Do the headaches recur for weeks at a time?
Cluster headaches occur off and on for weeks at a time over the course of a few months. These headaches are rare, but most often affect men and smokers. Cluster headaches:
- Begin and evolve quickly, becoming intense within minutes
- Tend to develop at the same time of day or night
- Can occur several times per day during a cluster period
- Usually affect one side of your head, often behind an eye
- May occur with tearing, redness or swelling of the eye on the affected side of the head
- Cause a runny or stuffy nose
- Typically last from 15 minutes to three hours
- May cause agitation or a restless feeling
Cluster headaches tend to subside quickly, so treatments need to be fast-acting. Treatments may include:
- Injectable medications, such as sumatriptan (Imitrex, Sumavel Dosepro, others), for quick relief during an attack
- Prescription triptan nasal sprays, such as zolmitriptan (Zomig NS) or sumatriptan (Imitrex Nasal Spray)
- Oxygen therapy (breathing pure oxygen via mask)
- Preventive medications, such as verapamil (Verapamil HCL, Verelan, others)
Do you take pain medication more than 2 or 3 days a week?
Medication-overuse headaches occur from overuse of pain relieving medications for headaches for at least three months. They develop at least 15 days out of the month, and often occur along with chronic daily headaches. Taking pain medication several times per month can increase the risk of developing medication-overuse headaches.
Sometimes called rebound headaches, medication-overuse headaches:
- Feel dull, achy, throbbing or pounding
- May awaken you early in the morning and persist all day
- May be most painful when medication first wears off
- Occur daily or nearly daily
- Sometimes cause nausea, trouble concentrating or irritability
Typical treatment involves discontinuing the medications that cause these headaches. Sometimes medications need to be tapered off, and sometimes they are stopped altogether.
You may need preventive medications or other treatments, called bridge therapy, to help control pain as you stop taking the medications that caused your medication-overuse headaches. Your doctor can help you come up with the best plan.
Recognize emergency symptoms
Seek emergency evaluation if you experience:
- A very severe, sudden headache
- Headache after a head injury or fall
- Fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking
- Pain that worsens despite treatment
These symptoms suggest a more serious underlying condition, so it's important to get a prompt diagnosis and treatment.
Almost everyone gets headaches, and most are nothing to worry about. But if headaches are disrupting your daily activities, work or personal life, it's time to take action. Headaches can't always be prevented, but your doctor can help you manage the symptoms.
July 28, 2015
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