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Reading your headache pain

Many of us get headaches. We take an over-the-counter pain reliever such as paracetamol, aspirin or ibuprofen, and in no time we feel better. But some headaches persist or are unusually severe, in which case you might be looking at a headache disorder.

Understanding the location of the pain can help doctors to diagnose what kind of headache you have. ‘Diagnosing a headache disorder includes a detailed history of the nature and character of the headache, as well as a detailed neurological assessment,’ says Dr Irshad Siddi Ganie, a neurologist at Life Mount Edgecombe Hospital. ‘This allows the clinician to classify the headache disorder and initiate appropriate treatment.’ 

These are some of the types of headache:

Sinus headache 

Where the pain is: In the sinus cavities of your forehead, cheekbones and behind the bridge of your nose. ‘This usually occurs secondary to a viral or bacterial sinus infection,’ says Dr Siddi Ganie. ‘Patients who have migraine are often misdiagnosed as having a “sinus headache”.’

Things that make it worse: Sudden head movements or strain can intensify the pain.

Symptoms: Face pain, a runny nose, feeling of fullness in the ears, fever and swelling in the face.

Tension headache

Where the pain is: Across the forehead. ‘They are not aggravated by physical activity, although there may be pericranial tenderness and sensitivity to light or noise,’ says Dr Siddi Ganie.

Things that make it worse: Stress

Symptoms: The headache can last up to seven days and can be associated with stress, muscular tightness in the neck and poor-quality sleep. 

Cluster headache 

Where the pain is: On one side of the head, affecting the eye or temple, developing rapidly and typically lasting up to 90 minutes. 

Things that make it worse: Alcohol, strong-smelling substances such as petrol, paint fumes, perfume, bleach or solvents, exercise and becoming overheated. 

Symptoms: ‘The affected eye demonstrates increased tearing, redness or eyelid swelling, and there may be associated nasal congestion and a runny nose,’ says Dr Siddi Ganie. Cluster attacks come in bouts which may last up to three months, he adds.

Migraine headache 

Where the pain is: A pulsating headache affecting predominantly one side of the head, lasting approximately between four hours and three days.

Things that make it worse: Routine physical activity. ‘As a result, the migraine sufferer avoids activities such as walking, bending and movement [in general] during the headache phase,’ says Dr Siddi Ganie.

Symptoms: Migraines also come with some combination of light sensitivity (photophobia), the inability to function properly and nausea.

What to do if your headache persists

See your doctor

When headaches persist, it’s time to get professional help. ‘Pharmacists generally give a patient about three days of self-medicating before recommending that they see a professional about their headaches,’ says Sharifa Essack, Clinical Practice Pharmacist at Life Brenthurst Hospital. If the GP can’t help, you will generally be referred to a neurologist.

Use OTC medication with caution

Sharifa adds that while over-the-counter pain relievers can be helpful, they’re not without side effects. ‘For example, non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen can have negative effects on the stomach lining. NSAIDs have also been known to adversely affect the kidneys.’ She explains that codeine can cause constipation, in addition to being addictive and having adverse effects on the liver.

Don’t share medication

Sharifa cautions against sharing medication with anyone else. ‘You might not know the person’s allergies (e.g. an ibuprofen allergy) or their co-morbidities (what other conditions they suffer from), such as asthma or kidney problems. This could result in a severe allergic reaction (anaphylaxis), kidney failure or an acute asthma attack. Also, they could be on other medications that might interact with what you are sharing with them,’ she concludes. 

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.