He Headache or headache Is a symptom that affects most people at some point in their life. However, knowing their causes can be applied treatments and remedies that help control or eliminate them.
Suffering intense and constant headaches has repercussions in all areas of life, personal, social, work, assuming a high cost for both sufferers and society.
In the emergency department it has been seen as the fifth most frequent reason for consultation, affecting all age groups and both men and women.
However, the latter are the ones that most frequently suffer from this problem as well as the more disabling and more severe attacks.
The frequency of attacks is variable, suffering daily or several times a week. According to statistics the average frequency is 1 to 4 per month.
As for severity, the existence of sensory symptoms is synonymous with greater severity.
Prevalence studies indicate that headache affects 10-16% in men and 20-26% in women (Van der Helm-Hylkema, 1990; Russell, Kristiansen, Saltyté-Benth and Kvaerner, 2008).
In addition, between 3 and 5% of the population suffer headache almost daily (Gladstone, Eross and Dodick, 2003). As far as the age, no differences are observed until the puberty, but from that moment, the women point out being made up to 2.5 times more frequent. From the age of 45, there is a slight decrease in their prevalence, both in men and women (Russell et al., 2008).
Headache may be an isolated symptom or manifestation of a more serious disorder. The clinical characteristics of presentation, comorbid symptoms and physical examination can guide us on the etiology.
What explains the headaches?
There are several theories:
- The hereditary theory, which was significant in Lennox's 1960 studies of twin twins, and the 1968 studies by Refsum, who compared monozygotic and dizygotic twins, finding that 60% of the first had headaches compared to a 10- 40% of the seconds.
- And the theory of instability of the vegetative nervous system where it supports the idea of the existence of an increased sensitivity of the cranial arteries of origin. It was also seen that these patients in their childhood suffered cyclic vomiting and dizziness.
On the other hand, there is a more processual perspective that does not consider headaches from a purely descriptive perspective. It is thought that the problem seems to have its origin rather than in a certain specific organic deterioration, in the way in which the subject behaves in the different situations, especially in the stressors, in those in which adaptive strategies of control.
Precipitating factors of headaches
These factors are disparate in nature and origin. We can refer to:
A) Emotional disorders, 67% of patients have repressed hostility.
B) Being subjected to highly stressful situations, for example, those who see their responsibilities increased by ascending to an executive position, by committing serious faults, by examinations...
C) Physical diseases such as physiological dysfunction, hypertension , epilepsy , Allergy and visual defects.
D) Hormonal changes, triggered by the menstrual cycle and combined oral contraceptives.
E) Substances present in some medications such as nuts, spinach, chocolate, red wine, cheeses... This is due to the existence of a defect in the oxidation of phenylethylamine and tyramine.
F) Vitamin deficiency, Alcohol intake , Muscle tension, eating deficit, sleep habits, sudden intense illumination, trauma, violent exercises, water balance disorders..
Classification of headaches
Although the headache may be caused by various organic disorders, such as epilepsy, eye or ear diseases, Brain tumors Or by side effects of some drugs, most cases are functional pictures.
Over the years various headache classifications have been proposed, the first was made in 1962 by the Ad hoc Committee, and in 1988 the Intervational Headache Society updated that classification. Finally, in 2004 a review is carried out and the existence of:
- Tension headache
- Migraine with and without aura.
- Headache from overuse of medication.
Here are some of the main characteristics of these.
Symptoms concomitant with tension headache and migraine
Below I will define some of the words that you can find in the table.
- Photophobia: intolerance and exaggerated sensitivity to light. This is both annoying and painful.
- Phonophobia: intolerance and exaggerated sensitivity to sound. This is both annoying and painful.
- Hemiparesis: refers to the decrease of the motor force or partial paralysis that affects an arm and a leg of the same side of the body.
- Paresthesia : Sensation or set of abnormal tingling, heat or cold sensations that are experienced on the skin.
- Dysarthria : Difficulty in articulating sounds and words caused by paralysis or ataxia of the nerve centers that govern the phonatory organs.
- Ataxia : Difficulty coordinating movement.
Evaluation
To evaluate headaches, the clinical history is fundamental in the diagnostic approach of the patient with headache. A detailed Anamnesis Will allow a diagnostic approach to the underlying cause of headache.
The identification of personal history, triggers and alarm signals is essential both from the point of diagnosis and when taking therapeutic actions. The physical examination is essential, it provides information of great value and allows to adopt the appropriate therapeutic behaviors to the particular case of each patient.
Psychological aspects
As for the psychological aspects, there is a negative repercussion of the headaches in aspects of the quality of life from the patients. People have high levels of anxiety Which in turn influence the frequency of headache, with a relationship between the duration of headache and the Depression . They also generate a high degree of disability.
Drug abuse
If we focus on headache over medication abuse we see that it has a special interest. Apart from the primary headache from which it proceeds and evolves, there is much similarity to any drug addiction .
A person who has a headache and constantly uses drugs to relieve pain, causes a tolerance in the body to develop such drugs, the person needing to increase the dose of them to achieve the same effectiveness.
