POORLY UNDERSTOOD

Why your regular headaches may not be a normal disease

This third-most prevalent illness in the world is often self-medicated. But medics warn persistent headaches are merely a symptom of something else, and it's important to have the type and history examined

In Summary

• Patients should identify the root cause of their predicament, instead of concluding that headaches are “normal”.

• Even when it is clear medical attention is needed, most patients still self-diagnose through the Internet.

A woman holds her head at work
A woman holds her head at work
Image: COURTESY

Until three months ago, Caroline Mbeneka suffered persistent headaches that, she later found out, were mostly triggered by the strong, flickering CCTV flashlights on Nairobi roads.

She moved from Paracetamol painkillers, which had become a daily dose, to stronger medication that still did not work, until she met a neurologist recently.

“I have learnt to avoid the triggers and I have been fine about 70 days now,” she said recently during a World Brains Day event. It was held at the Westgate Mall in Nairobi under the theme, “Headache disorders and women”.

The neurologist who medicated Mbeneka also suggested she monitors herself using HeadApp, a mobile application, to predict how she is faring and identify the triggers.

Mbeneka further discovered her problem could be hereditary because her mother experienced similar problems in her late 20s.

A small percentage of people who have migraines also experience aura symptoms. These visual disturbances may include blind spots, flashing lights, zigzag patterns, pins and needles and numbness of limbs.

Dr Sylvia Mbugua, a consultant neurologist at the Aga Khan University Hospital, said while headaches are hereditary sometimes, patients should always look out for triggers.

“It could be sensitivity to a strong perfume, stress, muscle tensions on the neck due to various reasons, noise, stress, light and a variety of things,” she said at the event.

Despite visiting doctors, the reason for the everyday episodic headaches that have ailed me since 1986 could not be ascertained
Speaker at World Brains Day event

ROOT CAUSE

Dr Mbugua urged patients to try and identify the root cause of their predicament, instead of concluding that headaches are “normal”.

Research by the Star found many people like Mbeneka, though with different triggers to their headaches. Some blamed a lack of tea or coffee in the morning (caffeine withdrawal headaches).

Others could not withstand strong perfumes and avoided perfume users at all costs, with the majority being men. A few blamed loud music. However, the majority blamed stressful working environments with lots of pressure to deliver, and juggling work pressures with family time.

More reasons were mainly lifestyle-related: lack of exercise, skipping meals and mainly lack of greens and fruits in the diet. Lack of water was also an ingredient to the cause of the poorly understood disease.

Medics who spoke at the meeting complained even when it is clear medical attention is needed, most patients still self-diagnose through the Internet.

“Patients these days go to Google to get a list of drugs to treat headaches, and then head straight to the pharmacy to buy painkillers. They hardly read the instructions, which is more worrying,” Dr Mbugua said.

Long-term use of Paracetamol, neurologists said, has side-effects for most people. They urged expectant women to always see a physician for any medication.

They explained that most headaches occur occasionally and can be treated effectively by eating, drinking water, resting or taking over-the-counter painkiller medication.

RESEARCH FINDINGS

Headaches are among the top 10 causes of disability in the world, and the third-most prevalent illness in the world.

WARNING SIGNS

Dr Judith Kwasa, a neurologist at Kenyatta National Hospital, said living with headaches should not be normal. She recommended taking headaches and migraines more seriously when it persists despite use of painkillers.

“Especially when you get headaches every day or that range from 7-15 times in a month, that should be concern enough to see a specialist and not self-medicate,” she said.

Dilraj Sokhi, a neurologist at Aga Khan University Hospital, said, “Overuse of painkillers that are normally taken by patients for primary headaches is not that safe. They lead to secondary headaches that can be controlled at a primary stage.”

Dr Mbugua added that one is at a higher risk of getting a stroke if under medication of headaches and other diseases. You just need to recognise that headaches and migraines are disorders and a symptom of something else.”

She talked of home remedies that one can easily take into consideration as preventive medication and other approaches expectant mothers should also consider.

Headaches are among the top 10 causes of disability in the world according to the World Health Organisation, and the third-most prevalent illness in the world, according to Migraines Research Foundation.

According to the medics, all drugs are poisonous and more so dangerous when self-administered by patients. They backed up the statement with the reason behind pharmacists always insisting on a doctor's prescription and their insistence on background information, even on headaches.

Mandeep Sokhi, a retail pharmacist, expressed her concern that patients do not give descriptions of the headaches or their history.

“It is very important that you give pharmacists a background history of the headaches and how they occur. It helps to determine the stage and the right treatment. Do not simply ask for Maramoja or Panadol (painkillers),” Mandeep said.

I have often written sick leave notes to patients due to headaches, and employers hardly take them seriously, despite it being the most common medical complaint
Retail pharmacist Mandeep Sokhi

WOMEN MOST AFFECTED

The three neurologists at the event said there are up to 42 types of headaches, which may also comprise other sub-headaches, and all are categorised into two groups: primary and secondary headaches. They acknowledged to headaches being a public health issue, which mostly goes undiagnosed and untreated.

“I have often written sick leave notes to patients due to headaches, and employers hardly take them seriously, despite it being the most common medical complaint,” pharmacist Mandeep sadly noted.

The neurologists called for increased public awareness campaigns by pharmacists, insurance companies and the Pharmacy and Poisons Board, as well as the Health ministry.

Dr Mbugua said primary headaches are the most common with people and mostly affect women. The primary headaches comprise of migraines, tension-type headache (TTH) and cluster headaches.

Migraines, according to the neurologists, are more common with women in their 30s. Cluster headaches mostly affect men, frequently recur (episodic) and are chronic.

TTH is a common primary headache, which is episodic and occurs in more than 70 per cent of some populations.

Children also suffer from headaches, and the doctors advise seeking medical attention instead of self-medicating them. Boys are affected more than girls before puberty, but during adolescence stage, the risk of migraine ascends in girls.

Secondary headaches occur due to overuse of Paracetamol and other painkillers that treat primary headaches, for example, Betamine.

Medication overuse is the most common reason why episodic migraine turns chronic. Depression, anxiety and sleep disturbances are common for those with chronic migraine.

During the event, organised by former beauty queen Pinky Ghelani, several patients expressed their battles with headaches.

A man who identified himself as an artiste confessed to battling with the headache disorder for over 30 years.

"Despite visiting doctors, the reason for the everyday episodic headaches that have ailed me since 1986 could not be ascertained," he said.

Medical doctors and researchers are yet to find a cure for headaches, but they say headaches can be managed. Kenya suffers a lack of enough specialists, as there are only 15 neurologists in the country.

Those at the event noted that a patient can take tests and scans and come out with a clear medical history, yet they still have headaches.

The neurologists, and a number of doctors from different fields also present, advised the public to live a healthy lifestyle.

Edited by Tom Jalio