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HEADACHE TREATMENT

Headache Treatment in Hyderabad | Migraine, Sinus & Cluster Headache Care

Headaches can severely affect your daily life, making expert medical attention essential. PACE Hospitals, renowned as the best hospital for headache treatment in Hyderabad, Telangana, India, offering specialized care for all types of headaches, including migraine, cluster, tension, sinus, and spinal headaches. Our expert neurology specialists provide personalized care plans, ensuring effective relief and long-term well-being.

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Best hospital for Headache Treatment in Hyderabad, India | Headache Treatment in Hyderabad | Top Headache Treatment Hospital in Telangana
Best Headache Treatment in Hyderabad, India

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Headache Treatment in Hyderabad with Best Neurologists & ENT Specialists

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Cluster, Migraine, Tension, Sinus, Spinal Headache Treatment

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Headache diagnosis in Hyderabad, India

Headache diagnosis

Diagnosing headache requires a thorough examination of symptoms, medical history, and, in certain cases, imaging tests. Primary headaches are not life-threatening and require no emergency imaging. Many secondary headaches (e.g., temporomandibular joint (TMJ) disorders, uncomplicated otitis media or hangover headache) are generally benign, requiring little or no further testing beyond a thorough history and physical examination. Though less prevalent, serious aetiologies of secondary headache need to be examined before making a primary headache diagnosis.


The neurologist considers the following before selecting the appropriate tests to diagnose headaches: 



  • Taking a detailed Medical and headache history 
  • Conducting Physical and neurological examination

Medical and headache history taking

  • The history needs to include a detailed account of the present headache, a thorough examination of systems, and a description of any previous headache problem or history. 


  • Furthermore, detailed questions about any potentially life-threatening causes of secondary headaches need to be asked, as the responses along with any physical examination results will determine additional testing or emergency treatment. 


  • Based on any chief complaint of pain, the history needs to begin with the following questions:
  • Where exactly is the pain?
  • When did the pain start?
  • What was the patient doing when the pain first started?
  • How severe is the pain?
  • How has the pain been progressing? Is it getting better, worse, or staying the same?
  • Is anything making the pain better or worse?
  • Has the patient previously experienced pain like this?
  • Is the pain radiating?
  • What other medical history does the patient have?
  • Is the patient taking any new medications, or recently changed them? 
  • Did the patient experience a seizure?


Physical and neurological examination

  • A comprehensive physical examination is necessary for all individuals who suffer from headaches. Although the neurologic exam is the most prominent criterion, it is also essential to perform a thorough HEENT (Head, Eyes, Ears, Nose, Throat) exam, which may reveal findings suggestive of either benign (sinusitis, odontogenic headache, otitis) or serious conditions (e.g., papilledema indicating intracranial pressure, temporal artery problems indicating giant cell arteritis).


  • Physical examination includes examining vital signs and overall appearance, examining the scalp for tenderness or swelling, and evaluating the temporomandibular joint for dysfunction.


  • Neurological examination includes testing reflexes, motor capabilities, sensory responses, and cognitive function, as well as examining for symptoms of meningeal irritation (such as neck stiffness) and focal neurological abnormalities.


  • Certain clinical signs indicate that a patient is unlikely to have a major headache etiology. Conversely, screening mnemonics such as SNOOP can be beneficial in eliciting clinical clues for severe illnesses.


  • SNOOP: Warning signs for serious underlying conditions.
  • S- Systemic conditions (fever, pregnancy, cancer, and HIV)
  • N-Neurological signs or symptoms (confusion, seizures, focal neurologic signs, papilledema)
  • onset is new or sudden (particularly if the patient is older than 50 years).
  • other associated characteristics (head trauma, drugs or exposure toxic substances, headache waking up from sleep or worsening with Valsalva, caused by coughing or exercise).
  • P-previous history of headaches with progression or change in features


  • A history and physical examination are usually enough to identify primary headaches if no high-risk symptoms are present. Doctors need to be able to differentiate between different types of primary headaches to start appropriate treatment.


