headache Flashcards
types of primary headaches
tension, migraine, cluster
dif btwn primary and secondary
primary not associated with underlying cause
self-treatment for secondary
all excluded from self-treatment except for minor sinus HA
tension HA location
- Bilateral
- Top of head to base of skull
- pain like a band squeezing the head
tension HA nature
Varies: diffuse ache to tight, pressing, constricting pain
tension HA onset
gradual
tension HA duration
minutes to days
tension HA other symptoms
scalp tenderness
tension HA, consult physician if
chronic, ≥15 days/month for ≥ 6 months
tension HA non-drug treatments
physical therapy, relaxation exercises, acupuncture
migraine HA location
-Usually unilateral
migraine HA nature
- Throbbing, may be preceded by an aura
- pain, nausea, visual changes typical
migraine HA onset
Sudden
migraine HA duration
Hours to 2 days
migraine HA other symptoms
Nausea, vomiting, photophobia, phonophobia, sinus symptoms, tinnitus, light-headedness, vertigo, irritability
migraine HA family history
70% have family history
migraine HA non-drug treatments
- Maintain regular sleep, eating and exercise schedules
- Stress management
- Biofeedback
- Cognitive therapy
- Ice/cold packs with pressure to forehead or temple
- Avoid triggers
migraine HA drug treatments timing
- Predictable migraines (e.g. menstruation), ibuprofen or naproxen before and throughout event
- Once migraine starts, analgesics less effective
migraine HA supplements
Oral magnesium reduces migraine frequency and intensity
cluster HA location
pain is in and around 1 eye
sinus HA location
Face, forehead or periorbital area
sinus HA nature
Pressure behind eyes or face,
Dull bilateral pain
Worse in the morning
sinus HA onset
Simultaneous with sinus symptoms, including purulent nasal discharge
sinus HA duration
Days (resolves with sinus symptoms)
sinus HA other symptoms
Nasal congestion
Intensified with stooping or blowing nose
analgesics limitations
limit to 3 days/week to avoid medication-overuse headache
do not take >10 days unless reommended by provider
referral, length
Persists ≥ 10 days
referral, age
< 8 years of age
referral, migraine
Undiagnosed migraine HA
referral, pregnancy
3rd trimester of pregnancy
referral, medical conditions
History of liver disease
High fever or signs of serious infection
referral, alcohol
≥ 3 alcoholic drinks/day
headache treatment goals
Alleviate acute pain Restore normal functioning Prevent relapse Minimize side effects Reduce frequency Prevent medication overuse
sinus HA cause
Infection/blockage -> inflammation or distension of sinus walls
Accompany acute sinusitis
-Symptoms: toothache (upper teeth), facial pain, nasal congestion, nasal discharge
sinus HA treatment
Respond well to decongestants
Pseudoephedrine most effective
sinus HA, referral if
Persistent sinus pain and/or discharge suggests infection and requires medical referral
analgesics overuse, rebound HA
Rebound following analgesic withdrawal
Associated with > twice/week use for ≥ 3 months
preventing rebound HA
Taper analgesics and subsequently eliminate
Treat with medical supervision
Prescription medication may be needed for increased headaches during withdrawal period.
