You have a headache? It’s a headache

2023-04-19 09:14:08

If you have a headache, you suffer from what is called headache, one of the most frequent reasons for visiting medical consultations, although, according to the Spanish Society of Neurology (SEN), more than 40% of patients who suffer from it on a regular basis it is still undiagnosed. April 19 is National Headache Day.

Up to 89% of the male population and 99% of the female population claim to suffer or have suffered from a headache at some point in their lives and that is why it is common for them to be regularly consulted in Primary Care centers, in the emergencies and in neurology services where, specifically, it is the first reason for care.

More than 200 types of headache or headache

According to the International Classification of Headaches, there are more than 200 types of headaches that are divided into two large groups: primary headaches and symptomatic or secondary headaches.

within the primary headachesthe migraine and the tension type headache are the most frequent types, indicates the neurologist Pablo Irimia, coordinator of the SEN Headache Groupwho explains that these are “diseases in themselves and, furthermore, they are the most common: they account for more than 90% of headache cases.”

“Las symptomatic or secondary headachesas its own name indicates, are those in which the headache is a symptom of another type of disease, but the primary headaches , specifies.

The prevalence of headache

The World Health Organization (WHO) estimates that at least 50% of the world population has suffered from a primary headache, at least once, in the last year.

And in Spain, according to data from the SEN, more than 74% of the population has suffered or suffers from some type of primary headache, with a gender distribution of 69% for men and 79% for women.

In addition, 4% of the population is affected by some type of chronic primary headache, that is, they have a headache more than 15 days a month.

Up to 46% of the Spanish population presents some type of active primary headache. However, according to data from the SEN, more than 40% of patients who suffer from headaches on a regular basis are still undiagnosed and around 50% of patients with headaches self-medicate with non-prescription analgesics.

In addition, “primary headaches are among the diseases that generate the greatest disability and have a high socioeconomic impact, since they usually affect a sector of the population that is in the most productive years of their lives,” says the neurologist.

Migraine, the leading cause of global disability

“Migraine is the world’s leading cause of disability in people between the ages of 15 and 49 and is one of the five leading causes of years of life lived with disability,” says the specialist who refers to the Global Burden of Disease Survey, a global program that evaluates mortality and disability caused by the main diseases, injuries and risk factors, a consortium of more than 9,000 researchers and 162 countries.

The migraine It is a primary headache that affects approximately 12% of the world population.

In Spain, it is the neurological disease with the highest prevalence -it affects some five million people- and is responsible for a high percentage of absenteeism and loss of labor productivity in the national territory, with an estimated annual cost of two billion euros. euros, according to the SEN.

EFE/Alessandro Di Meo

Migraine symptoms and their chronification

Headache crises, especially migraines, present with headache, discomfort, nausea, vomiting, intolerance to light, smells or sounds, among others.

Some consequences that produce a “significant limitation in the activity of the person who suffers them, forcing them to reduce it in more than 50% of the occasions and requiring bed rest in up to 20-30% of the cases,” says Dr. Irimia.

In addition, some patients present anticipatory anxietythat is, constant fear that new crises will occur, which affects their state of mind, generating greater anxiety and aggravating the disease, ”explains the specialist.

But they can also generate limitations in professional development and even in education, since in many cases it begins in childhood or adolescence, he points out.

The symptoms of primary headaches are highly variable depending on who suffers from them. It ranges from an occasional headache to very frequent and intense pain crises.

In addition, depending on each patient, the headache can evolve in very different ways: ”Remission of the crises can occur over time, a certain persistence of the crises can be experienced but with relative stability (this is called episodic headache), or the disease can progress to the chronification of pain”, says the neurologist.

“Migraine is, in fact, the type of headache with the greatest tendency to become chronic. We estimate that 3% of patients with episodic migraine evolve annually to chronic migraine and that close to 50% of Spanish patients who suffer from chronic headache suffer from migraine”.

“The lack of diagnosis and treatment and self-medication are the factors behind the majority of cases that become chronic. And although not all primary headaches are the same, they are all characterized by the fact that with a correct diagnosis and treatment it is possible to control the disease and prevent it from becoming chronic”, highlights the SEN expert.

“A chronic headache will not only generate more disability, but its management will become much more complex. Therefore, on days like today (National Headache Day) it is important to highlight the importance that anyone who begins to experience a headache with some recurrence and incapacitates them in their daily lives, should consult their doctor,” he advises. .

The neurologist emphasizes: “Not all available treatments are valid for all types of headache, nor are they effective in all patients and falling into self-medication is the first step for our headache to become chronic.”