Headache: A throbbing problem

A headache comes in all shapes and sizes, and so does its treatment


Most of us experience headaches and tend to get rid of them by simply popping an over-the counter pill. Headaches are commonplace in our high paced world, so much so that it is estimated that more than 70 per cent of women and 50 per cent of men have reported experiencing at least one headache per month, and greater than 90 per cent of both sexes experience a throbbing headache at least once in a lifetime.
They are termed as either primary or secondary. Secondary headaches are those that are due to conditions like brain tumours, sinusitis or haemorrhages. But primary ones are   common —they account for 90 per cent of all headaches.

Migraine, tension-type, cluster headaches and other nerve related pains are the main types of primary headaches. Also, there are some uncommon types such as the ones due to cough, exertion or those that come after sexual activity. Tension-type one is usually episodic but like migraine, it can become chronic, occurring daily or almost daily, for more than 15 days a month. Among the primary ones, the tension-type headaches are most common.


Migraine is the most recognised headache syndrome. Its occurrence is more common in women. Migraine can be grossly classified into migraine without aura [common migraine] and migraine with aura. Generally, many hours or a day before the onset of a migraine attack, patients experience varied symptoms like changes in mood or personality. Fatigue also is common, and occasionally hyperactivity occurs as well. Migraines may even trigger nausea and vomiting. Some migraine sufferers even experience a perpetual disturbance known as the aura. The aura is a well-defined visual deficit that lasts for less than an hour and is followed by a headache. Most auras are marked by flashing lights that are initially small, which enlarge or move across the visual field. Migraine attacks can last anywhere between 6 – 72 hours. The throbbing pain caused by migraines is usually one-sided but some patients experience bilateral pain. Migraines may even bring about a morbid fear of light or noise and in rare cases odours. It is best to avoid physical activity after an attack sets in as it exacerbates the pain.

Tension-type headache

This type of headache is characterised by generalised pressure or a sensation of tightness in the head. Unlike migraines, physical activity doesn’t worsen the discomfort caused by this headache. However, in rare cases patients may undergo nausea and fear of light or sound. Tension-type headache could be either episodic [less than 15 days a month] or chronic [lasting more than 15 days a month].

Cluster headache

A cluster headache is most often seen in young men and is a one-sided headache that may involve excess watering from the eyes and a stuffy nose. Its prominent feature is that the attacks occur regularly for a week to a year and are separated by long pain-free periods of a  month or more.

Management of headaches

Treatment usually depends on the specific headache type and a proper diagnosis by a neurophysician. Different medications are available for each type of primary headache. Consult your doctor to find the best medication for you. However, the major trigger of headaches is stress. Reducing stress is all one might need to prevent and minimise the pain of a mild headache. Stress can be comfortably managed with relaxation techniques like yoga, meditation or massage. Applying a cold, moist cloth, an ice-pack or even peppermint oil to the forehead and temples helps in eliminating the headache. Taking over-the-counter pills for headaches more than three times a week can rebound headaches hence they are best avoided. Maintain a headache journal to monitor frequent occurrences and consult a doctor if required. A good posture helps in preventing muscle tension leading to headaches. Last but not the least, live a healthy lifestyle—eat healthy meals at regular times, sleep well and avoid alcohol.

This was first published in the March 2013 issue of Complete Wellbeing.

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Gautam Tripathy
Dr Gautam Tripathy, MD [Medicine], DM [Neurology], is a full-time consultant in neurology at Dr L H Hiranandani Hospital, Powai, Mumbai.


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