Why can a headache when you are nervous
Headache (cephalalgia) is a condition that is probably familiar to everyone. According to statistics, this is the most frequent complaint on admission. More than 40 known diseases, which are accompanied by unpleasant sensations in the head and neck. Sometimes they are so severe that the person loses the ability to engage in daily activities and need of sick leave. Some species of cephalalgias are easily removed by drugs, others resistant to medical treatment. In any case, the quality of life of such patients is significantly reduced.
According to who, 47% of the population regularly experiences a headache, about 90% of adults at least once during the past year. The prevalence of this disease varies from country to country. So, from primary headaches associated primarily with stress, suffer more Europeans than the people living in developing African countries. Migraine is significantly more common in women, spider and headaches, a rare (about 0.5%) as a whole, often affect men.
Types of headaches: classification
According to the international classification, we distinguish 14 major types of headaches (see table). The first four are referred to primary. It is an independent disease, based on the functions of muscles, nerve trunks or vascular system. The rest of cephalgia secondary, i.e. They are a symptom or complication of another disease, whether organic brain damage or disturbance to any other system of the body.
Table 1. The international classification of headaches (2nd edition, 2004) and frequency of occurrence in the population, according to different sources.
|Type of headache according to MKGB-2||Prevalence in population|
|Part I: the Primary headaches|
|Beam headache and other trigeminal autonomic cephalgia||0,1-0,4%|
|other primary headaches (cough, associated with physical exertion or sexual activity)||3,5%|
|Part II: the Secondary headaches|
|Headaches associated with head trauma and/or neck|
|Headaches associated with vascular lesions of the skull and cervical spine||About 1%|
|Headaches associated with intracranial extravascular lesions|
|Headaches associated with various substances or their abolition||Headaches associated with various substances or their abolition|
|Headaches associated with infections|
|Headaches associated with the disturbance of homeostasis||About 1%|
|Headaches and facial pain associated with the violation of structures of the skull, neck, eyes, ears, nasal cavity, sinuses, teeth, oral cavity||2,82%|
|Headaches associated with mental illness||0,24%|
|Part III: Cranial neuralgias, Central and primary facial pain and other headaches|
|Painful cranial neuropathies and other facial pains||2,67%|
|head pain||at 5.76%|
Headaches associated with stress
The Occurrence of tension-type headache (TTH) and migraines directly associated with stress, physical or emotional overload. This is the primary cephalgia, i.e. Organic lesions in the nervous system or other organs are not observed, but the patient's condition may be so severe that daily tasks become overwhelming.
Tension-type headache is a classic example of stress. Emotional overload combined with prolonged forced position of the head (sedentary office work, driving a car) leads to a pathological increase in tone acroceraunia muscles. This will disturb their blood supply, and soreness occurs in the muscles. In the development of migraine more involved heredity and hormonal disorders, however in many instances, attacks are provoked by stress.
Treatment of primary cephalalgias has been a doctor-neurologist. Only he can properly diagnose, identify the causes and predisposing factors. However, if a painful condition caused by stress, you need to connect a psychotherapist, he will help to find the source of emotionalvoltage and control the disease. Reflex and experts in the field of physiotherapy to help select a range of non-pharmacological treatments that reduce emotional stress and eliminate muscle dysfunction.
When urgent help is needed:
- headache appeared suddenly, without cause, at full health ("thundering");
- it is permanent and increases in intensity;
- pain appeared after an injury;
- cephalalgia accompanied by nausea, vomiting, changes in speech, of consciousness, loss of orientation or movement disorders;
- severe pain in combination with a voltage stiff muscles and increase body temperature.
Diagnosis of TTH and of migraine, as all primary pain, is based primarily on analysis of clinical manifestations, as a possible diagnosis should be considered and abussou headache. The mechanism of its formation is as follows: constant pain forced the patient to take painkillers. If it is uncontrolled, over time, their effect is dulled, people have to take large doses that are becoming less and less effective. Sooner or later a situation arises where pain is present constantly and only slightly attenuated by analgesics. In this case we speak about abosutely tsefalgii.