Over time the drug has little effect and consumption is done daily or almost daily in direct relation to the presence of headache. If the medication is withdrawn at that time, an intense rebound effect occurs, similar to abstinence syndrome Also appearing nausea, vomiting or sleep problems. It persists until the person consumes his daily dose.
In this way an addiction to drugs occurs whose function that initially served to alleviate pain, becomes a function to avoid an undesirable effect of pain.
Headache in children and adolescents
On the other hand, in children and adolescents with headaches, the impact on quality of life is important. It is often observed that the child who lives in a family with a history of chronic or recurrent headache suffers from the problem as well but does not say it, or does it superfluously, considering it as normal in his life.
In these cases the current health system, where a good record system is programmed throughout childhood, may be adequate to detect them and prevent possible complications.
On the other hand, there are times when the child frequently complains of headache and the family worries about the possible underlying concomitant illnesses.
In short, it is observed that there is an effect on the quality of life, in its academic performance , As well as in the expression of psychosocial conflicts with the burden of suffering they entail.
Personality
With respect to the underlying personality factors, they are usually people with a tendency to psychosomatic disorders, who are urgent when speaking, are Perfectionists , Meticulous and retailers, prone to excessive worry and highly intelligent.
There are worrying data that relate the suffering of pathologies such as headaches and migraines and increased risk of accident.
What else do they exist to combat headache?
Next I will mention the therapeutic treatments that are used to combat the headaches, attending to the aforementioned division.
In general we can talk about the existence of medical, dietary and psychological treatment.
It is necessary to take into account that often the relief of the concomitant emotional symptoms diminishes the subjective perception of pain, diminishing also the headache.
For tension headache
- Use of analgesics
- Use of tranquilizers and Antidepressants . The last two seek to alleviate the collateral emotional effects that in the form of anxiety , Irritability or sadness , Accompany the experience of pain.
- Using the Muscle relaxation Like homework.
- Biofeedback Electromyographic (EMG) that reports the electrical activity of a muscle or muscle group through surface electrodes and by means of which the increase and decrease of muscular tension is measured.
For migraine
- Use of Propanolol As a more widespread prophylactic treatment. Disadvantages: high economic cost, liver and gastrointestinal side effects...
- Dietary treatment.
- Behavioral treatment based on Relaxation techniques And biofeedback of temperature and electromyography.
One must take into account the above mentioned about the excessive consumption of drugs and the possibility of an addictive disorder.
In these cases it is advisable an abrupt or gradual withdrawal of the medication, under medical supervision. It is important to keep in mind that this withdrawal is very annoying and leads to numerous relapses.
As for the dietary treatment, we speak of a preventive effect. Intake of certain foods can trigger the migraine attack because of its potent vasoactive effects. It is advisable to reduce and / or eliminate a series of foods from the diet.
As for the psychological treatments, the techniques of muscular relaxation and biofeedback are widely used. It has been seen that 50% of people with headache benefit. However, the other 50% do so with techniques such as Assertiveness training The Cognitive restructuring .
These intervention techniques are applied according to the altered process level and the responses involved.
As for the technique of relaxation, it is considered to be the one of choice for headaches, as it has good results and does not need devices like biofeedback.
It has been seen that the practice at home is fundamental, and its daily practice of little more than a few seconds correlates with an improvement of the different parameters of the headache.
One must take into account; It is often the case that people who suffer headache and are trained in relaxation show a decrease in the frequency and intensity of pain attacks, but once triggered the efforts to relax are not as effective.
With respect to Assertiveness training , May be a bit paradoxical at first sight, however many episodes of headache may be due to the person's inability to handle interpersonal conflicts.
As a consequence, a tension created by the subject itself is generated through internal negative self-verbalizations about conflicts. Consequently, with this technique it is tried to effectively control situations that generate them great tension and that end up causing the headache.
Finally, in the area of children and youth the primary care pediatrician must take into account certain issues in the management of headaches:
- Medication should not always be used.
- Can be very useful Stress management , Since being subjected to stress is a variable that predisposes to suffering headaches.
- Take care of her Sleep hygiene .
- Perform physical exercise (not in excess).
- Learn to recognize and avoid as far as possible the triggers.
CONCLUSIONS
With this article I have tried to give you an overview of all the factors that exist behind the headache so common that we experience people. Also, be aware that the abuse of medication can lead to fatal consequences.
So why not try other techniques like relaxation?
And what do you do to treat headaches or headaches?
Bibliography
- Alonso de Ozalla, R. (2007). Headache in the primary care pediatrician's office: a challenge. Madrid. Revista Pediatría de Atención Primaria, vol. IX. No. 36.
- Amigo Vázquez, I., Fernández Rodríguez, C. and Pérez Álvarez, M. (2009). Psychological manual of health (3rd edition). Editions pyramid. Cover theme, no. 35.
- Comeche, M.I., Vallejo, A. and Díaz, M.I. Psychological treatment of headache. Prediction of improvement in an active-passive approach.
- Labrador, F.J., De la Puente, M.L. Treatment of functional headaches: current considerations and intervention proposal. Yearbook of Psychology, nº 38, 1988.
- Merino Espí-López, G.V., Colorado Luch, I.C., Vicente Herrero, Ma. T. Tension-type headache in women. Characteristics, impact and usefulness of physiotherapy in its treatment.