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Looking to Lift the Burden of Headaches
The pain of an unremitting headache
may not be the stuff of sensational headlines, yet in terms of
the cost to human productivity and quality of life, headaches
pose a tremendous burden.
Headache disorders affect two-thirds
of adult men and more than 80 percent of women in developed countries.
They're equally destructive in developing countries, according
to the World Health Organization (WHO).
"There's an attitude that headaches
are not a disease, that they don't threaten life in a meaningful
way, but headache has a tremendous impact on quality of life,"
said Dr. Ellen Drexler, director of the Headache Center at Maimonides
Medical Center in New York City.
"Chronic daily headaches, meaning
people with headaches more days than not, is 4 to 5 percent of
the general population so it's very, very large numbers in population
terms," Drexler added. "These are staggering proportions. Headache
really exceeds the frequency of many other illnesses and, in terms
of the amount of disability, is equal to many other illnesses."
To increase awareness of this looming
issue, the WHO and several international groups have launched
a new campaign, "Lifting the Burden." Specifically, the campaign
hopes to increase awareness among government and health care authorities.
Other groups involved are the International Headache Society,
the World Headache Alliance and the European Headache Federation.
According to WHO figures, about
half the people who suffer from a headache don't get any treatment.
"Looking over the past 10 years,
the proportion of patients who have consulted a physician has
increased but it's still just under half," Drexler said. "More
than half have never seen a physician and the number who have
never been prescribed a medication is much larger."
In the United States, headaches
are one of the leading causes of missed work and school. And the
absenteeism, lost productivity and medical expenses cost American
industry some $50 billion a year.
Dr. Seymour Diamond, executive
chairman of the National Headache Foundation, said headaches can
be roughly divided into three groups.
Less than 2 percent are symptoms
of some other malady, such as a brain tumor or aneurysm.
By far the largest group, about
80 percent, are tension headaches, most of which are treated with
over-the-counter medications. People with this type of headache
usually only seek a doctor's help when the problem becomes a daily
occurrence.
The third group is "vascular headaches,"
which include migraines and cluster headaches and can be extremely
debilitating. They involve blood vessels and may also involve
the nervous system.
"Migraines affect about 18 percent
of women and 6 percent of men at some time in their life, most
commonly in their most productive years, the 20s to 50s," Drexler
said. "There's a general effect on productivity and ability to
enjoy life."
Some 28 million to 30 million people
in the United States are affected by migraines, 70 percent of
them women. "One of the triggers is the hormone variation in any
one-month cycle and women have this, where, more or less in most
instances, men's hormones are stable," Diamond said.
There are specific medications
for migraines, namely the class of drugs called triptans. Still,
these debilitating headaches are probably one of the most undertreated
of conditions, Diamond said. They are frequently misdiagnosed
or underdiagnosed.
About 90 percent of cluster-headache
sufferers, on the other hand, are male.
"It usually centers around one
eye and is called cluster because it occurs in a series or bunch,
several in a day for two or three or four months and then they
go away," Diamond said. "It's a very severe, terrifying pain and
the only suicides we see from headaches are with cluster-headache
patients because of the severity. It will wake a man up from a
sound sleep. It's one of the most severe pains that a man can
get."
Cluster headaches can involve other
symptoms as well, including drooping eyelids, tearing of the eye
and congestion of the nose. Again, there are medications to lessen
the pain during an attack, to stop short an attack and to prevent
an attack.
The American Council for Headache
Education recommends you contact your doctor if:
- Your headache is accompanied
by a stiff neck, fever, shortness of breath, dizziness, drowsiness,
severe vomiting, unsteadiness, weakness, slurred speech, numbness,
tingling or unexpected symptoms affecting your eyes, ears, nose
or throat.
- You have three or more headaches
a week.
- You take a pain reliever daily
or almost daily.
- You take more than recommended
doses of over-the-counter medications.
- Your headaches are triggered
by exertion, coughing, bending or sex.
- Your headache keeps worsening
and won't go away.
- Your headaches began after age
50.
- Your headaches began after a
head injury.
More information
For more on the new World Health
Organization campaign, visit Lifting
the Burden.
Reference
Source 101
July 14, 2004
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