  • However, if individuals have high-risk characteristics or a history and physical examination that are not consistent with primary headaches, the etiology of secondary headaches needs to be examined. The following are some of the most essential diagnoses of secondary headaches to consider.


  • Subarachnoid hemorrhage: Physical examination findings may include hemotympanum, focal neurological impairments, or nuchal rigidity.


  • Meningitis and encephalitis: Some physical exam findings include the Kernig sign (painful knee extension during hip flexion), the Brudzinski sign (passive hip flexion during active neck flexion), papilledema, and a petechial rash.


  • Ischemic or hemorrhagic stroke/cerebrovascular accident: Neurological impairments, altered mental status, and facial droop may be observed during the physical examination.


  • Carbon monoxide poisoning: A physical examination may indicate pink-tinged skin, hyperventilation, wheezing, singed nares, and an oedematous oropharynx.


  • Hypertensive emergencies: A physical exam may reveal an altered mental state, heart failure signs, bradycardia, papilledema, jaundice, and a renal vein bruit.

✅Headache diagnostic tests

Based on the above information, a neurologist advises the required diagnostic tests for individuals suffering from headaches. The following are the tests that might be recommended to diagnose headaches:


Laboratory tests

  • Routine laboratory testing is usually ineffective for diagnosing headaches. However, specific tests may be beneficial if a life-threatening cause of headache is suspected.


  • Laboratory tests include blood, urine, and fluid tests.


  • Female patients who experience headaches and high blood pressure need to be checked for pregnancy.


  • Patients with headaches, changed mental status, or focal neurologic impairments need to check their serum glucose levels. If carbon monoxide poisoning is suspected, a carboxyhemoglobin level needs to be determined.


  • If giant cell arteritis (GCA) is suspected, levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) need to be tested. However, if these are normal and suspicion remain high, patients need to be treated for GCA pending the temporal artery biopsy findings.


  • Patients with suspected cerebral venous thrombosis may have abnormal coagulation tests.


  • In low-risk individuals (defined as those with a normal neurologic exam, normal head CT, and absence of risk factors including current or recent pregnancy), D-dimer may be effective in excluding cerebral venous thrombosis (CVT); however, high-risk patients need to proceed to magnetic resonance venography (MRV) regardless of the D-dimer level.


  • White blood cell (WBC) abnormalities are associated with infectious or inflammatory aetiologies, but they are not specific.


Neuroimaging tests

  • Non-contrast head computed tomography (CT) is the preferred screening test for patients suspected of having an emergent headache. However, alternative and additional imaging options need to be focused on the specific emergent diagnosis in question.


  • Cerebral CT angiography (CTA) can help diagnose nontraumatic subarachnoid hemorrhage, dural sinus thrombosis, arterial dissections, and posterior circulation conditions.


  • Although non-contrast CT and CTA can detect dural sinus thrombosis, the preferred diagnostic test is magnetic resonance imaging (MRI) with MR venography (MRV) or CT with CT venography if MRI is not available.


Cerebrospinal Fluid (CSF) analysis

  • Some patients with headaches need to undergo lumbar puncture (LP) and cerebrospinal fluid tests.


  • Indications for lumbar puncture include fever, altered mental status, meningeal symptoms, focal neurological abnormalities, and a history of HIV or other immunocompromised conditions.


  • Furthermore, lumbar puncture is recommended in patients whose history and physical exam suggest idiopathic intracranial hypertension, as elevated opening pressure would be diagnostic.


  • It is notable that CT is expected to be negative in up to 5% of patients having subarachnoid hemorrhage; therefore, CSF screening for red blood cells or xanthochromia can be beneficial if the index of suspicion for hemorrhage is high.


Electroencephalogram (EEG)

  • Electroencephalogram (EEG) is an important diagnostic tool for some headache types, especially when distinguishing between migraines and other neurological illnesses such as seizures. 


  • While it gives valuable information regarding brain activity, its limitations mean that it is most commonly used as an addition to complete clinical assessments rather than as a primary diagnostic tool for headaches. Further research into EEG patterns related to migraines may improve diagnostic opportunities in the future.

