Headache

A headache is a pain or discomfort experienced in the head, scalp, or neck. It can range from a mild, dull ache to severe, debilitating pain. It may occur as a primary condition or symptom of an underlying issue. There are generally two types:

Primary Headaches:

An underlying condition does not cause these headaches and include:

Tension Headaches: Result from muscle tension in the head, neck, or shoulders

Cluster Headaches are Characterized by severe, piercing pain, typically around one eye, that often occurs in cyclical patterns or clusters

Exertional Headaches: Triggered by physical activity

Migraine: Marked by intense, throbbing pain (often on one side of the head), accompanied by symptoms such as nausea, vomiting, and sensitivity to light or sound

Secondary Headaches:

An underlying medical condition causes these headaches and include:

Cervicogenic Headache: Pain originating from the neck, such as poor posture or cervical arthritis

Medication Overuse Headache: This occurs due to the frequent use of pain-relief medications

Head Injury: Trauma to the head can lead to persistent headaches

Dehydration: Insufficient fluid intake often results in dull and throbbing pain

Eye Strain: Prolonged screen time or uncorrected vision problems can cause discomfort

Trigeminal Neuralgia: Intense, stabbing facial pain, often mistaken for a headache

Lifestyle Factors: Sleep problems, stress, and anxiety

Assessment and Diagnosis:

To effectively manage headaches, a thorough evaluation is crucial for identifying the underlying cause. This includes the following components:

Comprehensive history and assessment

Investigation: MRI, X-ray, CT scan

Follow-up for the personalised multimodal management plan

Review of the agreed-tailored pathway outcomes

Multimodal Treatment:

The underlying cause determines treatment and may include:

Initiation of oral analgesics

Physiotherapy, massage, acupuncture

Relaxation techniques such as deep breathing, meditation, or yoga

Cognitive Behavioural Therapy (CBT) for stress or anxiety

Injections to the occipital nerves

Trigger point injections with local anaesthetic and steroids

Botox injections to the forehead, temples, neck, and shoulders

Spinal injections to the medial branches of the cervical facet joints

Radiofrequency denervation or ablation of the medial branches of the cervical facet joints

Surgical consultation, if necessary

Headache

Primary Headaches:

Secondary Headaches:

Assessment and Diagnosis:

Multimodal Treatment:

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