Most of us would only realize that we are under intense pressure when we feel the start of a migraine. Unlike the usual headache, migraines are often accompanied by photophobia (light sensitivity), phonophobia (sound sensitivity) and/or nausea (sometimes, it can be as severe as vomiting). Health care providers point this out as one of the most frequent complaints.
This episodic disorder affects more women than men. It is more frequent during two phases of life: puberty and/or perimenopausal. If you have not reached out to your doctor about this, it can cause a significant mental, physical, financial, medical, societal, and personal burden.
Primary care practitioners are essential in identifying and treating headache disorders, including migraine. That is why you should give them pertinent information from headache specialists to give better care to their patients. The International Classification of Headache Disorders (3rd edition) defines migraine to include the following:
- At least five or more attacks in a lifetime
- Headache attacks lasting 4-72 hours
- At least two out of four features (unilateral location, pulsating/throbbing quality, moderate-severe intensity, aggravation by/causing avoidance of routine physical activity)
- At least one of the following symptoms (nausea, vomiting, photophobia, and phonophobia)
Headache is one of the most common symptom presentations in primary care with more than 90 percent of all primary headaches falling into two categories, namely: tension-type headache and migraine headache. It is estimated that three billion individuals worldwide suffer from headaches, with 1.89 billion patients with tension-type headaches and 1.04 billion with migraine.
Most often, people complain about tension headaches, but they mistakenly call them migraine. The latter is considered the second most disabling medical condition worldwide, impacting all domains of life. Given the pervasiveness of headaches in the populating and frequency with which patients present in a primary care setting, your doctor should have a good grasp of the different headache syndromes and management.
Classification of Headaches
It is understandable that you depend on your doctor for your medical needs. But having basic knowledge about headaches will help you. Headaches are (traditionally) classified as primary (tension-type headaches, migraines, cluster headaches) or secondary headaches (intracranial pathology, vascular disease, medication overuse headaches). With careful diagnosis and a thorough review of your medical history, your physician can identify which type.
Your doctor would take note of the historical features, including location, characteristics of the headache, degree of functional impairment, duration, and associated symptoms. The physical examination should focus on discriminators of secondary etiologies: vital signs (blood pressure and pulse), bruits of the head and neck, palpation of the temporal arteries, and palpation of the head, neck, and shoulder muscles, with a detailed neurological examination, including cranial testing, fundoscopy, and symmetry of motor, reflex, cerebellar and sensory testing.
Your doctor will tell you that you are at low risk of secondary headaches if you are:
- Age 50 years or younger
- Features typical of a primary headache syndrome
- History of similar headache with no change in the usual pattern
- Normal physical examination
As mentioned in this article, we would experience migraine at least five times in our lifetime. It may be brought about by tension or a symptom of something graver. With that said, it is important that we inform our doctor of all pertinent information.
If your headaches are hindering you from functioning, you should ask for help from a respected doctor in Tyrone, GA. We take great pride in our profession and will do everything within our means to put you back on track, so schedule an appointment now!