✅Headache differential diagnosis

The differential diagnosis for headaches is vast. Below are some of the conditions that are included in the differential diagnosis of headaches:


  • Acute sinusitis: Acute sinusitis is characterized by sinus inflammation. Because the sinuses and nasal passages are connected, rhinosinusitis is generally a more suitable term.


  • Hydrocephalus: It is defined as the symptomatic buildup of cerebrospinal fluid (CSF) in the cerebral ventricles. This accumulation could be because of an obstruction in the normal flow of CSF, difficulty with absorption into the venous system by Pacchionian arachnoid granulations, or excessive CSF production.


  • Brain malignancy: It is often known as a malignant brain tumor, this condition is an intracranial spinal canal, which frequently causes considerable neurological damage and necessitates sophisticated treatment options.


  • Post-concussive syndrome (PCS): It refers to a set of symptoms that typically arise after a mild traumatic brain injury (TBI), with patients who have had more than one brain injury are more likely to develop it. Symptoms can be physical, cognitive, behavioral, or emotional in nature. Common symptoms of post-concussive syndrome include headaches, exhaustion, visual abnormalities, balance difficulties, confusion, dizziness, sleeplessness, and difficulty concentrating.


  • Vascular malformations: These are uncommon conditions of the vascular system, that includes veins, arteries, and lymph vessels. Vascular abnormalities occur before birth. Instead of normal, smooth networks of vessels, the vessels expand or form tangles, pockets, or shunting vessels, resulting in abnormal blood flow.


  • Pituitary tumors: It is an abnormal proliferation of cells within the pituitary gland. Pituitary tumors sometimes go undiagnosed because their symptoms are similar to those of many other more common disorders.


  • Dental cavities: Cavities are decaying portions of the teeth caused by a process that gradually destroys a tooth's hard outer surface (enamel) and moves toward the interior. These are holes or structural deterioration in the teeth.

✅Goals of headache treatment

The overall treatment goals for headache management are to enhance patients’ quality of life while minimizing headache-related impairment. Below are the main treatment goals:


  • The primary goal of headache treatment is to provide rapid relief from headache and related symptoms (e.g., nausea, photophobia) in order to restore normal function as quickly as feasible.


  • Effective acute treatments need to avoid the recurrence of headaches after temporary relief, minimizing the frequency of following attacks.


  • Ideally, treatments should be simple for patients to use themselves, giving them more control over managing acute headache episodes.


  • Improving the patient's quality of life by decreasing headache-related impairment is an important goal. This involves managing comorbid conditions that can worsen headaches.



  • Treatment plans need to be individualized based on patient preferences, previous treatment responses, and particular headache features to increase adherence and effectiveness.
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Headache Treatment in Hyderabad, India

Headache Treatment

Headaches are a frequent medical problem, and their treatment can be categorized into acute and preventive treatments. Below includes the systematic approach to the numerous headache types and treatments: 


  • Acute treatment
  • Preventive treatment 
  • Non-pharmacological treatments

Acute treatment

Acute treatment options are used to relieve headache symptoms as they develop. The type and severity of the headache determine the appropriate treatment.


Migraine headache treatment

Medications: The medications that are commonly used in the treatment of migraine include:

  • NSAIDs: These medications are useful in treating acute migraine attacks.
  • Anti-emetics: These medications can help reduce the nausea related to migraines.
  • Triptans: Specific triptans have proven their effectiveness in stopping migraine attacks.
  • Combination therapies: Combining NSAIDs with triptans can improve efficacy


Cluster headache treatment

Medications: The medications that are usually used in the treatment of cluster headaches include:

  • Triptans: Subcutaneous triptans are particularly helpful for cluster headaches and have a rapid beginning of action.
  • Oxygen therapy: Inhaling 100% oxygen is a highly effective acute treatment that provides relief in minutes for many individuals.


Tension headache treatment

Medications: The medications that are usually used in tension-type headaches include:

  • Analgesics: Antipyretics and NSAIDs are frequently prescribed for TTH relief.
  • Combination analgesics: Caffeine-containing formulations may also be effective but need to be used with caution to avoid medication overuse headaches.

