Dr Manjit Matharu explains why getting the correct headache diagnosis is so important
It might seem that treating headaches is simple: Take painkillers and wait for the pain to pass. Yet, a lot of people are living with chronic and severe headaches, causing a significant impact on their quality of life.
The good news is, there’s actually lots we can do to help – and getting an accurate diagnosis is the first step.
“I often say to my trainees and colleagues that of all the things we do, by far the most vital step is the diagnosis. Because if you get that wrong, then everything else is going to be wrong,” says leading UK headache specialist, Consultant Neurologist Dr Manjit Matharu.
So what’s causing my headache?
There are hundreds of different types of headache. “This can obviously cause quite a challenge when it comes to getting an accurate diagnosis,” says Dr Matharu, who explains headaches are generally separated into two groups: Primary headaches and secondary headaches.
“Secondary headaches are due to an underlying abnormality, such as a tumour, high pressure or inflammation in the brain – but these are rare. The vast majority of patients have primary headaches, such as a migraine or tension-type headache. Here, what you have is an abnormality of the function of the pain system in the brain.
“I often use a computer analogy to explain this: It’s a bit like having a software problem in the brain, rather than a hardware problem.” Find out more in our information video on the difference between primary and secondary headaches.
But I’m pretty sure it’s a migraine…
Two of the most common types of headache are migraine and tension-type headaches. While sometimes similar in terms of pain patterns, migraine tends to be associated with a range of additional symptoms, including nausea, vomiting, and sensitivity to light, sound and motion. Around a third of patients also experience ‘aura’, or visual disturbances. Cluster headaches are rarer and are known to be excruciatingly painful. They tend to occur in ‘clusters’ of attacks lasting from around a week to, in some cases, three months, and often recur around the same time each year. Our ‘Headaches and Migraines’ information video playlist explains more.
It might seem easy enough to self-diagnose your headache, but this can be problematic for a number of reasons.
A chronic problem
“Different headaches have different treatments. While there is some overlap, the difference can be very important,” notes Dr Matharu. “If you get the correct diagnosis, then you can get the correct treatment and it’s much more likely to be effective.”
There is also the issue of ‘medication overuse headaches’ – a type of chronic headache that’s actually caused by painkillers. “The problem is, if you start taking medication too frequently, paradoxically, you start getting more headaches. Most people don’t really know this, and in fact many doctors didn’t know until relatively recently that this was a real issue,” says Dr Matharu. “But it’s a very important one.”
Getting on the right path
For many people, seeing a headache specialist is key. As well as being best placed to confirm your diagnosis and arrange further investigations if necessary, a specialist will be able to advise on the full range of treatments that might be most effective for each individual patient, taking into account any other coinciding health problems too.
As Dr Matharu explains, the appropriate treatment path can also include medication – as well as lifestyle advice – to prevent your specific type of headaches occurring in the first place, so you’ll be able to reduce your use of painkillers and the risk of medication overuse headaches too.
Unsure what’s causing your headaches? Or struggling to manage chronic headaches? Book a consultation today.