Beginner’s Guide To Headache Types

Factors, Treatment, Prevention and Signs That Your Headache Requires Medical Attention

Did You Know? Headaches are the most common form of pain that necessitates a visit to the doctor. But many people don’t visit their physician concerning this ailment, and instead rely on over-the-counter medication. While this is a fine short-term fix, it isn’t a sustainable course of action for some conditions. With chronic headaches, it won’t be long before the recommended dosage doesn’t help with headache pain. Exceeding the recommended dosage of medicine for your pain can even cause a headache!

Most often, when your head hurts, you have a tension headache. Often related to stress, depression or anxiety, tension headaches are due to tight muscles in your shoulders, neck or jaw. Lack of sleep, alcohol use, and hunger can cause tension headaches, as can many of the stresses of everyday life.

Not every headache needs to be checked out by your doctor, of course. But the Headache Center at ADC would like to see you if any of these following statements are true for your headache. You should seek treatment in the following circumstances:

  • Sudden onset of excruciating pain
  • First or worst headache of your life
  • Worsening pattern of headaches
  • Fever associated with a headache
  • Rapid onset of headache with strenuous exercise
  • Any change in mental status or level of consciousness
  • New headache in patients under 5 or over 50

There are a number of other common types of headaches. Let’s look at each type and corresponding factors for each.

Sinus Headaches

Sinus headaches are caused by acute infection – usually with fever – producing blockage of sinus ducts. This blockage prevents normal drainage causing a gnawing pain over the nasal area. Often the pain increase in severity throughout the course of the day. Sinus headaches are rare, but migraine and cluster headaches are often misdiagnosed as sinus in origin.

  • Precipitating Factors: Infection, nasal polyps, anatomical deformities, such as deviated septum that blocks the sinus ducts
  • Treatment: Treat with antibiotics, decongestants, surgical drainage, if necessary
  • Prevention: None

Arthritis Headaches

Inflammation of the blood vessels of the head or bony changes in the structures of the neck is the cause of an arthritis headaches. They are recognizable by the pain at the back of head or neck which intensifies on movement.

  • Precipitating Factors: Cause of pain is unknown
  • Treatment: Anti-inflammatory drugs, muscle relaxants
  • Prevention: None

Caffeine-Withdrawal Headaches

Caffeine withdrawal headaches are real. They can occur multiple days after consumption of large quantities of caffeine. This headache is a throbbing headache caused by rebound dilation of the blood vessels.

  • Precipitating Factors: Caffeine
  • Treatment: Treat by terminating caffeine consumption in extreme cases.
  • Prevention: Avoiding excess use of caffeine.

Depression and Headaches

Depression is closely linked to chronic pain in the body – including migraine headaches, severe non-migraine headaches, and lower back pain.

  • Precipitating Factors: Causes can originate from a wide variety of complaints. Causes of depression are often categorized as physical, emotional, and psychic.
  • Treatment: Depression is a widespread affliction that can be treated. But diagnosing the presence of depression is frequently missed. Once discovered, however, there are many options for relief.
  • Prevention: Physicians can prescribe tricyclic antidepressants, selective serotonin re-uptake inhibitors, or monoamine oxidize inhibitors in the treatment of headaches associated with depression.

Exertional Headaches

Symptoms of exertional headaches include generalized head pain of short duration (minutes to an hour). They occur during or following physical exertion (running, jumping, or sexual intercourse). Passive exertion (sneezing, coughing, moving one’s bowels, etc.) can also bring on these types of headaches.

  • Precipitating Factors: Most (around ninety percent) are related to migraine or cluster headaches. In some cases, exertional headaches may be caused by organic diseases. Your doctor may look for signs of aneurysms, tumors, or blood vessel malformation.
  • Treatment: Extensive testing is necessary to determine the headache cause. Once determined, these are most commonly treated with aspiring, indomethacin, or propranolol. Surgery is occasionally the best way to correct the organic disease.
  • Prevention: Alternative forms of exercise; avoid jarring exercises

Fever Headaches

Fever headaches include generalized head pain that develops with fever, caused by the swelling of the blood vessels of the head.

  • Precipitating Factors: Caused by infection
  • Treatment: Aspirin; acetaminophen; NSAIDs; antibiotics
  • Prevention: None

Hangover Headaches

Migraine-like symptoms of throbbing pain and nausea, but it is not localized to one side. Hangovers can last up to 72 hours after drinking, but most are shorter in duration. Many personal and temporal factors drive the status of these types of headaches including: how much was consumed, level of dehydration, nutritional status, ethnicity, gender, the state of your liver, medications, etc.

