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The dreaded headache: the splitting, the debilitating, and the made up

R. Nial Bradshaw

Many people think a headache is not a big deal, and they can just tough it out. But experts say that's not always the best idea.

This week on "Take Care," we talk to Dr. Mark Green, director of the Center for Headache and Pain Medicineand professor of neurology and anesthesiology at the Mount Sinai School of Medicine.  Green discusses the different types of headaches, how to treat them, and debunks some headache myths.

The most common headaches, by far, are tension headaches, according to Green. The catch? By definition, tension headaches are mild. Mild enough for people to self-medicate and continue their day. It’s almost always two-sided, constricting and band-like, but does not induce light or sound sensitivity, or nausea.

The other kind of headache is migraine. These headaches are debilitating and often spark a visit to the doctor. They’re also more common than you’d think. They occur in a spectrum. Migraines can be severe and/or frequent, and often cause sufferers to question if there’s another underlying problem, Green says.

Even if there isn’t an underlying problem causing your migraines, there can be many other causes. Green mentions bad weather, a drop in blood sugar and tension as triggers for migraine. Sensitivity to a lot of things (alcohol, missing a meal, stress, oversleeping, etc.) will often cause a migraine.

“Turns out that 50 percent of people with migraine are not getting diagnosed at all, or they're getting misdiagnosed or they're self-diagnosing as something else,” Green says. The term migraine is used as an umbrella term to cover headaches caused by a variety of triggers.

Avoiding a headache is simple: keep everything even. If you drink caffeine each day, continue to have your cup of joe. If you sleep for seven hours each day, try to keep your time in bed the same.

As far as treatment, here are a few to try: analgesics with caffeine, and anti-inflammatories like ibuprofen and naproxen. More important than the kind of drug you choose to treat your headache is this simple fact:

“You need to treat early,” Green says. Avoid over-medicating, of course, but never wait to see if a headache subsides.

But what about sinus headaches?

Sinus headaches are a public health problem, as far as Green is concerned, but not for the reason you’d think.

“There really isn’t probably such a thing as sinus headache,” Green says. The concept that a sinus headache is a common headache is flawed and outside of the United States, Green explains, many health professionals don’t recognize it as fact.