Recognizing and Managing Headaches
- Category: Must-reads
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- Written By: Beau Leonard, Nurse Practitioner at Terrebonne General Neurology Care
Headaches are one of the most common health complaints, yet they affect everyone differently, and for some, they can be debilitating. Understanding the causes, triggers, and treatments can make all the difference. Beau Leonard, Nurse Practitioner at Terrebonne General Neurology Care, shares expert insights to help you recognize warning signs, manage symptoms, and improve your quality of life.
- What are the most common types of headache, and how do they differ?
The most common headache types are:
- Tension headaches: A dull, pressure-like band around the head. Often linked to stress, posture, or muscle tension.
- Migraines: Throbbing pain (often one-sided) with nausea, light or sound sensitivity, and sometimes visual “aura.”
- Cluster headaches: Intense, piercing pain around one eye, occurring in cycles (“clusters”) with tearing or nasal congestion.
- Sinus headaches: Facial pressure and pain with nasal congestion, usually tied to sinus inflammation or infection.
Each type of headache has a different cause and pattern, which helps guide treatment.
- Can you describe what happens in the brain during a headache or migraine?
During a headache or migraine, the brain’s pain pathways become activated, but the reasons differ depending on the type.
In tension headaches, tight muscles and stress signals irritate pain-sensitive areas around the head and neck.
In migraines, the process is more complex: brain cells become unusually sensitive, triggering waves of electrical activity and changes in blood flow. This activates the trigeminal nerve (a major pain pathway) and causes the release of inflammatory chemicals, leading to throbbing pain, nausea, and sensitivity to light and sound.
In short, headaches often stem from tension or irritation, while migraines involve a heightened brain response and inflammation.
- What are the common triggers you see in patients?
Many patients share similar headache and migraine triggers. The most common include:
- Stress – A major trigger that causes muscle tension and hormonal shifts.
- Lack of sleep or irregular sleep – Disrupts the brain’s pain pathways.
- Dehydration – Even mild dehydration can spark a headache.
- Certain foods – Aged cheeses, alcohol (especially red wine), processed meats, and artificial sweeteners are frequent culprits.
- Caffeine changes – Too much or suddenly cutting back can trigger headaches.
- Hormonal shifts – Common in women during menstruation, pregnancy, or perimenopause.
- Bright lights, strong smells, or loud noises – These sensory triggers often affect migraine sufferers.
- Weather changes – Shifts in humidity or barometric pressure can bring on headaches.
Identifying personal triggers can make prevention much easier and help reduce headache frequency.
- How can someone tell the difference between a “normal” headache and one that signals a serious medical issue that should prompt a patient to seek immediate medical care?
A “normal” headache is usually mild to moderate, improves with rest or over-the-counter pain relievers, and isn’t paired with unusual symptoms. Red flags for a more serious issue include:
- Sudden, severe “thunderclap” pain – peaks within seconds
- Headache after a head injury
- Neurological changes – like confusion, weakness, slurred speech, or vision problems
- Neck stiffness + fever
- A new type of headache – in someone who doesn’t usually get them
- What is the typical diagnostic process for someone with chronic or severe headaches?
The diagnostic process for chronic or severe headaches typically begins with a detailed medical history, including your symptoms, triggers, lifestyle habits, and any relevant family history. A provider then performs a physical and neurologic exam to check reflexes, vision, balance, and muscle strength.
If the pattern suggests something unusual, your provider may order imaging tests (such as MRI or CT scans), blood work, or, less commonly, other tests to rule out underlying conditions. Often, keeping a headache diary helps pinpoint patterns and guide treatment.
- How do you determine the best treatment plan for a patient?
Finding the best treatment plan starts with understanding the type and cause of the headache. A provider reviews the patient’s symptoms, triggers, medical history, and headache patterns, then considers both acute (to stop the pain) and preventive (to reduce frequency) options. Treatment may include:
- Lifestyle changes like sleep, hydration, and stress management
- Targeted medications for migraines, tension, or cluster headaches
- Prevention therapies such as daily medicines, supplements, or injections
- Non-drug options like physical therapy, relaxation techniques, or avoiding known triggers
The plan is typically tailored and adjusted over time to suit the patient's needs.
- What practical tips or strategies do you give patients to cope when headaches strike?
Some helpful, practical coping tips include:
- Rest in a quiet, dark room to reduce sensory overload
- Use cold or warm compresses on the head or neck
- Hydrate – even mild dehydration can worsen pain
- Practice slow, deep breathing or gentle stretching to release tension
- Take prescribed or over-the-counter medication early, before the pain peaks
- Avoid known triggers (bright screens, strong smells, skipped meals) when possible
These simple steps often ease symptoms while longer-term treatments take effect.
While headaches can be frustrating and sometimes overwhelming, understanding the cause, recognizing triggers, and seeking proper care can empower you to manage your symptoms effectively. With the right guidance and treatment, you can find relief and improve your quality of life.
