Headaches can be acute or chronic. An acute headache that causes severe pain, visual problems, or symptoms like speech difficulties, muscle weakness or numbness can be a very serious situation and requires immediate emergency care. Chronic headaches, however, tend to be related to problems like a muscle spasm, neck injuries, and migraines. Pain may range from mild to severe, and migraines are often accompanied by other symptoms.
Muscle tension occurs for several reasons. The head weighs about 12 pounds, and sitting or standing with the head thrust forward can stress the neck muscles. Spending long hours in front of a computer can also stress neck muscles and cause joint irritation. Alignment problems in the neck and degenerative disc disease can also cause muscle tension and spasm. All of these may lead to tension headaches, as can chronic generalized stress.
Although migraines may also be associated with muscle tension, they are primarily vascular. Blood vessels in the brain suddenly narrow and then expand when a migraine occurs. Migraines may cause an “aura” that precedes the actual headache; flashing lights are a common sign of a migraine. In addition to pain, people with migraines may be acutely sensitive to light and noise, or have nausea and vomiting. A migraine may only last for a few hours or may last for several days. Another type of vascular headache is a cluster headache.
Although both muscle tension and migraine headaches may be treated with pain medications, they are typically treated with different kinds of medicines. Over-the-counter medications may be sufficient for muscle tension headaches but in severe cases, medications to relax the muscles may also be used. Migraines may be treated with preventive medications that include medications to affect the blood vessels, antidepressants, and anti-seizure medications. Medications to control the pain include opioids, ergot for long-lasting migraines, and triptans, which block pain pathways in the brain. Lifestyle factors like stress management, good sleep habits and diet may also affect migraine patterns. Identifying and avoiding headache triggers is also important. Botulinum toxin injections are FDA approved for treatment of chronic headaches. Other injections may also be effective including trigger point injections, occipital nerve blocks, and cervical facet injections. Physical Therapy, heat, ultrasound, massage, stretching, and range of motions exercises may also be helpful.
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