Headache Treatment in Delhi, India

A chronic daily headache (CDH) is commonly defined as a headache occurring for 15 or more days in a month or at least for three months. Chronic daily headache (CDH) is where a person experiences frequent headaches that are challenging to manage. A recent population-based survey shows that nearly 5% of the unselected population has daily headaches.

Most of the patients with persistent headaches have primary headache syndrome. Headache is the most common complaint which brings a patient to a neurologist. Although most headaches are benign in origin, some can have severe and sometimes life-threatening causes.

Headaches can be classified into various types based on their characteristics and underlying causes. The common types of headaches are:

• Tension headaches - It is the most common type of headache, characterised by a dull, constant ache around the head or neck.

• Migraine headaches - These are intense, throbbing headaches that can last for several hours or days and are often associated with other symptoms such as sensitivity to light and sound and vomiting.

• Cluster headaches - These are rare but extremely painful headaches that occur in cycles or clusters, usually lasting for several weeks or months, followed by periods of remission.

• Sinus headaches - These headaches are caused by sinusitis, an inflammation of the sinuses, and are characterised by pain and pressure around the eyes, cheeks, and forehead.

• Rebound headache - This type of headache is caused by overuse of pain medication, which can actually worsen the headache when the medication wears off. It is typically characterised by a dull, persistent headache that occurs daily or almost daily.

• Hormone headache - Women may experience headaches that are related to hormonal changes during their menstrual cycle, pregnancy, or menopause.

• Thunderclap headache - This is a sudden, severe headache that can be a symptom of a serious underlying condition such as a ruptured blood vessel or brain aneurysm. It requires immediate medical attention.

• Hemicrania continua - This is a rare type of chronic headache that can result in continuous pain on one side of the head. It typically responds well to a medication called indomethacin.

• Primary stabbing headaches, Also known as "ice pick headaches," are sudden, sharp, stabbing pains that last only a few seconds. They can occur anywhere on the head and are not usually a cause for concern.

• Primary exertional headaches are headaches that occur during or after physical activity, such as running or weightlifting. It generally lasts only a few minutes but can be severe.

• Chronic paroxysmal hemicranias are a type of headache that causes severe, stabbing pain on one side of the head that can last for minutes to hours. They are often associated with other symptoms, such as tearing of the eyes and nasal congestion.

• Medication overuse headaches occur when a person overuses pain medication to treat headaches. This can cause the headaches to become more frequent and severe.

• Fever, neck stiffness, personality change or abnormal neurological symptoms, which demand prompt attention.
• A sudden, new or different headache in someone over 50 years old
• Headache that develops within minutes “thunderclap” headache
• Headache associated with confusion may be indicative of encephalitis
• Inability to move a limb or abnormalities on neurological examination, mental confusion, being woken by headache
• Headache that worsens with changing posture, headache worsened by exertion, coughing, straining Visual loss or visual abnormalities and jaw claudication (jaw pain on chewing that resolves afterwards)
• Signs of irritated brain surface, such as severely stiff neck(a sign of meningitis), or sudden spike of pain with quick movement of head
• History of a known serious disease that can involve the head or brain, such as acquired immune deficiency disease (AIDS) or Cancer. A sudden change in headache pattern such as increased frequency, intensity, or duration
• A headache that is associated with neurological symptoms such as weakness, dizziness, sudden loss of balance or falling, numbness or tingling, paralysis, speech difficulties, mental confusion, seizures, personality changes/inappropriate behavior, or vision changes (blurry vision, double vision, or blind spots)
• Headache with unexplained fever, shortness of breath, weakness on one side of the body
• Headache pain that awakens you at night (Cluster headache or alarm clock headache)
• Headaches with severe nausea and vomiting (Migraine)
• Headaches that occur after a head injury or accident
• Nontrivial head trauma or convulsions
• Relentlessly worsening headache over days or weeks
• Blood pressure higher than 180/115

The following migraine or headache symptoms do not require urgent care, but you should contact your headache doctor if you, or your loved one, have any of these symptoms.

