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Oh My Aching Head

By Matthew Holsen

Types & Symptoms Of Primary Headaches

More than 90 percent of headaches occur on their own, meaning they aren't caused by any underlying disease. These types of headaches are called primary headaches. And while a migraine is the most common primary headache doctors treat, there's another type people get more often.

"Sometimes they're mild, sometimes they're severe and people are miserable with them," Sanford Neurologist Dr. Jerome Freeman said.

The headache Freeman is describing is by far the most common, known as a tension-type headache. They can make it seem like you have a tight band around your head or give you the uncomfortable feeling that your head and neck are stuck in a vice.

"Sometimes a build up of stress and pressure can contribute to that type of headache," Freeman said.
Pain from a tension headache usually starts in the middle of the day and can get worse as the day goes on. It can last for hours or days if untreated and can happen several times a week.

"Sometimes treatment to the neck can help like massage or heat, neck exercises, a lot of times they'll use a neck pillow," Freeman said.

Another type of primary headache is the migraine. The pain of migraine headaches is often described as an intense pulsing or throbbing pain in one area of the head.

It's considered to be one of the most debilitating diseases in the world and it affects nearly 28 million percent.
A lot of people use medicine to keep their migraines as mild as possible, but sometimes, taking several meds isn't enough to keep headaches at bay.

"I often see people who've been on five or ten medicines and they still have an every day headache so you have to do things other than just medicine to get that person better," Freeman said.
Learn more about primary headaches online.


More Women Complain Of Headaches Than Men

If you feel like women complain of headaches more often than men, you're right. In fact, three out of four people who have migraines are women.

Like most women, the birth of a new baby is only one of the blessings associated with Ashlee Johnson's pregnancy.

"If they've had a history of migraines, most of them will actually have improvement in their migraines. Very few will have a worsening of their migraine symptoms when they're pregnant," Dr. Ashley Briggs, an OBGYN with Sanford Women's Health, said.

But unfortunately, doctors also believe the same hormone that plays a role in pregnancy, may also play a role in who gets headaches most often.

"We believe it's related to the hormones and specifically the estrogen that women have in a higher concentration than men," Briggs said.

Ironically, while a high level of estrogen actually protects many women from having headaches during pregnancy, a sudden drop in that same hormone can also cause a dramatic jump in a woman's headaches around that certain time of the month.

"So that can definitely be a sign when women would start having migraine headaches when they develop their menstrual cycle," Briggs said.

In fact, more than half of all women's migraines hit either right before, during or after a period. That's because just days before a woman's cycle begins, hormone levels fluctuate and estrogen, which usually helps boost the brain's tolerance for pain, drops off sharply.

"As their hormone levels stabilize, their headaches will improve," Briggs said.

So while Johnson may still get an occasional headache these days...
"The stress on your body, you have more tension in your back and sometimes it leads to your head," Johnson said.

She's awfully glad she can expect fewer of them while she's expecting.


Large Number Of Migraine Sufferers Go Untreated

Migraines are a serious problem for those who get them. But there are many things that can be done to buffer the pain. A lot of people seek medical treatment, but there are still many who don't and doctors aren't sure why.

Maybe one of the reasons doctors don't see as many patients as they would like has something to do with the use of over-the-counter medications. They are usually the first line of defense for people who have headaches. And doctors say they can do a lot to help people with all types, including migraines.

"The strong majority of the patients can respond to something to make their life better so that they're managing their life rather than their headaches managing their life," Dr. Carol Miles with the Avera Headache Clinic said.

Some of the most commonly used headache remedies include acetaminophen and non-steroidal anti-inflammatory drugs. Acetaminophen, or Tylenol, increases the amount of pain your brain can handle while anti-inflammatory drugs like aspirin, Advil, Motrin or Aleve, interrupt the production of certain pain-inducing chemicals. If these aren't enough, you might want to visit a doctor to see if prescription medications are your next step.

"At this time, there's so many good treatments it's kind of silly not to go in and get treated," Miles said.

Doctors can prescribe a variety of things for their patients when a migraine hits. But you won't know what works for you unless you see a doctor for your pain.

"They give them a combination of medication depending on what they're complaining about with their headache at that time," Miles said.

And since not very many people head to the doctor's office for their headaches, a lot of people with pain are going untreated.

"The numbers are incredibly high," Miles said. "It's not a curable disease but it is a treatable disease."

"You're kind of limited to what you can take for the headache so they don't go away as fast," Johnson said.


Using Botox To Help Migranes

If different pain medications don't work for your headaches, you may need to find something else to help. It's up to you if that means controlling what you can by eating better or getting exercise. But there are other ways to ease the pain and one in particular might surprise you.

You've likely heard of people using Botox to get rid of unwanted wrinkles on their face, but the treatment is also helping headache sufferers in South Dakota. Allison Heitmann has battled migraines for more than a decade and sometimes the pain can be almost too much to bear.

"I'd end up actually passing out because of them and throwing up and be in the ER for a few hours and then I'd be on my way," Allison said.

Being in and out of the hospital because of severe headaches isn't something anyone wants to deal with, especially someone like Allison with a husband and a little boy at home. She says it often takes all she has just to make it through her workday and once she heads home, she doesn't have the energy to be with her family.

"When she comes home, you know she just needs a break, and so that's when I come home and Blaine and I get to hang out and have supper," husband Jeff said.

After trying just about every kind of medication you can think of, her doctor approached her with a new idea.
"I had a newborn to take care of so I went to the physician and he said that Botox was a good option and I thought, 'Botox? That's kind of what the stars use for their face,'" Allison said.

After thinking about it for a moment, she decided to give it a shot. And now, Allison gets the injections in her forehead about every three months.

"It feels like a piece of tape is across your forehead but if it helps, heck, we'll do it," Allison said.
And living like that has been the only way she's been able to get her migraines under control.

"I've had them for 15 years and I'm not really the one to kind of sit in the back and just kind of put up with them because they do affect your life. I mean, you miss work and you miss family activities when you have to be in a dark room, in a quiet room with an ice pack on your head," Allison said.

Changing The Way You Think About Pain

That struggle to live life free of headache pain can lead a lot of people to frustration and sometimes depression. If medications and treatments designed to help you get better don't work and you start feeling overwhelmed, it might be time to take a look at how you think about pain.

Donald Baum specializes in pain management at the Avera Behavioral Center. He says a lot of his patients have literally been overtaken by how bad they feel on a daily basis.

"They start to take on a pain identity, it's like pain becomes who they are," Baum said.
Most of the people who come to his office are sent by doctors who are at their wit's end when it comes to figuring out what's wrong.

"When they get to that point when they feel like they've done everything they can do and they're really not coming up with anything new that's really helping the patient progress further, then we'll come in and look at the psychological part," Baum said.

But it's not always a smooth transition for the patient.

"Of course they have that kind of, 'Oh, so you think it's in my head,' kind of feeling," Baum said.

He says once they get over that idea and embrace that how they think can have a big impact on how they feel, progress can be made and people can once again start to gain control of their life.

"Even though the pain is still there, they start to realize that, 'Well yeah, I have pain but it's there. It's part of my life but I also have all these other parts of my life that are just as important, more important that I want to work at,'" Baum said.

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