Medicines for Severe pain
Headaches: Causes, types, and treatment

What is the headache

A Headache defines as a pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes. There are three major categories of headaches:

  • Primary headaches,
  • Secondary problems, and
  • Cranial neuralgias, facial pain, and other headaches

Assessment of trouble should be comprehensive for example to include

  • Age at onset
  • Presence or absence of aura and prodrome
  • Frequency, intensity, and duration of an attack
  • Number of headache days per month
  • Quality, site, and radiation of pain
  • Associated symptoms and abnormalities

Primary Headache

Primary headaches embrace, migraine, tension, and cluster headaches, furthermore as a spread of different less typical kinds of bother.


Migraine Headache

This is characterized by a trial of paroxysmal headache, vomiting, and focal neurological events (usually visual). Migraine Headache is more common in females than in males. Often there is a family history of migraines.

Associated precipitants include:-

  • Dietary (cheese, chocolate or red wine)
  • Psychological stress


General Measures

  • Avoidance of precipitants
  • Relaxation to reduce stress

Medicine for headache

IIn acute attack provides analgesics:

A: Paracetamol 1g instantly then every four hours; Georgia home boy 4g per day OR A: pain pill 600mg, repeat when four hours if required. Plus C: Metoclopramide oral/IM, ten mg three times daily. In severe attack give C: alkaloid salt 1-2 mg, most 4mg in 24hours, to not be continual at intervals but four days. For bar functions, give C: Propranolol 80-160mg daily ORC: Amitryptiline 10-50mg in the dead of night. Referral

  • Patients with other medical specialty signs or additional risk factors for other associate identification, like an immune deficiency. These patients need brain imaging
  • Sudden onset of a primary severe headache might indicate serious organic pathology, like subarachnoid hemorrhage
  • Acute migraine, not responding to treatment
  • Recurrent migraine not controlled with prophylactic therapy

Tension headaches

While tension headaches are the first oft occurring form of drawback, the cause is that the presumable contraction of the muscles that cowl the os. Once the tissues covering the top ar stressed, they will spasm and cause pain. Common sites embody the bottom of the os, the temple, and, therefore, the forehead. Tension headaches occur as a result of physical or emotional stress placed on the body.


  • A. The pain begins within the back of the pinnacle and higher neck and describes as a band-like tightness or pressure.
  • B. Often is delineated as pressure skirting the pinnacle with the foremost intense pressure over the eyebrows.

  • C.The pain typically is gentle (not disabling) and bilateral (affecting either side of the head).
  • D. The pain isn’t related to AN aura (see below), nausea, vomiting, or sensitivity to lightweight and sound.
  • F. The pain happens periodically (infrequently and while not a pattern); however, it will occur often and even daily in some folks.
  • G. The pain permits most of the people to perform usually, despite the headache.


  • The key to creating the identification of any headache is that the history given by the patient
  • If the health care practician finds Associate in Nursing abnormality, then the identification of the problem wouldn’t be thought of till the potential for alternative styles of issues has investigated.



Tension headaches area unit painful, and patients are also upset that the designation is “only” a headache. Albeit it’s not grievous, a problem will affect the activities of everyday life. The subsequent work well for many people:

A: Aspirin (300-900mg (O) every 4-6 hrs max 4g daily)


A: Ibuprofen (1.2-1.8g regular in 3-4 divided doses preferably after food max dose

2.4g daily, a maintenance dose of zero.6-1.2g daily is also adequate.) OR

A: Paracetamol 1g (O) 8hrly


D: Naproxen 0.5-1g in 1-2 divided daily doses

Massage and stress management can all used as adjuncts to tension headaches.

  • When pain medications used for a prolonged period, headaches can recur as the effects of the drug wear off. Thus, the problem becomes a symptom of the withdrawal of medication (rebound headache).

Cluster headaches

Cluster headaches are headaches that are available teams (clusters) lasting weeks or months, separated by painless periods of months or years. The explanation for cluster headaches is unsure. Some proof shows that brain scans performed on patients WHO aramid a histamine headache shows abnormal activity within the neural structure. Cluster headaches:

  • May trigger by changes in sleep patterns
  • May triggered by medications (for example, nitroglycerin)

If a person is during an inclined amount for the problem, fag smoking, alcohol, and a few foods (for example, chocolate) can also be potential causes for the matter



  • The pain usually happens once or double daily and last for thirty to ninety minutes
  • Attacks tend to occur at regarding identical time daily f
  • The pain sometimes is painful and situated around or behind one eye. The affected eye could become red, inflamed, and watery.


Note: Cluster headaches square measure rather more common in men than girls.



C: Sumatriptan 6mg; Dose may repeat after 1 hour. Max dose 12mg a day


C: 100% Oxygen at the rate of 10-15L/min for 10-20 minutes

Next cluster headache may include the following:

C: Verapamil 240-960mg (O) 8 -12 hourly divided doses


C: Amitryptiline 25-50 mg (O) daily


Prevention cluster headaches

Since cephalalgia episodes are also spaced years apart, and since the primary problem of a brand new cluster episode cannot predict, daily medication might not be secured.

Changes in lifestyle can help to minimize the risk of a flare of cluster headache.

Secondary headache

Secondary headaches area unit thanks to associate degree underlying unwellness or injury that has to diagnose and treat. Early designation and treatment is crucial if the harm is to be restricted

Examples of Secondary headache:

  • Head and neck trauma
  • The Blood vessel problems in the head and neck
    1. Stroke or transient ischemic attack (TIA)
    2. Arteriovenous malformations (AVM) may cause trouble before they leak
    3. Carotid artery inflammation
    4. Temporal arteritis (inflammation of the temporal artery)
  • Non-blood vessel problems of the brain
    1. Brain tumours, either primary or metastatic
    2. Seizures
    3. Idiopathic intracranial hypertension once named pseudotumor cerebri,
  • The Medications and drugs (including withdrawal from those drugs)



  1. Malaria
  2. Meningitis
  3. Encephalitis
  5. Systemic infections



  • However, some patients gift in crisis with an attenuate level of consciousness or unstable vital signs. In these things, the health care professional might commit to treating a particular cause while not watching for tests to substantiate the identification

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