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Aching Head

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EHS Corporate Care

Most busy executives have suffered from a pounding headache at one time or another. Pain can occur bilaterally across your forehead, on one side of your head or even in the back of your head and down your neck.  The pain can be throbbing, burning, jabbing or dull.  The pain can even range from annoying to so fierce nausea or dizziness soon follows.  There are many different kinds of headaches, all with different causes and symptoms. On top of these differences, most headache symptoms are divided into four different phases and different people experience the phases to varying degrees.

Although headaches can be caused by a multitude of events and conditions, ultimately, headaches are due to some basic issues.  While brain tissue itself has no sensitivity to pain, the head includes blood vessel walls, membranous coverings of the brain, and scalp and neck muscles which are considered pain structures. Thus, headaches may be caused by muscle contraction of the scalp, face or neck; blood vessels dilation in the head; or swelling that stretches the brain’s coverings. Specific nerves within your face and head can also cause common headaches.

In general, the most common headaches are considered tension-type headaches (TTH) and experts estimate that more than three-quarters of all headaches are TTH.   As the name implies, TTH is often related to stress or anxiety, and is caused by tightening or stiff muscles in your shoulders, neck, scalp, and jaw. Too much work, too little sleep, skipping meals and alcohol can cause headaches that fall within the TTH category, and certain foods or additives such as chocolate, cheese, coffee and monosodium glutamate (MSG), are tension headache stimuli.

The average person will treat these periodic TTH with over-the-counter pain relievers, an ice pack, and if you’re lucky, a nap. Massage, meditation, and relaxation exercises are also helpful. However, avoid aspirin, ibuprofen, or acetaminophen for an alcohol related headache because these may irritate your stomach lining and even cause liver problems.

Far more severe are migraine and cluster headaches.  The horrendous migraine headaches often include other debilitating symptoms like visual disturbances or nausea. An “aura” of various forms of light often is a warning sign to the throbbing, pounding, or pulsating pain of a migraine.  Cluster headaches are sharp, extremely painful headaches that often occur multiple times a day for months and then disappear for months.

Less common headache types include sinus headaches which cause pain in the front of your head and face due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes.  More rare, are the headaches that preclude severe health issues – brain aneurysms (a weakening of the wall of a blood vessel that can rupture and bleed into the brain), brain tumors, strokes or TIA, and brain infections such as meningitis or encephalitis.

Executives over the age of 50 that begin experiencing headaches for the first time should be aware of a condition called temporal arteritis.  Because there is a risk of blindness, if your headache is accompanied by impaired vision and pain that’s aggravated by chewing, contact your doctor immediately for treatment.

Headaches can range from annoying to debilitating.  If you suffer repeated headaches, or the more severe types, contact your doctor at EHS Corporate Care for a personalized therapeutic solution.

John P Mamana, M.D.

EHS Corporate Care

(703) 230-6990


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