Think… How many times in the past year have you had a headache? According to the World Health Organization (WHO), 47% of the population answers “at least once” to this question. Proof, if one were needed, that headaches are very common. It must be said that these can manifest themselves on very different occasions. An evening with too much water, a bad flu, taking certain medications, possibly in too large quantities, or even exceptional fatigue. More serious, but fortunately much rarer, a stroke, tumor or meningitis may be involved.
According to the International Headhache Society (which in 2013 published the third edition of its international classification of headaches), there are four types of primary headaches: tension headaches, migraines, trigemino-autonomic headaches and a fourth category which includes varied, much rarer, and often contextual headaches: during physical exertion, when coughing or during sexual activity. “More anecdotal still, some of these headaches are caused by the cold or during traction or pressure”, specifies Dr Anne Donnet, neurologist at the Timone hospital (Marseille) and president of the French Society study of migraines and headaches.
It is the most common headache
Although very common, tension headaches are the poor relation of research. So that to explain it, we do not have certainties, only hypotheses. The first concerns punctual tension headaches. “As they are mainly caused by stress, it is thought that this causes tension in the pericranial muscles and that it is these tensions that induce headaches”, explains Dr Anne Donnet.
When tension headaches are recurrent, on the other hand, “they are thought to be due to malfunctioning pain control systems, as is the case in other chronic conditions such as fibromyalgia“, adds the neurologist.
Technique of distraction, relaxation, self-hypnosis are effective
We can prevent tension headaches by adopting anti-stress strategies, such as relaxation, yoga, physical activity. To really benefit from them, these activities must be practiced regularly. Ideally, at least once a week.
The anti-inflammatories such as ibuproben or paracetamol are quite effective against tension headaches. Nevertheless, notes Dr. Luigi Titomanlio, head of the clinic for migraine and pediatric neurovascular pathologies at the Robert-Debré hospital (Paris), “when tension headaches are recurrent, there is a real risk of overconsumption of medication to the point that these can, in turn, lead to headaches. As a result, we prefer to advise to avoid using them as much as possible”.
“The technique of distraction is one of the most effective strategies to get over the headache, especially in children: we choose to do an activity that we like in order to distract our attention from the pain”, specifies Dr. Luigi Titomanlio. physical activity and relaxation, by reducing muscle tension and stress, are also very effective. Learn to practice self-hypnosis can also be a good way to combat pain when it occurs.
Caffeine too, but beware of excess
Coffee and caffeinated beverages also show some effectiveness against tension headaches. But here too, be careful! “Caffeine can reduce pain, but if you already drink a lot of it, it doesn’t work and leads to a vicious circle: you will need caffeine to avoid headaches and, to heal, you will have to wean yourself off caffeine”, warns Luigi Titomanlio. Not to mention that too much caffeine is not without consequence on excitability.
When should you consult? When the headaches are recurring or do not go away. When they prevent you from leading a normal life several days a month. When combined with other general signs (fever, fatigue).
And when the headache appears very suddenly, a bit like a clap of thunder, it is necessary to consult urgently.
When the frequency or intensity of headaches increases over time, an MRI or CT scan is recommended.
But also in front of any unusual headache or when the headaches are associated with other neurological symptoms (epilepsy, partial paralysis, difficulty in speaking). Ditto when they appear in very specific situations (cough, physical effort, sexual activity, etc.).
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