Preventive treatment

Preventive therapies are used daily to lessen the frequency and severity of headaches.

Migraine prevention

  • Medications: The FDA has approved beta-blockers, anticonvulsants, and CGRP inhibitors for the prevention of migraines.
  • Botulinum Toxin A: This treatment, administered every three months, can reduce the frequency of chronic migraines in people who have no response to common preventive medications.


Cluster headache prevention

  • Corticosteroids: To reduce attack frequency, short courses can be used during cluster periods.
  • Calcium channel blocker: This calcium channel blocker is usually the first-line preventative treatment for cluster headaches.

Non-pharmacological treatments

In addition to medications, some non-pharmacological treatments can be beneficial in headache management.


Cognitive behavioural therapy (CBT)

  • CBT can assist patients in managing the psychological aspects of persistent headaches by addressing negative thought patterns and reducing anxiety associated with headache pain.


Physical therapy

  • Spinal manipulation, soft tissue therapies, and therapeutic exercises have proven beneficial, especially for tension-type headaches (TTH) and cervicogenic headaches.
  • Combining physical therapy with additional treatments, such as relaxation training, can improve outcomes for migraine patients.


Biofeedback

  • According to research, biofeedback can considerably reduce the frequency and severity of headaches, allowing patients to reduce their dependency on medications.
  • Biofeedback training has been proven to promote self-efficacy and reduce anxiety and depression symptoms, contributing to overall better treatment outcome for headache conditions.


Acupuncture

  • It has emerged as an effective treatment for headaches, mainly migraines and tension headaches. According to studies, acupuncture can help reduce the frequency and severity of headaches. 
  • A systematic review found that needling acupuncture significantly improved headache outcomes compared to sham acupuncture and drug therapy, with noticeable reductions in headache intensity and frequency.

✅Headache prognosis

The prognosis for headaches differs mainly based on the type of headache and the individual patient's characteristics. Below are the main aspects of the overall prognosis of headaches: 


  • Primary headaches (migraines and tension type headaches) typically have a good prognosis. Most people do not have lasting disability or life-threatening complications from these conditions, althoughs they can cause severe distress and temporary impairment during episodes.


  • Chronic headaches (lasting 15 or more days per month) can cause significant disability and are frequently associated with lower long-term outcomes than episodic headaches. They may need continuous medical care to alleviate symptoms.
headache symptoms | headache types | headache triggers | headache treatment in India

Headache - Symptoms, Types, Causes, Prevention, and Treatment

By Pace Hospitals • December 14, 2024
Headache: A Common Ailment. Discover the various types of headaches, their underlying causes, and effective treatment options. Learn how to recognize symptoms, prevent headaches, and find relief from pain.

Frequently Asked Questions (FAQs) on Headache treatment

  • What is a thunderclap headache, and is it dangerous?

    Thunderclap headaches are acute and severe headaches that reach their maximum intensity within one minute and are frequently described as sudden, exploding pain. They can indicate a serious illness, such as a subarachnoid hemorrhage or cervical artery dissection, requiring quick treatment to rule out potentially fatal causes. While certain cases may be identified as primary thunderclap headaches without an identified underlying conditions, complete diagnostic imaging is essential for proper evaluation and management. 

  • What is a migraine headache, and how is it treated?

    Migraine is a condition in which a person experiences repeated episodes of moderate to severe throbbing and pulsating pain on one side of the head. It occurs in both children and adults, and it affects women more frequently than men. Migraine symptoms vary from person to person, although they typically include recurring headaches. They may also include nausea, vomiting, mood changes, excessive fatigue, and sensitivity to light, noise, and odors.  

  • Can lack of sleep cause headaches, and how can it be prevented?

    Yes, lack of sleep can result in headaches. According to research, there is a strong connection between sleep deprivation and a variety of headaches, including tension headaches and migraines. Insufficient sleep affects normal sleep stages, mainly REM sleep, which is required for pain regulation; this disturbance can lower the pain threshold and cause headaches. Individuals experiencing sleep loss frequently report increased headache frequency and intensity, emphasizing the need to get enough sleep for headache prevention. 