  • Precipitating Factors: Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.
  • Treatment: Liquids (including broth); consumption of fructose (honey, tomato juice are a good source)
  • Prevention: Drink alcohol only in moderation

Hunger Headaches

A hunger headache is exactly as it sounds. A lack of proper nourishment causes muscle tension, low blood sugar, and rebound dilation of the blood vessels.

  • Precipitating Factors: Strenuous dieting or skipping meals
  • Treatment: Regular, nourishing meals containing adequate protein and complex carbohydrates
  • Prevention: Regular, nourishing meals containing adequate protein and complex carbohydrates

Hypertension Headaches

Very high blood pressure can trigger an event known as malignant hypertension, or a hypertensive crisis. This is most recognizable with generalized or “hair band” type pain that is most severe in the morning. It diminishes throughout the day.

Malignant hypertension usually is also associated with blurred vision, chest pain, and nausea. Read more about hypertension here.

  • Precipitating Factors: Severe hypertension: over 200 systolic and 110 diastolic
  • Treatment: Treat with appropriate blood pressure medication
  • Prevention: Keep blood pressure under control

Menstrual Headaches

For some women, Migraine-type pain occurs shortly before, during, or immediately after menstruation. For other women, this pain happens at mid-cycle (at the time of ovulation). The cause or trigger is thought to be the change of the level of estrogen. The blood level of this chemical (hormone) falls just before a period.

  • Note: A menstrual headache does not mean a low estrogen level. It is the natural dip of the hormone level that causes the pain.
  • Precipitating Factors: Variances in estrogen levels
  • Treatment: Taking a magnesium supplement might make your headaches shorter and your periods easier. Before beginning a new supplement, discuss this with a doctor. Limiting dietary salt before a period starts will reduce excess water in the body, which could create extra pressure.
  • Prevention: Biofeedback; beta blockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs

Chronic Daily Headaches

This refers to a broad range of headache disorders occurring more than 15 days a month. These headaches are categorized by duration of pain (less than four hours and more than four hours).

  • Precipitating Factors: Typically evolve from transformed migraine. Can be associated with medication overuse. They are not related to chronic tension-type headache, but can evolve from episodic tension-type headaches.
  • Treatment: Depending on the type of CDH, different treatment options exist. It is important to limit analgesic use.
  • Prevention: Based on diagnosis of headache, how long they last, and the number experienced per month. This requires extensive doctor or specialist intervention.

Finding out what triggers a headache or migraine may help to avoid or lessen the effects of headache symptoms. Also, we would love to help. Contact us if you need to schedule an appointment or have any further questions.

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Shift Work and Problem Sleepiness

Daytime sleepiness

About 20 million Americans (20 to 25 percent of workers) perform shift work. Most shift workers get less sleep over 24 hours than conventionally-scheduled day workers. Additionally, sleep loss is greatest for night shift workers, those who work early morning shifts and female shift workers with children at home. As a result, roughly 60 to 70 percent of shift workers have difficulty sleeping and/or problem sleepiness.

Roughly 60 to 70 percent of shift workers have difficulty sleeping and/or problem sleepiness.

The human sleep-wake system is designed to prepare the body and mind for sleep at night and wakefulness during the day. These natural rhythms make it difficult to sleep during daylight hours and to stay awake during the night hours, even in people who are well rested. It is possible that the human body completely adjusts to nighttime activity and daytime sleep, even in those who work permanent night shifts.

In addition to the sleep-wake system, environmental factors can influence sleepiness in shift workers. Because our society is strongly day-oriented, shift workers who try to sleep during the day are often interrupted by noise, light, telephones, family members and other distractions. In contrast, the nighttime sleep of day workers is largely protected by social customs that keep noises and interruptions to a minimum.

Problem sleepiness in shift workers may result in:

  • Increased risk for automobile crashes, especially while driving home after the night shift
  • Decreased quality of life
  • Decreased productivity (night work performance may be slower and less accurate than day performance
  • Increased risk of accidents  and injuries at work

What Can Help?

