There is probably no one who has never experienced a headache. When you are stressed or nervous, you may have a headache and an unknown migraine. As headaches are a very common symptom, people often ignore them or just take painkillers and pass them over. However, there are more than 100 diagnoses of headaches, of which they are rare, but sometimes they can be life-threatening. Even if they are not dangerous, they may progress chronically and become refractory if left unattended for a long time or take the wrong medicine. Then, how should we discriminate and treat them? I asked everything to Lee Tae-gyu, a neurologist.
What types of headaches do you have?
Headaches are largely divided into primary headaches and secondary headaches. Primary headaches occur when there are no abnormalities when MRI, MRA, or blood tests are performed, that is, when there is no clear structural disease. Tension headaches, migraines, and cluster headaches are typical. Secondary headaches are caused by diseases that can cause headaches. For example, brain tumors, cerebral hemorrhage, and cerebrovascular dissection are found on MRI, resulting in a headache due to high levels of inflammation on blood tests, or headaches due to aggregation of muscles behind the neck on X-ray.
Headaches caused by stress or fatigue are common, why?
It is the most common 'strained headache'. It is caused by psychological tension, muscle tension, sleep problems, etc. The exact mechanism is not known, but when you are nervous, your muscles become strained. In particular, the muscles in the shoulder behind the neck are prone to clumping, but since the muscles themselves all continue, headaches can occur. If the nerves that dominate the muscles act toward the brain and become chronic, the head can hurt every day. When psychological tension is added to this, they interact. Because psychological tension is likely to be accompanied by depression, even the same pain can be more severe. In this case, an 'autonomous nerve test' is required to check the patient's usual stress.
How do you treat tension headaches?
Treatment varies depending on the cause. If muscle tension is the cause, take a pain-inducing injection that relaxes the muscles or take a muscle relaxant. If it is due to psychological tension or depression, drugs such as stabilizers and antidepressants can be helpful. Sleep apnea can also cause tension headaches, and in this case, treating sleep apnea, which causes sleep apnea such as sleeping with a positive pressure device, can relieve the headache.
Stretching also helps relieve tension headaches?
For people who work sitting and working for a long time, correct posture and stretching are very important because their muscles are easily clumped together. When viewed from the side, the cervical spine needs to be C-shape, but when looking at the monitor, it is easy to stick out your neck without realizing it. Then, not only becomes a straight neck, but also the neck muscles are very loaded. This can lead to headaches while releasing neurotransmitters that hold muscles together and cause pain. Therefore, it is better to relax your muscles by stretching your neck upside down. One minute per hour is enough. If the monitor is far away, you should pull it closer.
What are the causes and symptoms of migraines?
It is easy to think of migraines as hereditary. Even though they do not have parents, their grandparents may have suffered from it. Here, migraines are often compared to guns. When a trigger is activated while a bullet called a genetic predisposition is loaded, you get a headache. What acts as a trigger varies from person to person. ▲Before and after menstruation, or when it rains or is cloudy ▲Eating certain foods or ▲Smelling certain odors such as perfume ▲Taking or shaking a car for a long time ▲Excessive stress can be caused, or ▲Certain light can cause it.
How do you treat migraines?
There are three main types that vary from patient to patient. First of all, medication, such as injection or medication, is the basics, and second, it is very important to have a regular lifestyle. This means that you should always set your sleeping time, waking time, and eating time regularly. I slept less and drank a lot of coffee on busy weekdays, but if I don't sleep late and drink coffee because it's the weekend, my brain perceives it as a sudden change and I get migraines. This is why people who live irregularly or work shifts day and night complain a lot of migraines. Therefore, it is better to maintain the same lifestyle 365 days a year as much as possible. Third, avoid situations that cause migraines. You can learn and avoid certain smells or alcohol on your own.
If you have migraines, do you think it's better to quit drinking coffee
In fact, each person's sensitivity to coffee varies from person to person. Some people can help if they have migraines, while others can worsen. Also, if you keep drinking coffee and suddenly quit, your migraines may worsen due to caffeine withdrawal. So if you're the right person for coffee, say one or two cups at a certain time are fine, except before going to bed.
You should avoid mixing alcohol like "so-maek" and fruit wine. This is because fruit wine contains many ingredients that irritate blood vessels. If you have to drink, distillers such as soju and whiskey are less likely to cause migraines.
What should I do if I don't get better after taking a headache pill?
Regular headache pills may not be effective when the pain is severe because they are weak. In this case, you should visit a neurologist and see a specialist. Migraine painkillers are currently very effective and usually improve within an hour or two. Sometimes if you don't even listen to the drugs given by the neurologist, you should change them to another drug or check how to take them yourself. There are cases where you postpone it due to your resistance to the drug but don't listen well if you take it later. It is much more effective to take it right away when you have a migraine.
You treat headaches with Botox?
If the pain is severe from the beginning, the medicine is ineffective, or there is no time left, Botox injections are applied to the head. You just need to get it twice a year, but the medicine takes up to 3-6 months depending on the person. There are also advantages that it has a cumulative effect and no side effects. However, the only disadvantage is that the cost is high. There is also an injection that blocks a neurotransmitter called 'CGRP' that is injected into the stomach.
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