Headaches are a common intermittent disorder experienced by most people at least some of the time. Chronic headaches of various etiologies are experienced by 1 in 6 Americans (16.54% of the population) and includes migraine headaches in 1 in 9 (10.29% of the population). Most headaches are of the tension-type which have been associated with muscle tension, stress, anger, anxiety and fatigue, and are characterized by mild to moderate, non-pulsating bilateral pain. The pain may begin in the front of the head or back of the neck, and may spread to involve the whole head. For occasional mild headaches, simply massaging the head and neck has proven effective.
Migraine pain usually presents unilaterally with a distinct pulsating quality often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraine may be caused by intolerance to certain foods, such as red wine, chocolate, aged cheeses, nitrates, aspartame, beer, cured meats, and Brewers yeast. Migraine pain usually worsens with physical activity. These headaches are often preceded by an aura or visual disturbance and lasts an average of 4 to 72 hours.
Over-the-counter analgesics (e.g., aspirin, acetaminophen or NSAIDs) are the most common treatment for headaches. However, using analgesics more than three times a week may lead to rebound headaches; chronic daily headaches that require additional intervention and with it the iatrogenic risk of liver, kidney and gastrointestinal disease. Many prescription drugs are used to treat or prevent headaches. Among these are low-dose tricyclic antidepressants such as amitriptyline which may cause side effects (e.g., dry mouth, constipation, sexual dysfunction, blurred vision, dizziness, etc.).
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