Headaches are among the problems experienced in the society with a frequency of up to 90%. Migraine and tension-type headaches constitute 90% of these pains. While the age range in which migraine is most severe was determined as 20-60 years, it was observed that the severity and frequency of pain decreased in patients after the age of 60. In 10-15% of all migraineurs, the disease begins in childhood. The incidence of migraine in childhood is 3-5%. This figure rises to over 10 percent after puberty. Children with sleep disorders, difficulty sleeping, vomiting without reason, allergies, and motion sickness are more likely to develop migraines in the future.
Migraine is more common in women than men. This is because; changes in women’s hormonal levels. It is stated that the decrease in migraine attacks in menopausal women and pregnant women is due to its relationship with hormonal changes.
In very common headaches, a doctor’s evaluation should be done. If the pain is persistent and of increasing severity, if the age is below 10 or over 50, if the severity of the pain that was previously present has changed, if it does not respond to treatment, the pain occurred during a physical activity (lifting a heavy load, sexual intercourse) and its severity increased. If it has increased, it is necessary to go to the doctor, even if it has been diagnosed before.
Migraine is a disease that decreases with age. It should be investigated whether there is an underlying cause in headaches that start in advanced ages. It can start in advanced ages at a rate of 2%. Two diseases that start especially at an advanced age and cause headaches are temporal arteritis (headache due to a specific vascular inflammation) and hypnic (nocturnal) headaches. For this reason, if a patient over the age of 50 has new-onset headaches, a doctor should be consulted.
The International Headache Society has classified headaches into 14 main groups and hundreds of subgroups. Headaches that appear directly with a headache picture and are not related to another disease are primary headaches. These are migraine, tension-type and cluster headaches. Secondary headaches, on the other hand, are headaches that occur at a rate of 10% and occur during the course of diseases such as cerebrovascular diseases, nervous system diseases, brain tumors, eye diseases, sinusitis, and meningitis due to a certain disease.
What is the difference between migraine and headache?
In migraine, the future of the pain can be felt before the pain (type with aura), it comes in the form of an attack and the pain occurs between 4-72 hours. Nausea may be accompanied by vomiting, discomfort from light, sound and smell, and pain aggravated by head movements or physical activity. Characteristics of tension-type headaches; there is no aura, the duration may be longer, it is possible to last up to 1 week and 15 days. It holds the whole head, it is effective on the top. It spreads from the back of the head to the front, it is usually bilateral, it can be unilateral. There may be nausea but no vomiting. Moving does not increase the pain. Tension-type headaches are usually caused by stress.
Migraine is divided into two groups: migraine with and without aura. Only 10 percent of migraines have auras. Aura is a precursor to migraine. It lasts about 30 minutes, after which the pain begins. Most aura symptoms are vision related. The patient reports seeing bright lights, zig-zag lines or blurred vision, loss of vision in one area or an area. In addition, numbness in the arms and legs, dizziness, speech disorders, and bad smells may also be seen.
Cause of migraine
Although the exact cause of migraine cannot be explained, researchers think that blood vessels and brain cells somehow interact and cause migraines. In genetically predisposed individuals, environmental factors such as stress, anxiety, insomnia, hunger, certain foods, as well as hormonal changes create an activation in the brain. This activation causes enlargement of brain vessels and chemicals are released. These, in turn, cause pain by stimulating the nerves.
Factors triggering migraine
air pollution, cigarette smoke
bright light or flickering light
Loud and continuous noise
Fragrance fragrance, other strong odors and chemicals
Changes in weather (pressure, temperature and humidity change, southwestern)
Seasonal changes (autumn and spring and seasonal changes)
hunger, skipping meals
Sleeping too much or little, disturbances in sleep patterns
birth control pills
Hormonal changes in women (menstrual period)
Some foods and beverages (chocolate, nuts, red wine, etc.)
Many foods are held responsible among the factors that trigger migraine. However, the food that increases migraine pain in each patient may be different. The important thing is that the person finds and discovers the substance that triggers the pain. Another method is to cut the foods that the intestines are sensitive to by having a bowel sensitivity test.
Another important issue in patients with headache is the drugs used by the patient. It should be noted that some blood pressure medications cause headaches. In addition, in case of increased blood pressure, there may be pain radiating from the neck to the head.
In patients with headache, tension in the neck muscles can also cause headaches. Therefore, it is important to evaluate the neck and neck-shoulder muscles as well.
Treatment of migraine
The goal of treatment is to reduce trigger pull factors, to suppress the sensitivity of the nervous system and the events in and around the veins that occur during pain.
Excessive painkiller consumption of migraine patients cannot relieve pain over time, so it is recommended not to use excessive painkillers. If the pain persists in patients with periodic pain, the possibility that the patient has used multiple painkillers or that there may be underlying psychological reasons should be considered. Therefore, regular follow-up is very important.
Acupuncture: It gives very effective results in both migraine and tension-type headaches. In many studies on this subject, it has been shown that acute pain is controlled and attacks are prevented with acupuncture.
neural therapy: Neural therapy, which has a regulating effect on the nervous system with the injection of local anesthetics, can be used in both migraine and tension headaches.
ozone therapy: Ozone therapy is one of the treatment methods used in migraine as well as in all chronic pain, with its antioxidant and circulatory-regulating effect.
Physiotheraphy:Superficial and deep heaters and low-frequency current applications help pain control by reducing tensions arising from neck and neck shoulder girdle muscles, especially in patients with tension-type headache.
Botulinum Toxin treatment: It is a method that can be used in both migraine and tension headaches and provides comfort for 4-6 months with a single application.
Exercise:Stretching and strengthening the neck, neck and shoulder girdle, as well as aerobic exercises contribute to increasing endorphins, especially in tension headaches and migraines.
Relaxation exercises:Relaxation training and biofeedback can provide supportive results.