So you have plenty of headaches, but how do you find out what causes headaches? There is so much information available on the internet, but unfortunately, if it hasn't been written by a headache specialist or reviewed by a doctor, it probably has some misleading ideas.
Headaches in general are divided into two categories: primary and secondary.
Primary Headache Primary headaches are those where the headache itself is the cause of the pain not some underlying medical condition.
The majority (90%) of all headaches that come into a doctor's office are from primary causes such as migraine, cluster and tension headaches.
Tension headache may be episodic or chronic.
Usually, these headaches are not associated with structural brain problems although numbness, tingling, and dizziness may occur with these headaches.
Imaging studies, such as CT scans and MRIs of the brain, and blood work are usually also normal.
When I examine a patient with one of these types of headaches, the exam is also usually normal.
Tension headache patients may, however, have cervical spasming which can also cause headaches such as migraine.
In this case, the spasming of the neck muscles causes a feedback system through the cervical spine to activate.
This sends signals to the central part of the brain responsible for the migraine cascade.
Once this starts up, the migraine may be only minutes to hours away.
Secondary Headache Secondary headache is a group that is more easily definable.
These are headaches that are caused by an underlying medical condition such as diabetes (hypoglycemic headache), hypertension, lupus, anemia and hypothyroidism.
Headache associated with brain tumor or meningitis is also in this group.
With secondary headaches, the head pain is not the main problem, but presents as part of a constellation of symptoms.
The underlying diagnosis is considered the true problem.
Lab work and other studies do show an abnormality here and the physical exam may also be abnormal.
Diabetes, tumors and meningitis may have what we call 'neurological signs' such as loss of feeling, weakness, slurring of speech, neck pain and cognitive difficulties.
It is vital for practitioners to listen to you the patient when headaches are part of the complaint.
Be sure to tell your doctor about the nature, timing and severity of your headaches.
Let them know too, what makes them better or worse.
Treatment of the underlying condition will not only relieve the headaches, but in some cases may also save your life.