Take action to get ahead of your painful headaches

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— Searing. Throbbing. Dull squeezing. Vice grip.

These are a few of the descriptions people use to characterize their headaches. They might also add "costly" to that list. The estimated 45 million Americans who have chronic headaches and 23 million who experience migraines rack up an annual $13 billion in missed work and lowered productivity.

June 4 through 10 is National Headache Awareness Week. For more information about diagnosis and treatments, contact the National Headache Foundation at 1-800-843-2256, or log on to www.headaches.org.

Ninety percent of all headaches fall into one of two categories: tension or migraine. Tension headaches affect both sexes equally and may be either isolated or a daily occurrence. Rarely one-sided, tension headaches usually create a dull, pressure-like discomfort in the temples, across the forehead and/or the back of the neck.

Stress, fatigue, noise, glare, inactivity or poor posture may aggravate the headache.

Prevention is the best treatment: Practice stress management techniques, get adequate sleep, massage the affected muscles and use over-the-counter analgesics for a short duration (long-term use may cause rebound headaches). Botulinum toxin, which can be injected into muscles to cause a temporary weakening, has been an effective treatment.

Migraine headaches most commonly occur in women and usually begin between the ages of 10 and 46.

Migraines may result from the constriction of blood vessels in the head and neck. They are usually characterized by a throbbing, pulsating pain on one side of the head that lasts for six to 48 hours.

Twenty percent of migraines are termed classical, which means they are preceded by a group of neurologic symptoms called an aura. Some of these symptoms are dizziness, tingling, nausea and sensitivity to light and sound.

Treatment of migraines may include avoiding known triggers, such as certain foods and smells, and taking analgesics and specialized medications. Those medications include beta-blockers, calcium channel blockers, antidepressants and drugs that affect serotonin levels in the brain. Botulinum toxin has also been effective.

Sometimes headaches indicate serious medical problems, particularly if they become increasingly frequent and severe. Seek medical attention promptly if your headache:

n Affects one side of the head;

n Is sudden and severe;

n Is accompanied by nausea, vomiting and sensitivity to light and sound;

n Causes confusion, loss of consciousness or change in vision;

n Lasts longer than 24 hours and does not respond to pain relievers;

n Is the worst headache of your life;

n Is associated with a stiff neck and fever; or

n Is the result of a head injury

Your health care provider will take a detailed history, so be prepared for questions by keeping a "headache diary."

A physical exam will also be performed. Rarely, patients may need a head MRI, sinus CT scan, temporal artery biopsy or other diagnostic tests. With the right diagnosis and treatment plan, you may get ahead of your headaches.

Maryann Wall, M.D., is an otolaryngologist and facial plastic surgeon with Northwest Colorado Ear, Nose, Throat and Facial Plastic Surgery in Steamboat Springs.

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