Last night, I went to Beijing Traffic Station 103.9 for an interview. With host Sheng Bo and Jia Jia and director Fan Bifa of the pain department of the Sino-Japanese Friendship Hospital, I briefly talked about some common sense about headache. Headache is a very common problem. Nearly 90% of the people have experienced headache, especially women. Most headaches are [primary], that is, headaches that cannot find out the cause. Other headaches are [secondary], that is, caused by other causes, such as brain tumors (which are the most concerned but also the rarest) or infections.
Since headaches are a common problem, General practitioners at the forefront of the medical system are often the first doctors patients see for headaches, At least in foreign countries. GPs should not only know how to diagnose and treat common primary headaches, but also be able to identify unusual secondary headaches so that patients can undergo reasonable examinations and be referred to appropriate departments, such as neurology and pain departments, when needed.
The two most common types of primary headache are primary headache, tension headache and migraine.
1. Tension headache
Tension headache is a common headache characterized by persistent pressure on the patient’s head (imagine the feeling of Sun Wukong when Tang’s monk recites the magic spell). This kind of muscle-like pain is generally felt on the forehead, temples, back of the head and neck, mainly bilateral pain. Sometimes neck or head touch will also cause soreness.
This headache can last for tens of minutes or even a whole week, usually without nausea or vomiting.
The cause of tension headache is unknown, and current research does not think it has anything to do with muscle contraction, although it feels the same. Most people with this headache are prone to it when they respond to stress or lack of sleep. Common inducements include incorrect sitting or sleeping posture, irregular meals, too long eyes on the computer screen, cold, etc.
Migraine is a serious headache, often some patients will affect work and rest because of it. The main difference with other headaches is that it will be accompanied by nausea or vomiting. Before headache occurs, some patients will have some special signs: common ones have seen flashes, blurred vision, narrowed vision, blind spots in seeing things, numbness of hands and feet and difficulty in speech.
Migraine is characterized by severe unilateral beating headache, like the feeling of someone nailing his brain with a nail, accompanied by fear of light, noise, nausea, vomiting, diarrhea, vision loss, and even weak hands and feet.
Without treatment, headache peaks in about 2 hours and can last for 6 to 48 hours. Patients often feel very tired after headache.
The cause of migraine is unknown, and the research results found that it may be related to the decrease in the concentration of some brain chemicals such as serotonin. Like tension headache, migraine has some common but different causes:
Hormonal changes such as before and after menstruation or after taking contraceptives
Specific foods such as alcohol, monosodium glutamate, excessive coffee, cheese, onions, etc.
Inadequate or irregular sleep
When feeling stimulated, such as too noisy, too bright or special smell
Excessive exercise or orgasm
Changes in air temperature or pressure
Specific drugs such as nitroglycerin (drugs used to treat angina pectoris)
Whether it is tension headache or migraine, the incidence rate of women is higher than that of men, and patients also have more family history of headache. Headache starts in adolescence, and the frequency varies from person to person.
How should headache be treated?
As the cause of headache is unknown, the medical profession has not found any cure for it. Headache patients should understand that doctors can only manage the primary headache, but cannot achieve the goal of radical cure. How to manage headache depends on many factors.
If you know the cause, Then avoid the inducement first. If it cannot be avoided, It can be relieved by taking painkillers or massage under the guidance of a doctor. If it is only committed once in a while, it is good to treat each disease. If the disease is frequent and serious, the doctor will consider taking some preventive measures. At present, some antidepressants, antiepileptic and antihypertensive drugs are helpful to prevent migraine.
Sometimes patients with headache come to see a doctor because suddenly they have a fear of the cause of their headache, usually worrying about brain tumors or vascular malformations.
In fact, brain tumor or brain tissue lesion is a very rare cause of headache. Generally, patients with headache can normally enter the doctor’s office to talk to the doctor normally as long as their age and condition are consistent. Without any language, mental or nervous system abnormalities, most of them are primary headaches.
However, if there are any of the following circumstances, you should go to the hospital at the first time:
Patients over the age of 50 who had no history of headache before suddenly began to have headache.
Patients with chronic headache suddenly have some changes in the pattern or form of headache.
A headache accompanied by a trance and abnormal consciousness.
If the headache gets worse and worse after the head injury,
Headache caused by cough, defecation, or rapid movement (not related to cold or sinusitis)
A headache accompanied by persistent fever and rash.
Like the most painful headache in my life struck by lightning.
Side effects of painkillers
Regarding the side effects of painkillers, do patients need to pay attention to some what?
Acetaminophen and ibuprofen are the two main types of painkillers bought in the market. Both drugs are basically safe. Unless patients are allergic to them, there are not too many side effects of what.
Acetaminophen such drugs, mainly can affect liver function. If the patient has liver disease, to avoid, if use not more than 3000 mg a day. Ibuprofen tablets such drugs, side effects are mainly affecting the stomach and kidney, especially older patients, long-term administration may cause gastric ulcer, so don’t eat on an empty stomach.