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Dr. Mark Kestner: Do you really need to see a doctor about your headaches?

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I am a proponent of the adage, “If in doubt, check it out.” I am also aware that in most instances, the average person’s common sense and logic will serve them well to make many decisions on their own.

That being said, however, as I recall 20 years of hearing patients’ stories, I have to admit there are exceptions. I have been baffled on more than one occasion to the point where I can hardly contain myself from responding, “What were you thinking?” Unfortunately, some people that probably should doubt some of their decisions rarely do.

This column isn’t for that type of person, though. It is for you, the sensible one. You don’t get worried about every little thing, but you see a doctor when you need to, right? I’m thinking you have above average intelligence, since you are a Murfreesboro Post reader!

That being said, I am going to give you a few hints about whether you need to see a doctor about headaches. Before I go further, let me suggest that you first apply the “If in doubt, check it out,” principle. If you have any doubt about why you have headaches, call your doctor sooner rather than later. Particularly if the headache is severe or sudden onset, accompanied by unusual symptoms, or is worse than you have ever had before. Headaches can be the sign of very serious disorders.

Most headaches, thankfully, are not related to serious illnesses. The vast majority of headaches fall into one of three categories: migraine, muscle tension or sinus pressure related. If you know what kind of headache you are experiencing, you may be more successful in finding relief.

A lot of patients in Middle Tennessee have sinus pressure related headaches. We just happen to live in an area where allergic responses create a lot of sinus congestion which leads to blockages of the air passages in the head. Since our weather changes every day, that leads to frequent cases of head pain. You may be surprised to learn that you can have sinus pressure headaches even if your nasal passages are clear. Even if you can breathe easily it is frequently possible that a sinus canal in the face or even farther back in your head may be blocked. As the barometric pressure changes, you get a headache.

Sinus headaches are frequently behind the eye, but may be felt in the cheeks or even at the back of your head. The pain may be worse when you bend forward, cough or sneeze.

Pain at the back of the head may also be coming from muscle tension headaches. Although many people with muscle tension headaches can feel increased tightness in their neck or shoulders, some patients seem to be unaware of increased muscle tension; they just feel the head pain. The tension can be in the neck or shoulders, the side of the head, or even in the mid and lower back. Mental or emotional stress and abnormal postures can often aggravate muscle tension headaches. Even grinding teeth or other jaw problems can cause tension headaches.

Last week’s column concerned migraine headaches and possible remedies. Recall that the characteristic of a migraine was the altered blood flow in the brain and possible neurological symptoms that accompany the headache. Although many people think of any severe headache as a migraine, the severity of the headache does not determine the type of headache

Many headaches can be relieved with simple inexpensive over-the-counter medications. Here’s where the advice to see a doctor comes in, though. If you are repeatedly taking any medication for headache, something is wrong. You should make an appointment to determine the cause.

As always, this column is intended to provide health related information. It is not intended to diagnose or recommend treatment for any condition. For specific information or diagnosis, see your doctor.

Next week this column will focus on a subject that men know practically nothing about, but think they do. (As women already know, this could be practically anything.)

Dr. Mark Kestner

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Members Opinions:
August 25, 2008 at 12:00am

It would be great to see something on cluster headaches, which are absolutely the worst headache you can ever have.
August 25, 2008 at 12:00am

Thank you for your response. You are right, cluster headaches are very difficult to treat and can be very difficult to withstand as a patient. The pain can be off and on for days or can be unrelenting.

Although this particular issue was intended to be narrow in scope due to the limited space available, I intend to address cluster headaches at some point in the future. If you have them, you have probably found treatment options have limited success.

I do read all email sent to this site or my email address from readers and it is very interesting. Whenever possible, I comply with readers' requests to cover a particular topic. Soon I will have an issue devoted solely to the more interesting responses (and some excellent suggestions) I have received.

Thank you for your comments.

Mark Kestner
August 27, 2008 at 12:00am

Thank you for your response, my son gets cluster headaches,I get migraines. He just came through a "cluster" that lasted about 6 weeks. He was in agony. You're right, the treatment he received helped some, but he still had to endure them. I really hope someday soon they will come up with a treatment that keeps people (mostly males I understand)from this agonizing illness.

I look forward to your article on the topic. Thanks again.
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