Sleep-there’s no substitute! Many people simply do not allow enough time for sleep on a regular basis. A first step may be to evaluate daily activities and sleep-wake patterns to determine how much sleep is obtained. If you are consistently getting less than 8 hours of sleep per night, more sleep may be needed. A good approach is to gradually move to an earlier bedtime. For example, if an extra hour is needed, try going to bed 15 minutes earlier each night for four nights and then keep the last bedtime. This method will increase the amount of time in bed without causing a sudden change in schedule. However, if work or family schedules do not permit the earlier bedtime, a 30-60 minute daily nap may help.

Medications/Drugs

In general, medications do not help problem sleepiness, and some make it worse. Caffeine can reduce sleepiness and increase alertness, but only temporarily. It can also cause problem sleepiness to become worse by interrupting sleep. While alcohol may shorten the time it takes to fall asleep, it can disrupt sleep later in the night, and therefore add to the problem sleepiness. Medications may be prescribed for patients in certain situations. For example, the short-term use of sleeping pills has been shown to be helpful in patients diagnosed with acute insomnia. Long-term use of sleep medication is recommended only for the treatment of specific sleep disorders.

If you think you are getting enough sleep but still feel sleepy during the day, contact us or schedule an appointment to be sure your sleepiness is not a symptom of an undiagnosed sleep disorder.

 

What To Expect When Visiting a Sleep Specialist

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According to the National Commission on Sleep Disorders, millions of Americans are needlessly suffering from undiagnosed or misdiagnosed sleep disorders. While poor sleep can have a negative effect on performance, alertness, memory, concentration and reaction times, it is also being linked to other health issues such as heart disease and depression.

Sleep disorders are a serious health concern. It is especially important for persons suffering from hypertension diabetes, obesity and heart failure to see a sleep specialist for the detection and treatment of sleep apnea as it may prevent heart attacks and strokes as well as minimize underlying symptoms of other diseases. Left untreated, sleep disorders can lead to increased health risks and an overall lower quality of life.

Symptoms of a sleep disorder can include:

  • Insomnia
  • Daytime sleepiness
  • Morning headaches
  • Constant leg movement
  • Gasping episodes at night
  • Overweight/obesity
  • Hypertension
  • Loud snoring
  • Dry mouth, sore throat
  • Forgetfulness
  • Loss of energy

What To Expect?

The first step will be an initial visit with our sleep specialist who will review your medical and sleep history. You will then schedule an appointment for an overnight visit. To help determine if a sleep disorder exists, your physicians will need to know what physiologic changes occur during your typical night of sleep. We do this by recording your brainwave pattern (known as the EEG) as well as your eye movements and degree of muscle tone. Using an EKG monitor, we will measure your heart rate and check for irregular heart beats during the night. Other measurements will include oxygen saturation, snoring, leg movements or jerking and respiratory effort. An intercom in the room will allow communication with the technician should you have any questions or require assistance. Studies will usually begin between 8:00pm and 9:00pm  and will conclude at about 6am. you will then follow up with your physician who will make recommendations for treatment of the disorder.

How To Prepare

 

In order to feel more comfortable with your stay, feel free to bring your toiletries and usual sleepwear and if you prefer, your own pillow. (It is helpful to avoid using hair products or skin lotions on the night of the study). It is recommended that you eat a meal prior to your study and continue to take medications as prescribed (unless your physician specifies otherwise). It is also preferred that you not consume foods or beverages containing caffeine after 5pm.

Finally…

Amarillo Diagnostic Clinic, P.A. is a distinguished group practice of physicians specializing in internal medicine and its major subspecialties and provides a wider range of diagnostic services on site. Each of the physicians at Amarillo Diagnostic Clinic has built their practices around their commitment to superior methods of diagnosis and treatment for their patients. Contact us if you have any questions or to set up an appointment.

Key Benefits Of ADC’s Patient Portal

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Ever walk out of your doctor’s office feeling overwhelmed or anxious? And please don’t even mention the painful wait times. That’s why we’ve given our patients the option to streamline their visits. Our Patient Portal is your safe and easy way to take care of many of your medical tasks associated with doctor visits.

Our portal is powered by FollowMyHealth, and it works as a universal health record. FollowMyHealth is a secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an internet connection. It’s also used by numerous health care organizations and thousands of physicians across the country. It is the driving force behind their hospital or clinic’s specific patient portal. While portals may have a different name, the technology is the same. Using a secure username and password, patients can view health information such as appointments, clinical summaries, medications, immunization, allergies, and lab results.

