because the tension is caused by a malposition of the jaw. Or there is a change in the cervical spine. In the case of migraines, which mostly affect women, decreasing vascular tension and hormone fluctuations can be triggers, but the consumption of chocolate, red wine and cheese also has an intensifying effect. Anyone who keeps a headache diary and notes what was on the menu before the respective flare-up will, after a while, find an indication of which foods and drinks should be avoided.
When is medication required?
Medication should be used as sparingly as possible and the dosage should be coordinated with your family doctor or a specialist doctor. Because the effect of many preparations decreases the more often you take them. This can lead to a dependency that requires withdrawal. Constant use can even trigger a drug-induced headache disorder that needs to be treated. This means that the painkiller itself then triggers the pain. Nevertheless, there are clinical pictures for which medication is helpful. Cluster headaches, for example, are treated preventively with medication or cortisone to alleviate or avert the mostly nocturnal flare-ups. Long-term drug treatment is sometimes recommended for migraines as well. Medications are used more often for chronic headaches.
How do you find out if a headache has a threatening cause?
In our neurology clinic, we always carry out a computer tomography of the head to clarify the cause. For example, we can quickly identify or rule out a tumor or bleeding. By examining the cerebrospinal fluid, on the other hand, we find out whether there is bacterial or viral meningitis if the clinical picture indicates it. Fever, vomiting and a stiff neck that prevents sufferers from bending their head forward are typical signs of meningitis. We will clarify this so that we can initiate the best possible treatment.
What treatment options are there for serious illnesses?
This is completely different depending on the clinical picture. We use antibiotics to treat bacterial meningitis. In the so-called temporal arteritis, headaches are caused by inflammation of the blood vessels. Here we administer cortisone over a longer period of time to prevent possible blindness. If a brain tumor has to be removed or bleeding stopped, we transfer the affected person to a specialist neurosurgical clinic. But that shouldn’t worry you. Far more than 90 percent of all complaints do not require such drastic measures.
What advice do you have for people who suffer from headaches?
If you only occasionally suffer from a slight headache, a little exercise and fresh air can often help. Drinking enough water also relieves the pain. However, if headaches occur more frequently or more intensely, you should have a medical examination carried out. Regularly resorting to painkillers on your own will not permanently eliminate the symptoms and can have uncomfortable and harmful consequences. Hence my advice: talk to your family doctor first. They identify the first causes and refer you to a suitable specialist medical practice or department.
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