Table 2. Comparative characteristics of the clinical picture of socially significant types of headache.
|Clinical sign||Migraine||TTH||MIGB (AGB)|
|location of pain||single-Sided, limited area of the eye, temple or forehead||Bilateral, diffuse in the temples, crown, nape||Single or double, no specific localization|
|Duration||Paroxysmal, the duration of the paroxysm to 72 hours||Paroxysmal, takes place during the day||Constant increases with exposure to precipitating factors|
|pain Intensity||the Pain is severe, almost unbearable, during the attack the person is disabled||the Pain is mild or moderate, does not interfere with daily activities||Weak or moderate, more intense in the morning|
|Weak or moderate, more intense in the morning||Emotional stress, menstruation, hunger, sleep disturbance, alcohol intake||Emotional stress, forced uncomfortable posture||Long drugs about the primary GB|
To facilitate diagnosis at admission used generic questionnaires that help to organize the clinical data.
Scale-questionnaire for the diagnostic conversation:
|Time duration||how Long did the headaches start? They occur often? What is the usual duration of your headaches? How many times a week it can occur?|
|Quality of pain||Where localized headache? Are there harbingers? How strong is the pain? How do you feel right after the attack?|
|Provocateurs||After any cases of acute headache? Are there any situations when it becomes stronger or, conversely, weaker?|
|Action||whether you are Able to remove their own attack? Than you normally treated? How headache prevent you to lead a normal active life?|
|State between pain||How quickly you recover after an attack? How well restored your emotional background? Or do the symptoms remain after the attack?|
having Prepared in advance the answers to these questions can greatly facilitate the diagnostic search for the doctor, but trying to diagnose yourself is not worth it. The specialist takes into account a lot of factors: data examination and instrumental methods. Last administered, if the specialist suspects a secondary character tsefalgii.
Advanced research methods
Most Often it is the radiography of the skull in different projections, computed tomography or magnetic resonance study.
|method Name||KL||That allows you to detect|
|Radiography||Previous head injury||Acute traumatic brain injury or post-traumatic headache|
|the Presence of secretions from the nose, constant stuffiness||Sinus pain|
|the Crunching and snapping noise when wide opening the mouth and chewing||temporomandibular joint|
|neck Pain, crunching movements of the head||Cervicogenic headache|
|Nausea, vomiting, especially in the morning after waking up||Tumor,volumetric education brain|
|dysesthesia or motor functions||Focal lesions of the brain, post-stroke state|
General principles of treatment of primary headaches:
- the use of medicamental and non-medicamental methods of treatment;
- movement from simple to complex;
- using the minimum effective doses of drugs;
- detailed informing of the patient about his condition and the mechanisms of the disease.
Individual treatment must be prescribed by a specialist based on the diagnosis, given the frequency of attacks and the severity of clinical manifestations. To non-drug treatments include massage, physiotherapy and sessions with a therapist. An important role is played by the normalization mode of the day, power, rational alternation of physical and mental work, proper sleep and elimination of precipitating factors. Unfortunately, often have to resort to drug therapy.
|drugs||Active ingredient||trade names|
|second line Therapy|
|Combination therapies||Paracetamol + analgin||"Pentalgin"|
|Paracetamol + diclofenac||"Fanigan"|
|Paracetamol + ibuprofen + caffeine||"Tamiful"|
|third-line Therapy – specific protivomigrenoznae drugs|
|Serotonergic tools||Sumatriptan||"Amigrenin", "Sumamigren"|
|ergot Alkaloids||Dihydroergotamine+ caffeine||"Dihydergot"|
|Derivative of glucocorticoids||Flamedragon||"Flamedragon"|
In Addition to relief of acute pain, interictal is treatment aimed at preventing the onset and reducing the frequency of attacks. Experts do not recommend the use of painkillers without a doctor's prescription. The uncontrolled use of analgesics – the right way to develop aboutuse headache, liver and other organs. To drug therapy was rational, all funds must be used strictly according to indications and to identify them correctly by a doctor. Effective treatment of headache possible, and the earlier they started, the more successful and easier to be held.
- Headache: classification and diagnosis. Sklyut Gitkina M. I. L. S./Medical news No. 4 – 1999.
- Osipova V. V. Modern approaches to diagnostics and treatment of migraine/ journal of family medicine, No. 2, 2010, pp. 19-24.
- I. B. Kuzmanov, G. R. Tabeeva, A. Skripkin Yu. Clinico-epidemiological analysis of chronic forms of primary headaches. (data from population-based studies of the adult population of the city of Rostov-on-don)