With FollowMyHealth, you can:

  • Review your medical records online in a safe, secure environment
  • Communicate privately with physicians via secure messaging
  • View test and lab results, read medical notes from your doctor
  • Update your health information (allergies, medications, conditions, etc.)
  • Request Rx refills
  • Schedule or change appointments
  • Fill out and submit forms prior to appointments
  • Share information with other doctors/clinics
  • Fax, print or email records for external use

Best of all, it’s available online anytime via any computer, tablet, or smart phone. With people bypassing the doctor’s office every chance they get, we believe that it’s important for medical offices to adopt these service improvements so patients can have the best experience overall.

Take the stress out of staying healthy. Sign up or log in now.

It’s Time To See Your Heart In Motion

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Some information provided by The American heart Association.

Echocardiograms use ultrasound to evaluate heart and circulatory function.  This non-invasive procedure gives your physician real-time images of the heart in motion.  These real-time images enable your physician to accurately diagnose a wide range of cardiac abnormalities and initiate appropriate treatment.

What Is It Used For?

Your doctor may suggest an echocardiogram if he or she suspects problems with the valves or chambers of your heart or if heart problems are the cause of symptoms such as shortness of breath or chest pain. An echocardiogram can also be used to detect congenital heart defects in unborn babies (fetal echocardiogram).

Why Do People Need An Echo Test?

  • The size and shape of your heart, and the size, thickness and movement of your heart’s walls.
  • How your heart moves.
  • The heart’s pumping strength.
  • If the heart valves are working correctly.
  • If blood is leaking backwards through your heart valves (regurgitation).
  • If the heart valves are too narrow (stenosis).
  • If there is a tumor or infectious growth around your heart valves.

Are There Any Risks?

Echocardiograms are considered very safe. Unlike other imaging techniques such as X-rays, echocardiograms don’t use radiation.  There are different types of echocardiogram tests. A transthoracic echocardiogram carries no risk. There is a chance for slight discomfort — similar to pulling off a Band-Aid — when the electrodes are removed from your skin.

How Can I Learn More About Echocardiograms?

Talk with a doctor. Here are some good questions to ask:

  • What are you looking for in my heart?
  • Why are you doing this test instead of another test?
  • What do I need to do to get ready for this test?
  • When will I know the results?
  • Do you expect me to have other tests?

At Amarillo Diagnostic Center, we will work with you to develop a treatment plan that is best for your needs. Contact us if you would like to set up an appointment or if you have any questions.

 

Smart Strategies To Living Less Stressed

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April is stress awareness month, which means it’s time to talk about how stress can negatively affect your physical and emotional health as well as give you some ideas on cutting the unnecessary stress out of your life. Ready? Let’s begin.

Chronic Stress

On one hand, stress is inevitable and a necessary part of life. There is, however, serious consequences to not handling stress in a healthy manner. Even short-lived stress can have an impact. Chronic stress has been proven to increases the risk of developing health problems including obesity, diabetes, heart disease, cancer, and a weakened immune system. Chronic stress also has a significant negative effect on a person’s mental health. Many studies show a correlation between stress and the development of mood disorders such as anxiety disorders and depression. According to the American Psychological Association, 66 percent of people regularly experience physical symptoms of stress, and 63 percent experience psychological symptoms. Some people don’t realize the effects of stress until the effects have already negatively affected them. 

Tips For Managing Stress

Fortunately, there are many ways to manage the unhealthy stress. Some of these tips may be more helpful than others, and some might already be included in your daily routine. Regardless, here’s a few tips that will help:

  • When feeling stressed, slow down and take deep breaths. Try to Inhale through your nose, and exhale through your mouth
  • Exercise
  • Find a friend or family member you can trust and talk it out
  • Laugh
  • Be Positive
  • Seek out activities that involve others
  • Manage your time, be sure to not overwork yourself
  • Take a walk
  • Don’t self-medicate with alcohol or other drugs

Even the most organized people aren’t immune to experiencing stress. If you have questions or need more advice on managing stress, contact us or schedule an appointment.

 

On Restless Leg Syndrome (Series: Pt .2)

Gary Polk, M.D.

Gary Polk, M.D.

The Role of Genes, Family History and Gender

RLS symptoms are not rare; it is one of the most common movement disorders. Some authors feel that after obstructive sleep apnea, RLS may be the most significant sleep disorder (4). In one circadian study as many as 15% of those surveyed had noted “restlessness of the legs”.