  • What are the best ways to prevent headaches naturally?

    Headaches can be prevented by taking measures such as maintaining a healthy diet and regular sleep patterns, regular physical activity, limiting alcohol and caffeine, maintaining proper hydration, and managing stress. 

  • Can low B12 levels lead to frequent headaches?

    Yes, low vitamin B12 levels can lead to headaches. Vitamin B12 insufficiency has been associated with tension-type headaches and migraines, with studies revealing considerably lower serum B12 levels in patients with these headache disorders compared to healthy controls. Lower blood B12 levels have been related to an increased incidence of migraine attacks, indicating that maintaining appropriate vitamin B12 levels is essential for headache prevention and management. 

  • How is a spinal headache treated effectively?

    A spinal headache occurs due to a leakage of cerebrospinal fluid (CSF), often after a lumbar puncture or spinal anesthesia, leading to severe headaches that worsen when standing. Treatment typically starts with bed rest, increased fluid intake, and caffeine consumption, which can help boost CSF production and relieve symptoms. Pain relievers (NSAIDs or prescribed medications) may be used for symptom management. If the headache persists, a blood patch procedure, where a small amount of the patient’s blood is injected into the epidural space to seal the leak, is often highly effective.

What is a headache, and what causes it?

A headache is defined as pain in any part of the head, including the face, scalp, and inside the head. Headaches can affect individuals of all ages, races, and economic statuses. Headaches vary considerably in intensity and severity of the underlying medical conditions that cause them. Some headaches occur frequently (episodic) and may last for days or weeks at a time (chronic). Pain may be slight or severe, and it may be accompanied by symptoms like nausea or increased sensitivity to noise or light. The activation of pain-sensitive structures in the brain, skull, face, sinuses, and teeth causes headaches. 

What is a rebound headache, and how can it be avoided?

A rebound headache, also known as a medication overuse headache (MOH), develops when people repeatedly use headache-relieving medications, resulting in a secondary headache condition. It often affects individuals with pre-existing primary headaches, such as migraines. It refers to headaches occurring 15 or more days per month because of overuse of acute headache medication for more than three months. The cycle frequently worsens the frequency and intensity of headaches, transforming episodic headaches into chronic ones. 

What are the effective treatments for right-side and left-side headaches?

Headaches occurring on the right or left side of the head can be caused by various conditions, including migraines, tension headaches, cluster headaches, sinus issues, or cervicogenic headaches. Treatment depends on the underlying cause.


Over-the-counter pain relievers, prescription medications, and lifestyle modifications can help manage symptoms. Cold or warm compresses, stress reduction techniques, proper hydration, and maintaining good posture may also provide relief. If headaches persist or worsen, a neurologist's evaluation is recommended to rule out serious conditions.

Can sinus infections or colds cause headaches?

Yes, exposure to cold can cause headaches, which are also known as cold-stimulus headaches. The consumption of cold foods, such as ice cream, or exposure to cold temperatures causes these headaches. They are distinguished by a sudden onset of pain, usually in the frontal or temporal areas. According to studies, this form of headache is more common in people who have a history of migraines, although it can affect anyone, and it often goes away quickly if the cold stimulus is removed. 

Is a cluster headache dangerous, and how is it treated?

Cluster headaches, also called "suicide headaches," are highly intense but may not pose a direct risk of physical injury. They are, however, associated with a high risk of suicidal thoughts due to the severity of the pain and the frequency of episodes, which can occur up to eight times per day. The extreme pain and distress can have a major impact on an individual's quality of life, thus appropriate management is necessary for reducing the psychological burden associated with this illness.

What is the best treatment for migraine headaches?

Migraine headaches can be debilitating, causing intense pain, nausea, and sensitivity to light and sound. The best treatment for migraines involves a combination of medications, lifestyle modifications, and preventive therapies. Acute treatments include pain relievers to alleviate symptoms during an attack, while preventive medications help reduce the frequency and severity of migraines. Lifestyle changes such as stress management, regular sleep, a balanced diet, and avoiding migraine triggers play a crucial role in long-term relief. 