• You feel so bad you cannot go to work or enjoy yourself
• Non-prescription drugs rarely provide relief
• Have three or more headaches per week
• Have headaches that keep getting worse and won't go away
• Need to take a pain reliever every day or almost every day for your headaches
• Need more than two to three doses of over-the-counter medications per week to relieve headache symptoms
• Have a history of headaches, but have noticed a recent change in your headache symptoms

Common factors responsible for headaches are as follows-

• Tension - Stress, poor posture, and anxiety can cause tension headaches.

• Hormonal changes - Changes in estrogen levels during menstruation or menopause can trigger migraines in some women.

• Environmental factors - Bright lights, loud noises, and strong smells can trigger headaches.

• Medical conditions - Headaches can be a symptom of medical conditions such as sinusitis, high blood pressure, and brain tumours.

To diagnose the cause of a headache, your doctor may perform a physical exam and ask you about your symptoms, medical history, and lifestyle. They may also advise additional tests to rule out underlying conditions, such as:

• CT scan or MRI: These imaging tests can help detect any abnormalities in the brain that may be causing headaches.

• Blood Tests: Blood tests can help identify underlying medical conditions that may be causing headaches.

• Lumbar Puncture: This test involves removing a small amount of cerebrospinal fluid from the spine to check for signs of infection or other conditions.

• Electroencephalogram (EEG): This test measures brain activity and can help identify seizures as a cause of headaches.

• Sinus X-ray: This test can help diagnose sinusitis, which can cause headaches.

The treatment for headaches varies depending on the underlying cause, but some common treatment options include:

• Non-prescription pain relievers like ibuprofen or acetaminophen can be purchased without a prescription.

• Modifying your diet, exercise regimen, and sleep patterns.

• Exploring alternative therapies such as acupuncture, massage, and other non-traditional treatments.

In rare instances, surgical intervention may be required to address underlying conditions contributing to the headaches.

Certain risk factors can increase the chances of developing headaches, including-

• Genetics - Migraines and cluster headaches can be inherited.

• Gender - Women are more likely to suffer from migraines than men.

• Age - Migraines often start in adolescence and peak in the 30s, while cluster headaches are more common in men over 30.

• Lifestyle factors - Poor diet, poor sleep and lack of exercise can increase the risk of headaches.

• Environmental factors - Exposure to secondhand smoke, pollution, and certain chemicals can trigger headaches.

Headaches can be a major symptom of various underlying conditions, some of which can lead to serious complications. Here are some potential complications of headaches:

• Stroke: Severe headaches, especially associated with weakness or numbness in the face, arms, or legs, may be a sign of a stroke.

• Brain Tumor: Although rare, headaches can be a symptom of a brain tumour. It's essential to have persistent headaches evaluated by a doctor.

• Meningitis: Headaches, along with a stiff neck, fever, and sensitivity to light, may indicate meningitis, a severe infection of the brain and spinal cord.

• Brain Aneurysm: A severe headache that comes on suddenly and feels like the "worst headache of your life" could be a sign of a brain aneurysm, a bulge in a blood vessel in the brain that can rupture and cause a stroke.

• Seizures: Headaches can sometimes be a symptom of seizures, which can cause sudden, uncontrolled movements and loss of consciousness.

If you experience any of these complications, seek medical attention immediately.

Headaches can be prevented by taking the following measures

• Stay Hydrated

• Manage Stress

• Get Enough Sleep

• Exercise Regularly

Max Institute of Neurosciences (MINS) provides world-class super speciality tertiary care for all kinds of headaches. Apart from an array of services like Advanced Brain Tumour Centre, Minimally Invasive Spine Surgery Centre, Stroke Centre, it has India's first Intraoperative MRI.

