Headache

A headache is a common condition that can be caused by a variety of factors, including tension, migraines, or other medical conditions. When a person experiences a headache, a Primary Care Provider (PCP) is often the first healthcare professional to assess the situation.

Here’s how a PCP may approach a headache:

The PCP will start by asking questions about the headache, including:

• Onset (When did it start? How long has it lasted?)
• Duration (How long do the headaches last?)
• Intensity (How severe is the headache?)
• Frequency (How often do they occur?)
• Location (Where is the pain—front, sides, back, or all over?)
• Triggers (Are there certain activities or situations that trigger it?)
• Associated symptoms (Nausea, light sensitivity, aura, etc.)

A thorough physical examination may also be performed, and if needed, a neurological examination to rule out other conditions.

The PCP may try to categorize the headache, which could be:

• Tension headaches: Often caused by stress, tight muscles, or posture.
• Migraine headaches: May be associated with nausea, vomiting, light or sound sensitivity, and visual disturbances.
• Cluster headaches: Severe headaches that occur in cyclical patterns.
• Secondary headaches: Caused by underlying conditions like sinus infections, head injuries, or even more serious conditions like a brain tumor or aneurysm.

The PCP may diagnose the type of headache based on the patient's history and physical exam. If the headache is atypical, severe, or persistent, the PCP may order imaging tests (e.g., MRI or CT scan) to rule out serious conditions.

• For Primary Headaches (e.g., tension or migraines): 
  • Over-the-counter medications like ibuprofen, acetaminophen, or aspirin.
  • Prescription medications for migraines (e.g., triptans, anti-nausea drugs, or preventatives like beta-blockers or anticonvulsants).
  • Lifestyle changes (stress reduction, adequate hydration, proper sleep).
  • Behavioral therapy like cognitive-behavioral therapy (CBT) for stress management.
• For Secondary Headaches: Treatment will depend on the underlying cause (e.g., treating an infection or managing high blood pressure).

If necessary, the PCP may refer the patient to a neurologist or a specialist in pain management for further evaluation and treatment.

If you have persistent or unusual headaches, it’s important to consult a PCP to ensure proper diagnosis and treatment.