Coping Chronic Pain : Chronic Headaches, Pain Basics

by Food and Drug Administration (FDA)

(Page 3 of 3)

Chronic Headaches

More than 45 million Americans have chronic headaches, according to the National Headache Foundation. The most common types include tension headaches, which are associated with muscle tension. These are sometimes described as feeling like a tight band squeezing the head. Cluster headaches are marked by severe pain around one eye. Migraines are characterized by throbbing pain on one side of the head. Most people with migraines also experience nausea and sensitivities to light and sound.

Andrew Fano, 38, of Lincolnshire, Ill., who has had migraines since he was 12, says headaches used to wipe him out for days. But things improved in 1992 when the FDA approved Imitrex (sumatriptan), the first drug in a class known as triptans. This class of drugs marked a huge leap forward for headache sufferers. Unlike some previous drugs that dulled the perception of pain, triptans stop the pain by narrowing blood vessels in the brain and reducing inflammation.

Fano's migraine treatment now includes a newer triptan called Frova (frovatriptan). Side effects include nausea, dizziness, and dry mouth. He also takes the pain reliever Vicodin as needed, sticks to a regular sleep schedule, and avoids red wine and other migraine triggers.

Migraines, tension headaches, and cluster headaches are considered primary headaches because they are not caused by underlying illness. "But it's important to rule out disease, especially when headaches are resistant to treatment," says Seymour Diamond, M.D., founder and executive chairman of the National Headache Foundation.

Diamond performed an MRI (magnetic resonance imaging) on Fano a couple of years ago. "We assessed him for a possible brain aneurysm, but luckily, there wasn't a problem," he says.

Most headaches can be successfully treated with over-the-counter pain relievers. But you should seek professional help for headaches if they persist or get worse or if the headaches are keeping you from work and social activities. "You should also see a doctor if you've never had headaches before and you start having them, if you get headaches upon exertion, or if headaches are accompanied by a stiff neck, fever or neurological symptoms like dizziness or blurred vision," Diamond says.

Pain Basics

People usually feel pain when receptors in skin, bones, joints or other tissues are stimulated by an injury or threat to the body. Neuropathic pain is triggered by changes in the nerves themselves, or caused by changes in the brain or peripheral tissues.

Pain involves the interaction between several chemicals in the brain and spinal cord. These chemicals, called neurotransmitters, transmit nerve impulses from one nerve cell to another. Neurotransmitters stimulate receptors found on the surface of nerve and brain cells, which function like gates, allowing messages to pass from one nerve cell to the next. Many pain-relieving drugs work by acting on these receptors. For example, opioid drugs block pain by locking onto opioid receptors in the brain.

Other drugs control pain outside the brain, such as non-steroidal anti-inflammatory drugs (NSAIDs). These drugs, including aspirin, ibuprofen, and naproxen, inhibit hormones called prostaglandins, which stimulate nerves at the site of injury and cause inflammation and fever. Newer NSAIDs, including Celebrex (celecoxib) and Vioxx (rofecoxib) for rheumatoid arthritis, primarily block an enzyme called cyclooxygenase-2. Known as COX-2 inhibitors, these drugs may be less likely to cause the stomach problems associated with older NSAIDs, but their long-term effects are still being evaluated.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.