Dr. Marc S. Husid, M.D

Migraines and tension-type headaches are by far the most common causes of chronic headaches - far more common than "sinus", allergies, "TMJ", eyestrain, etc. Migraines alone affect 18 percent of women and 6 percent of men. People with chronic migraines fearfully await the next episode and the accompanying disruption to work, family, and social life. In addition to personal suffering, the cost of headache to society, both direct (visits to doctors, emergency rooms, medications) and indirect (work loss and decreased productivity) amounts to billions of dollars per year.

Migraine headaches, often referred to as "sick headaches", usually cause moderate to severe, throbbing pain, accompanied by nausea, blurred vision, difficulty concentrating, and sensitivity to light, noise and/or odors. Attacks last from a few hours to several days, during which time the unfortunate sufferer typically prefers to hibernate in a dark, cool, quiet room. After an attack, head soreness and a washed-out, "hung over" feeling may persist.

Tension-type headaches, on the other hand, are usually less severe than migraines, and are often described as pressure/tightness which begins in the neck and may spread to the back of the head or encircle the entire head like a "vice" or a too-tight hatband. They are usually not accompanied by nausea, sensitivity to light, noise or odor.

Many headache experts (including the author) believe that migraine and tension-type headaches are most likely caused by the same or similar dysfunction in brainstem pain-regulating areas. A "short-circuit" generated in these areas leads to swelling and inflammation of the blood vessels covering the surface of the brain, which results in the throbbing pain, nausea, and other characteristics of a migraine attack. Medications such as Imitrex, Zomig, Maxalt and Migranal are able to quickly terminate an attack of migraine by specifically interfering with this sequence of events.

Thankfully, with all we now know about headaches, well over 90 percent of former sufferers can be successfully treated. A thorough medical history and physical/neurological examination is, in most cases, sufficient to make an accurate diagnosis and suggest an initial treatment course. Treatment is most successful when a complementary approach is used, combining appropriate use of medication with a thorough analysis of diet, exercise habits, and other lifestyle factors.

Dr. Marc S. Husid is a Board-certified neurologist who has specialized in headache for 15 years and has successfully treated thousands of sufferers.