Why Does it Hurt?
What hurts when you have a headache? The bones of the skull and
tissues of the brain itself never hurt, because they lack
pain-sensitive nerve fibers. Several areas of the head can hurt,
including a network of nerves which extends over the scalp and
certain nerves in the face, mouth, and throat.
A number of chemicals help transmit pain-related information to
the brain. Some of these chemicals are natural painkilling
proteins called endorphins, Greek for “the morphine within.”
Not all headaches require medical attention. Some result from
missed meals or occasional muscle tension and are easily remedied.
But some types of headache are signals of more serious disorders,
and call for prompt medical care.
* Sudden, severe headache
* Sudden, severe headache associated with a stiff neck
* Headache associated with fever
* Headache associated with convulsions
* Headache accompanied by confusion or loss of consciousness
* Headache following a blow on the head
* Headache associated with pain in the eye or ear
* Persistent headache in a person who was previously
* Recurring headache in children
* Headache which interferes with normal life
What Tests Are Used to Diagnose Headache?
Patients may be asked: How often do you have headaches? Where
is the pain? How long do the headaches last? When did you
first develop headaches? The patient’s sleep habits and family
and work situations may also be probed.
A complete and careful physical and neurological examination
will exclude many possibilities and the suspicion of aneurysm,
meningitis, or certain brain tumors. A blood test may be ordered
to screen for thyroid disease, anemia, or infections which might
cause a headache.
EEG’s can indicate a malfunction in the brain, but they cannot
usually pinpoint a problem that might be causing a headache.
Headaches are diagnosed as
* Muscle contraction (tension)
Vascular headaches – a group that includes the well-known
migraine – are so named because they are thought to involve
abnormal function of the brain’s blood vessels or vascular system.
Muscle contraction headaches appear to involve the tightening or
tensing of facial and neck muscles.
Traction and inflammatory headaches are symptoms of other
disorders, ranging from stroke to sinus infection. Some people
have more than one type of headache.
When is Headache a Warning of a More Serious Condition?
Like other types of pain, headaches can serve as warning signals
of more serious disorders. This is particularly true for
headaches caused by traction or inflammation.
Traction headaches can occur if the pain-sensitive parts of the
head are pulled, stretched, or displaced, as, for example, when
eye muscles are tensed to compensate for eyestrain.
Stroke. Headache may accompany several conditions that can lead
to stroke, including hypertension or high blood pressure,
arteriosclerosis, and heart disease. Headaches are also
associated with completed stroke, when brain cells die from
lack of sufficient oxygen.
Many stroke-related headaches can be prevented by careful
management of the patient’s condition through diet, exercise,
If you suffer from headaches and none of the standard treatments
help, do not despair. Some people find that their headaches
disappear once they deal with a troubled marriage, pass their
certifying board exams, or resolve some other stressful problem.
Others find that if they control their psychological reaction
to stress, the headaches disappear.
For those who cannot say no, or who get headaches anyway,
today’s headache research offers hope. The work of scientists
around the world promises to improve our understanding of this
complex disorder and provide better tools to treat it.