Chronic Pain (cont.)
- Headaches can be caused by many illnesses. There are several types of headaches, including
cluster headaches. Headaches can also result from sinusitis, trigeminal neuralgia, giant cell arteritis, or brain tumors. The treatment of the various kinds of headaches varies depending on the kind of headache and the severity of the pain. Often, non-opioid medicines are used. But, in some cases, opioid therapy is needed.
- Migraines are often on one side of the head. They can be associated with
nausea and vomiting, photophobia (light hurting the eyes), phonophobia (sound hurting the ears), and scintillating scotomata (parallel lines that vibrate at the edges of objects, especially at the borders between light and dark places). Sometimes these auras appear before the headache starts and alerts
the person that a migraine is coming. Migraine pain can vary in intensity from mild to severe. There are many specific medications for migraine. Sumatriptan (Imitrex) is particularly useful for some, but not all, migraine sufferers.
- Cluster headaches come in groups, sometimes several times a day, lasting for days to weeks. Many cluster headaches are severely painful. Oxygen therapy may be helpful for some cluster headaches.
- Sinusitis can cause facial pain and is frequently worse in the morning.
Sinus pain may respond to antibiotic treatment along with decongestants. Sometimes sinus surgery is needed.
- Trigeminal neuralgia is actually a peripheral neuropathy (nerve pain) that is severe. It occurs on one side of the head and face and has a "trigger point," usually on the side of the face, which causes intense pain if it is touched. Anticonvulsants (antiseizure medicine) are often helpful for this type of pain, and muscle relaxants drugs are also sometimes used.
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