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What kind of treatments are available for headache disorders?

Treatment for primary headache disorders, as outlined by the International Classification of Headache Disorders, 3rd edition (ICHD-3), includes a combination of physical therapy, lifestyle management, and pharmacotherapy. Physical therapy, particularly for tension-type headaches, involves exercises to improve posture, strengthen neck muscles, and reduce muscle tension, which can alleviate headache frequency and severity. Lifestyle management, essential for all primary headache disorders, includes identifying and avoiding triggers, maintaining regular sleep patterns, managing stress through techniques like mindfulness and relaxation exercises, and ensuring proper hydration and nutrition. Pharmacotherapy varies based on the type of headache: migraines are often treated with triptans, anti-inflammatory drugs, and preventive medications like beta-blockers or antiepileptics; tension-type headaches may respond to over-the-counter analgesics and muscle relaxants; cluster headaches often require acute treatments such as oxygen therapy and triptans, along with preventive medications like verapamil. Combining these approaches can provide comprehensive management of primary headache disorders, improving patient outcomes .

References:
1. Headache Classification Committee of the International Headache Society (IHS). (2018). The International Classification of Headache Disorders, 3rd edition. *Cephalalgia*, 38(1), 1-211.
2. Bendtsen, L., Evers, S., Linde, M., Mitsikostas, D. D., Sandrini, G., & Schoenen, J. (2010). EFNS guideline on the treatment of tension-type headache – Report of an EFNS task force. *European Journal of Neurology*, 17(11), 1318-1325.
3. Silberstein, S. D., Holland, S., Freitag, F., Dodick, D. W., Argoff, C., & Ashman, E. (2012). Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults. *Neurology*, 78(17), 1337-1345.
4. Robbins, M. S., Starling, A. J., Pringsheim, T. M., Becker, W. J., & Schwedt, T. J. (2016). Treatment of cluster headache: The American Headache Society evidence-based guidelines. *Headache: The Journal of Head and Face Pain*, 56(7), 1093-1106.

Primary Headache Disorders

Migraine

  •  Moderate to severe pulsating headaches

  • Headaches last hours to days

  • Often accompanied by nausea, vomiting, and sensitivity to light and sound

  •  Triggers for migraines can include stress, certain foods, hormonal changes, and environmental factors

Tension Type Headache

  • Most common primary headache disorder

  • Bilateral, pressing or tightening pain of mild to moderate intensity

  • Can last from 30 minutes to several days

  • Feels like a tight band around the head

  • Triggers include stress, poor posture, and muscle tension

Trigeminal Autonomic Cephalgia

  • A group of primary headache disorders characterized by severe, unilateral headache pain accompanied by autonomic symptoms

  • Localized around the eye or forehead with lacrimation, nasal congestion, and ptosis

  • Include cluster headache,  paroxysmal hemicrania, SUNCT and SUNHA

  • TACs often mimic other disorders, such as trigeminal neuralgia

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