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Headache- causes, triggering factors and its impact

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How common is a headache/ how many people are affected by it?

headache

WHO has found the headache to be an extremely common issue affecting almost everyone occasionally.

Tension-type headache has been found to be the commonest disorder that affects more than 1/3rd of men and more than half of women.

It is said that 1 in 20 adults has a headache every day or nearly every day.

Migraine has also been found to be very common affecting 1 out of 7 adults in the world.

Who is more prone to develop a headache?

Region: the problem occurs all across the globe but to some extent less common in the Far East.

Sex: it is found to be approx. 3 times more common in women than men which is considered to be hormonally-driven.

Age: it is most commonly seen in mid-age adults. It less commonly affects adolescents and elders over 60 years of age.

What is the impact of headache on world population?

The Global Burden of Disease Survey (GBD) 2010 found that Tension-type headache and migraine accounted for the 2nd and 3rd commonest diseases in the world in both males and females with an estimated prevalence of 20.1% and 4.7% respectively. These were ranked only behind dental caries.

Headache disorders were found to be the 3rd commonest cause of disability in people under 50 years of age in GBD 2015.

Approximately 3 billion people (just below half of the population) were estimated to have a tension-type headache(1.89 billion) and migraine (1.04 billion) in 2016. Migraine was found to cause 45.1 million years of life lived with disability (YLDs) and tension-type headache 7•2 million YLDs in 2016 which has increased by more than 50% from 1990.

In 2016, the age-standardized prevalence of migraine was highest in Italy and Nepal, and that of tension-type headache was highest in Brazil and Afghanistan. The lowest prevalence of both disorders was in China.

How it can affect your quality of life?

Headache disorders affect a person’s quality of life by producing periods of pain which not only damage his sense of well being but could also result in disablement. They can result in considerable personal distress, lack of confidence, fear/ anxiety, and loss of money. It can affect a person’s family life, work-life, and education resulting in a decline in one’s potential.

In spite of this, most of the people including many health workers tend to consider headaches as a minor complaint. This is partly because of the frequency of the self-limiting nature of the occasional headache that most people have. It is also partly because of the ignorance of the fact that it can be associated with other threatening conditions.

Thus in general the physical, mental, social, and economic load of the condition is poorly accepted in society.

What could be provoking/triggering factors for headaches?

There are multiple personal or environmental factors that can trigger am episode of headache in a person. These could be:

Physical factors: Fatigue, strenuous exercise, lack of sleep or sleep disturbance Hormonal factors: start of periods, ovulation, or birth control pills.

Emotional factors: stress, anxiety, anger.

Environmental factors: Change in weather like increase in humidity, heat, exposure to the sun, flickering lights, loud sound, strong smell, etc.

Dietary factors: Skipping meal, alcohol, Food items like chocolate, caffeine, MSG, etc.

What is the cause of a headache?

The exact cause of most of the headaches is not known. It is known that the brain tissue can’t sense pain due to a lack of pain receptors. However, the covering (meninges) surrounding the brain, some nerves originating from the brain, and head and neck blood vessels can signal pain. Pain signals can also be received from the sinuses, muscles, teeth, and soft tissue and periosteum surrounding the skull.

There are more than 300 types of headaches, but only minority headaches have a known cause/ underlying condition called as Secondary headache. The remaining majority of headaches can’t be associated with any underlying disease and are called as called Primary headaches.

What are the different types of headaches?

Headaches can be broadly classified into primary and secondary headaches.

Primary headache is a headache that is not associated with any other pathology or disease.

Secondary headache is seen as associated with other conditions and occurs as one of the symptoms or byproduct of the condition.

COMMON CAUSES OF HEADACHE

Primary HeadacheSecondary Headache
Tension-type 69%Systemic infection 63%
Migraine 16%Head injury 4%
Idiopathic stabbing 2%Vascular disorders 1%
Exertional 1%Subarachnoid hemorrhage <1%
Cluster 0.1%Brain tumor 0.1%
Source: J Olesen et al: The Headaches. Philadelphia, Lippincott Williams & Wilkins, 2005.

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