One interesting finding of the survey was that French Canadians had a higher frequency of symptoms compared to Canadians of English descent, indicating a potential genetic role in RLS. Large numbers of patience with RLS symptoms have a positive family history of RLS as well.

Although no specific gene abnormality has been found as a cause of RLS, patients with familial RLS (as compared to sporadic RLS) have an earlier onset and severity of symptoms. Overall it is estimated that the prevalence of RLS is 5-10% of the population. Additionally, there does appear to be an increased frequency in women compared to men by a 2 to 1 margin.

Impact On Quality of Life

RLS can have a significant negative impact on the quality of life. Quality of life surveys often show a decreasein vitality, physical functioning and general health in RLS sufferers compared to the general population. Other quality of life parameters negatively affected include social functioning and mental health. The disturbances caused by RLS were similar to other chronic medical conditions such as hypertension, diabetes mellitus, and osteoarthritis.

Poor Sleep

RLS sufferers often complain of poor or restless sleep. Many patients have marked difficult falling asleep at night due to leg discomoft. They also appear to have an increased frequency of awakenings during the night. Patients with RLS tend to spend more time awake during the night than the general population. Also about 80% of RLS patients have associated stereotypical leg movements, known as periodic limb movements of sleep that can disturb their sleep or the sleep of their bed partners.

Snoring?

We Can’t Get Away From It, Right? Wrong!

Snoring is one of those problems that affects women directly (if they snore) or indirectly (if their partner snores). The bad news is, snoring may be a symptom of a serious, potentially life-threatening, condition called sleep apnea. The good news is, for most people both snoring and sleep apnea can be eliminated in one day.

Approximately 40 million Americans suffer from chronic sleep disorders such as sleep apnea, narcolepsy or insomnia. An additional 20-30 million individuals experience intermittent sleep related problems.

Excessive sleepiness may be due to sleep-deprivation or may be a sign of a sleep disorder, the most dangerous of which is sleep apnea. Sleep apnea means cessation of breathing during sleep and usually occurs from a blockage in the back of the throat. Snoring is the most common symptom that warns of sleep apnea. When snoring and sleepiness co-exist, the likelihood of sleep apnea must be considered. In some cases, the sleepiness can be life-threatening, particularly for people who drive a motor vehicle or operate equipment that may be dangerous.

Simple non-invasive testing can be performed to accurately diagnose most of the conditions that cause snoring or excessive sleepiness. If treatment is necessary it can be accomplished through a second night study. In most cases, you will become more alert and productive the very next day without surgery or medications. These conditions can be very quickly corrected, resulting in an improved quality of life as well as decreasing cardiovascular risks for heart attacks, strokes and irregular heartbeats.

In an attempt to keep pace in today’s society, women are often plagued with numerous stressors in their life. Balancing home and family responsibilities along with a professional life may cause sleep deprivation, anxiety or even depression. A common symptom that can be brought on by this stress is insomnia.

Developing good sleep habits can often decrease or eliminate symptoms of insomnia. These include avoiding caffeine for six hours before bedtime and avoiding alcohol and smoking for one to two hours before bedtime. Exercise can be very helpful but not too close to bedtime. It is also important to maintain a regular sleep/wake cycle. By awakening every day at the same time and going to bed around the same time each day, your internal clock is able to be regulated and work with you.

Other disorders can also disturb your sleep. They may include periodic movements in sleep, restless legs syndrome, nightmares, panic attacks, sleep walking, sleep talking and many others.

The good news is that diagnosing and treating these ailments is nothing to lose sleep over.

Additional information about sleep disorders can be obtained from the American Sleep Disorders Association or by scheduling an appointment for a consultation with a sleep specialist.

ADC Sleep Disorders Center

ADC Sleep Disorders Center

Visit the Sleep Center at ADC

This Friday: “Gut Instinct” Event (Feat. Dr. Joanna Wilson)

Gut Instinct Lecture (HerCare)

Gut Instinct Lecture (HerCare)

ADC’s Dr. Sean Milligan (Neurology) Named Partner In MS Care

The National Multiple Sclerosis Society designated Dr. Sean Milligan, Neurologist, Amarillo Diagnostic Clinic, P.A. as Partner In MS Care

Congratulations Dr. Milligan!

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