Max Institute of Neurosciences offers the following facilities:

• Advanced Brain Tumour Centre
• Minimally Invasive Spine Surgery Centre
• Stroke Centre ·
• Special Clinics for Epileptic, Neuromuscular and Movement Disorders ·
• Interventional Neurology
• Neuro Immunology
• Brain Suite

Max Headache Clinic is a facility dedicated to treating headaches and related conditions, via a variety of options. The clinic is dedicated to quality diagnosis and comprehensive, individualised management of headaches and works in close cooperation with the patient's personal physician. Close communication with referring physicians is a strong goal of this clinic, as it is understood that headache is a chronic disease which requires ongoing treatment.

At Max Institute of Neurosciences, as part of planning treatment a detailed discussion is done with the patient to have better understanding in terms of medical history, symptoms etc. Below are few detailed points which are discussed as a part of this discussion:

• History of Headache Episodes: This is to record the response to recent onset of headaches to ensure that the pattern hasn’t changed (became more frequent or more severe, or both) even if the patient has always been somewhat ‘headachey’.
• Frequency of Headaches: This may lead to many varied responses. Still, the key is how many days are affected and on how many days does the patient have a significant disability. The patient can be advised to maintain a diary to record his pain pattern, frequency and list the medications taken to counter the pain.
  
• Describing the worst attacks: Understanding the pattern of severe attacks help in guiding the therapy. Severe attacks will have some migrainous features which can lead to a proper diagnosis.
  
• Triggers and family history: Migraine genes seem to confer a set of sensitivities to various triggers. The migraine brain has a variation which explains why triggers work on some days and not on others. This variability is perfectly compatible with the current view of migraine as a channelopathy. A well-maintained headache diary would address issues of medication overuse, confirm the number of days of headaches and migraine and may help in identifying the triggers.
  
• Analgesic overuse: Patients with daily headaches might often consume large quantities of analgesics. Consuming an acute attack medicine more than twice a week is probably its overuse. Usually, such patients have headaches that are improved by acute attack medicines, only to return (rebound headache) as the drug effect wears off. At Max Institute of Neurosciences, they help reduce and slowly eliminate the overuse of analgesics with proper discussion and counselling. Patients can reduce their use either by 10% every week or two, depending on their circumstances, or if they wish and there is no contraindication, by immediate cessation of use. Either approach can be facilitated by keeping a record of analgesic use and pain pattern.
  
  

Post the discussion, the experts recommend various diagnostic tests; and after the entire diagnosis report is studied, the treatment plan is prepared.

The prognosis for headaches depends on the underlying cause and severity of the headache. Some headaches, such as tension headaches, can be successfully treated and managed with lifestyle changes and medications. Other headaches, such as those caused by a brain tumour or aneurysm, may require more intensive treatment and have a less favourable prognosis. In general, early diagnosis and treatment can lead to a better prognosis for most types of headaches.

1. How do you cure a headache naturally?

Some natural remedies can be effective in treating headaches. These include drinking plenty of water, applying cold or hot compression to the affected area, practising relaxation techniques such as meditation, getting enough sleep, and avoiding trigger foods or activities. Other natural remedies that may help include ginger, peppermint oil, and lavender oil. 

2. Does water help with headaches?

Dehydration can be a common cause of headaches, so drinking plenty of water may prevent or relieve headaches. Drink at least eight glasses of water per day to stay properly hydrated. 

3. How long do headaches last?

The duration of a headache can vary depending on the underlying cause and severity of the headache. Most tension headaches last between 30 minutes and several hours, while migraines can last for several hours or even days.

4. Can a virus cause headaches?

Yes, viruses can cause headaches as part of the overall constellation of symptoms associated with viral infections. In fact, headaches are a common symptom of many viral illnesses, including the flu, the common cold, and COVID-19. Headaches may be accompanied by other symptoms such as fever, body aches, and congestion. While most viral headaches are mild and self-limited, it is important to monitor for other symptoms that may indicate a more serious condition.

Reviewed by Dr. Vinny Sood, Senior Consultant, Neurosciences, Neurology on 15-Jun-2023.

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