Headaches: A Brief Overview

Headaches are one of the most common concerns that family doctors see. In most instances, headaches are only occasionally annoying and don’t interfere with people’s daily activities. In these cases, a person’s symptoms can usually be managed with simple treatments or even the occasional Tylenol or Advil.  However, in other cases, they can cause significant symptoms and strain, interfering with a person’s work, sleep, and overall quality of life.

The most common type of headache is called a tension headache. Tension headaches often feel like a dull pressure or head fullness and tend to feel like a tight band around the head. The most common triggers are stress, mental strain, or even extended periods of looking at screens. Though they can affect anyone, patients who are younger and female tend to be affected more often. As mentioned above, acute episodes of tension headaches can be treated with medications such as Tylenol, aspirin, or other NSAIDs like ibuprofen or Advil.

Other types of common headaches include migraines and medication-overuse headaches. Migraine headaches can start suddenly and tend to involve one part of the head. Often, patients have a sensation of a pounding sensation, are sensitive to bright lights, and may even experience nausea and vomiting. Some people experience what is called an “aura”, where they might see strange shapes or experience other symptoms right before the start of the migraine headache. There are treatments available for acute episodes of migraines, as well as preventive treatments.

Briefly, medication-overuse headaches are just that headaches that result from overuse of medications (usually to treat said headaches). They are also known as “rebound” headaches. We typically address these by slowly decreasing the amount of medication used to treat headaches, with the goal to stop the need for medications in general. Sometimes, patients’ headaches will get worse during this period of weaning before they get better. Once we can stop the medication, we try to focus on a number of prevention strategies to manage the headaches.

So, when should you go see your doctor? If you’ve dealt with recurrent headaches for a while and have not seen a doctor for them before, you can always come in to be evaluated. Your doctor will ask a thorough history of your headaches, which will help them determine the need for further labs or imaging. If you have one of headache types discussed above, generally you won’t need imaging or labs to secure the diagnosis. However, there are things we call “red flag” symptoms which warrant immediate attention. These include a sudden, severe headache (the worst headache of your life, also described as a “thunderclap” headache), headaches with fever or weight loss, headaches after a head injury, or if you have any vision changes, numbness, or weakness. If you develop any of these symptoms, you should go to the emergency department to be evaluated.

Headaches affect a large portion of the population, and in most cases, can be managed by you and your PCP together. If you have any questions about the symptoms that you’re having, see your PCP. Together, the goal will be to control your overall symptoms and help you feel like you’ve regained control over your headaches.

Dr. Katie Vu is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.