What I Wish Everyone Knew About Headaches

In this medical education video, double-boarded pain specialist and neurologist Dr Sader discusses the 3 most common headache types: migraines, tension headaches, and cluster headaches. For each one, he breaks down symptoms, diagnosis, and treatment options.

Migraines classically come with a throbbing/pulsating pain usually on one side of the head but it could be both, associated with nausea, vomiting, sensitivity to light (photophobia) and sound (phonophobia), dizziness/vertigo. They have 4 stages: prodrome (where patients feel tried and irritable), aura phase (usually a visual aura like flashing lights), the headache phase, and then the postdrome phase (sleepy/tried). Migraine triggers include fasting (not eating), hormonal changes, sleep disturbances, food items, alcohol, and stress. Migraine treatment consists of rescue therapy (to stop a headache that is currently happening) classically with triptans but more recently CGRP (gepants) like nurtec or ubrelvy, and prophylactic/preventative therapy, classically with tricyclic antidepressants or beta-blockers, but these days we more often use CGRP medications (nurtec, qulipta) or Botox injections which are excellent options.

Tension headaches often a misdiagnosis: 99% of the tension headaches I see are either cervicogenic headaches (coming from the neck, due to irritation of the occipital nerve by chronic stress on the neck muscles and traps), or migraines. The problem with labelling someone's headaches as "tension headaches" is that we'd be withholding a lot of effective treatments for them (such as Botox, occipital nerve blocks) if they were diagnosed correctly.

Cluster headaches are part of a family of primary headaches known as the trigeminal autonomic cephalalgias (TACs), which also includes hemicrania continua and paroxysmal hemicrania. All of these headache disorders have prominent autonomic features such as tearing, eye redness, droopy eyelid, or runny nose. Cluster headaches are centered around the eye and tend to be unilateral (one side of the head), very sharp stabbing severe pain. Cluster headache treatment consists of rescue therapy (to stop a headache that is currently happening) classically with oxygen but pragmatically with triptans, and prophylactic/preventative therapy, with verapamil or occipital nerve blocks.

Chapters:
0:00 Intro
1:42 Migraine
7:08 Tension
10:23 Cluster


Footage from Storyblocks (licensed).

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Disclaimer: The information in this video is provided for general informational and educational purposes only and is not a substitute for medical advice. Before taking any actions based upon such information, we encourage you to consult with your own doctor.

Sader Consulting, LLC

#headache #painrelief #migraine #tensionheadache #medicaleducation