One of the most common pain complaints is a headache. At some point, greater than 90% of the population will experience a headache.
Headaches are classified as either being associated or not associated with an underlying illness. Examples of headaches not associated with an underlying illness include episodic and chronic tension-type, and comprise the majority of headaches among the population. Other reasons people have headaches may be related to a medical condition they have, such as head trauma.
Is self-treatment appropriate?
Over-the-counter (OTC) therapy is appropriate only for tension-type headaches, diagnosed migraine headaches, and sinus headache and not for headaches associated with another medical condition. Other treatment exclusions include:
• Severe head pain
• Headaches that persist for 10 days with/without treatment
• ≤ 7 years of age
• Fever or signs/symptoms of infection
• Symptoms consistent with migraine with no medical diagnosis
• Pregnant women in the last trimester
• Medical history of liver disease
What type of headache do I have?
Tension-type headaches are the most common type of headache. Other names for this may include “stress headache” or “muscle contraction headache”. These generally present as either facial or diffuse pain of the head that can radiate to the neck and shoulders. Often they can be linked to stress, anxiety, depression, emotional conflicts, or fatigue.
Migraines are much less common but more severe than tension-type headaches. They are generally recurrent and can occur with or without aura, which is described as shimmering/flashing areas or blind spots in the visual field, and even difficulty with speech. Headaches often last up to 30 minutes but the throbbing pain may last much longer. Migraine headaches can be precipitated by stress, fatigue, fasting or missing a meal, caffeine, alcohol, and even changes in the menstrual cycle. It is only appropriate to treat migraine type headaches with OTC products if you already have a medical diagnosis.
Sinus headache is usually localized to the face, especially of the areas over the sinuses. Blowing the nose and coughing can both exacerbate pain. If the sinus headaches persist, you may have sinusitis. It is an infection of the sinus cavities and is generally accompanied by tooth pain in the upper teeth, nasal stuffiness, and discharge yellow to green in color which should warrant you to seek medical attention.
What treatment options are available?
Treatment of headaches can be accomplished with non-drug therapies and OTC analgesics, such as Tylenol® (acetaminophen), Motrin® (ibuprofen), or aspirin.
Stretching, relaxation exercises, stress reduction, and maintaining a healthy diet and sleep pattern can all help reduce the risk of a headache. For migraine sufferers, avoidance of trigger foods, low blood glucose, and hunger are recommended strategies. Sufferers may also find that ice bags or cold packs applied to the forehead are helpful.
Always check with your pharmacist before taking any of these products, as they would be able to tell you if there are any drug interactions with other medications that you are currently taking. The duration of therapy should be no more than 10 days. If you have a headache lasting 10 days or longer with or without treatment, see your physician for further follow-up.
There are also a myriad of combination products such as Excedrin®. Some people may find combination products helpful. Many of them contain caffeine. If too much caffeine is taken, it can cause insomnia, rapid heartbeat, and an increase in blood pressure so their use should be limited. Other combination products contain antihistamines which can cause drowsiness so always be sure to check what the product you are taking contains.
Selecting an appropriate product for your type of headache is key to treatment.
If you have any additional questions or need help selecting an appropriate product be sure to ask you local Foster’s pharmacist or contact us.