Saqib Rather
Srinagar, Sep 12: For many people, a headache is something to be endured rather than investigated.
A painkiller, a cup of tea, some rest and the day continues. But when the pain begins returning again and again, it can quietly become part of a person’s daily routine.
Doctors say that is when a headache should no longer be treated as an occasional inconvenience.
“Do not ignore recurring headaches and do not assume that every headache is normal,” neurologist Dr Parvaiz Shah. He advised people to understand their symptoms, identify possible triggers and seek medical advice when headaches become unusually severe or change in character.
Headaches are not all the same. Migraine and tension-type headache are among the most common primary headache disorders, but the symptoms and treatment can be very different.
Migraine may involve throbbing or pulsating pain, sensitivity to light or sound, nausea and, in some cases, visual or sensory symptoms known as aura. Tension-type headaches are generally associated with pressing or tightening pain.
The problem often begins when people try to manage repeated pain on their own.
A person who gets relief from a tablet may take the same medicine the next time. If the headache returns, another tablet follows. Over time, frequent use of some headache medicines can itself become part of the problem.
It is advised for healthcare professionals to consider medication-overuse headache when headaches develop or worsen after regular use of certain medicines for three months or more. The thresholds vary by medicine: some drugs, including triptans and combination painkillers, can pose a risk when used on 10 or more days a month, while paracetamol, aspirin and NSAIDs are associated with risk at 15 or more days a month.
Dr Shah has also warned against self-medication.
“Avoid self-medication, maintain a healthy lifestyle, get adequate sleep and consult a healthcare professional whenever symptoms change or become unusually severe,” he said.
The issue is not new in Kashmir. Research involving school-going children in Srinagar has previously documented a high burden of primary headache disorders. A study of 5,000 students aged 8 to 18 found primary headache disorders in a substantial proportion of the study population, with tension-type headache and migraine being the major categories reported.
For adults, the impact of repeated headaches can extend beyond the pain itself.
Frequent attacks can interfere with work, studies, sleep and normal social activities. Someone may continue with everyday responsibilities while repeatedly adjusting their routine around the next episode.
Doctors therefore look not only at how painful a headache is, but also at how often it occurs, how long it lasts and whether its pattern is changing.
Doctors recommends that people with recurrent headaches can keep a headache diary, recording the frequency, duration and severity of attacks, associated symptoms, medicines taken and possible triggers.
Such a record can help distinguish a one-off headache from a recurring disorder and can also show how frequently painkillers are being used.
Chronic migraine, for example, is defined by headache occurring on at least 15 days a month, with migraine features on at least eight of those days, for more than three months.
But frequent headaches should not automatically be assumed to be migraine.
Doctors also look for warning signs that may require urgent assessment. Doctors advises further evaluation for headaches that appear suddenly and reach maximum intensity within five minutes, headaches accompanied by fever, a new neurological deficit, impaired consciousness, recent head trauma, headaches triggered by exercise or coughing, or a substantial change in an established headache pattern.
A new or unusually severe headache, therefore, should not simply be covered up with another painkiller.
At the same time, medical guidance makes clear that most people with primary headaches do not need brain imaging simply for reassurance. Diagnosis is generally based on the pattern of symptoms and examination, with further investigation considered when warning signs are present.
Dr Shah’s message is therefore less about fearing every headache and more about recognising when a familiar symptom has become a recurring medical problem.
“Headaches are among the most common neurological complaints worldwide, but they are also among the most treatable when approached correctly,” he said.
For someone who has begun every morning by reaching for a painkiller, or who has started planning work and travel around the possibility of another headache, that distinction matters. The question is no longer simply how to stop today’s pain. It is whether the repeated pain has a pattern—and whether that pattern needs to be diagnosed rather than simply endured.