Can tooth pain trigger headaches?

Yes, tooth pain can cause headaches. Dental problems, such as cavities or temporomandibular disorders (TMD), can cause pain, which presents as headaches. Studies have found a significant association between dental issues and headache problems, implying that conditions such as TMD may increase headache symptoms by affecting the trigeminal nerve pathways, which are related to both dental and headache pain. 

What are the most effective ways to relieve tension headaches?

Effective treatments for tension headaches include over-the-counter analgesics and nonsteroidal anti-inflammatory medications (NSAIDs), both of which have been suggested to relieve pain. Additionally, psychological therapies such as relaxation training, cognitive-behavioral therapy, and EMG biofeedback can help reduce muscle tension and stress, which are typical causes of tension headaches. Furthermore, massage therapy aimed at the neck and shoulder muscles has been shown to significantly reduce headache frequency and intensity. 

How to stop a headache caused by stress and overthinking?

Some people may find that taking hot or cold showers or baths relieves their headaches. A person could also choose to relax in a quiet area with a cool towel on their forehead. Massaging the muscles in the neck and head area may provide relief. If people are experiencing headaches because of stress or anxiety, they should to practice relaxation techniques. 

Is steam therapy effective for headache relief?

Steam can help relieve headache symptoms, mainly those related to tension and sinus problems. Inhaling steam relaxes tense muscles and reduces sinus pressure, which can contribute to headache pain. Furthermore, steam inhalation has been indicated to help with nasal congestion and increase relaxation, potentially lessening headache severity. Regular sauna bathing has also been shown to effectively reduce the pain intensity of chronic tension-type headaches, suggesting that heat exposure may play a role in headache reduction. 

What is best possible treatment for cervicogenic headache?

Cervicogenic headaches, originating from the neck, require a comprehensive treatment approach to relieve pain and address the root cause. Treatment includes physical therapy, posture correction, and targeted exercises to strengthen neck muscles and improve mobility. Heat or cold therapy, massage, and trigger point release can help reduce muscle tension, while over-the-counter pain relievers (NSAIDs) or prescription medications may be recommended for pain relief.


Cervicogenic headache treatment at home involves gentle neck stretches, maintaining proper posture, using an ergonomic pillow, and practicing stress management techniques like yoga and meditation to alleviate symptoms. In severe cases, nerve blocks, spinal manipulation, or minimally invasive procedures may provide long-term relief.

What are the best treatment options for sinus headaches?

Sinus headaches occur due to inflammation or infection in the sinuses, causing facial pain, pressure, and congestion. Treatment focuses on relieving sinus inflammation and improving drainage. Decongestants, antihistamines, and nasal sprays can help reduce swelling and open nasal passages, while steam inhalation, saline nasal irrigation, and warm compresses provide natural relief. Over-the-counter pain relievers (NSAIDs) can help manage discomfort. In cases of bacterial infections, antibiotics may be necessary. For chronic or severe sinus headaches, allergy management, sinus drainage procedures, or surgery may be recommended.

How can post-traumatic headaches be treated effectively?

Post-traumatic headaches (PTH) occur after a head injury or concussion and can present as migraines, tension headaches, or cluster headaches. Treatment focuses on pain management, neurological evaluation, and addressing underlying causes.


Over-the-counter pain relievers and prescription medications may be recommended based on headache type and severity. Physical therapy, stress management, cognitive-behavioral therapy (CBT), and lifestyle modifications like proper sleep, hydration, and avoiding triggers can aid recovery. If headaches persist or worsen, a neurologist’s evaluation is necessary to rule out complications.

Which foods can trigger headaches, and what should be avoided?

Certain foods can cause headaches, mainly migraines. Common dietary causes include alcohol (particularly red wine and beer), chocolate, aged cheeses, caffeine, and nitrate-containing processed meats. Furthermore, monosodium glutamate (MSG) and artificial sweeteners such as aspartame have been identified as possible triggers. According to studies, the prevalence of these food triggers varies by individual, with some reporting headaches quickly after consumption and others having delayed reactions of up to 12 hours.

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