Drug Rebound or Medication Overuse Headache :
This headache results from overuse of headache medications. The initial ‘cure’ later becomes the ‘cause’ of the headache. The offending drugs include both prescription drugs and over-the-counter pain medications. Overuse of codeine, caffeine and combination analgesics with any of the above can cause rebound headaches. Ergotamine, a drug commonly used for migraine, is the main cause of Medication Overuse Headache in India.

These headaches usually occur daily, and one theory is that daily or almost daily use of pain killers and other relief medications over a period of time interferes with the body’s own pain-fighting systems in the brain. Eventually, the person becomes more vulnerable to headache as soon as the effect of the drug starts to wear off. Treatment of this type of headache includes withdrawal from painkillers or from medications containing codeine, or other narcotics or ergotamine tartarate and generally requires a brief stay in the hospital. Inpatient management and detoxification works much better than outpatient treatment for this type of headache.

Post-Traumatic Headache :
Headache is common following injuries to the skull/neck. Not only head injuries, but even damage to the cervical spine can end up giving you a headache. Imaging studies may be normal and there may be little or no correlation between the seriousness of the injury and the severity of the headaches.Post traumatic/concussion headache is generally constant and dull rather than episodic. Head injury may occasionally trigger typical migraine attacks and this is called ‘Trauma - triggered migraine’.

In addition to headache, other symptoms in the post - traumatic or post - concussion syndrome commonly include faintness, poor memory, inability to concentrate, short attention span, anxiety, insomnia and irritability. After head injury, some people become depressed and lose interest in their usual activities and pleasures. Less common symptoms include ringing in the ears, spinning sensations or vertigo, fatigue, intolerance of alcohol or medications, fainting and sexual difficulties. Adults may not perform as well at work or children may start to fail in school.

The same preventive and relief medications used to treat other chronic headache disorders are effective, and biofeedback can often help as well. Many benefit from psychological intervention.

Secondary Headaches are headaches where the underlining cause is identifiable on examination or on investigation. Some of the more sinister causes of secondary headaches are brain tumors, blood vessel anomalies, brain abscesses and infections like meningitis, while some of the benign causes of secondary headaches are sinusitis associated headaches and temporo-mandibular joint headaches.

Secondary Headaches of A Serious Nature :
They constitute only about 1 to 2% of all headaches but it is important that these causes are ruled out before beginning treatment for head pain. That is why it is always said 'seek medical help if you have persistent headache or if you develop new headaches or if there is a change in the pattern of your headache or if there is a neurological deficit associated with your headache or if there is progressive worsening of your headache'. These are what can be called the Danger Signals of Headache.

Secondary Headaches of A Benign Nature :
That are not life-threatening are……….

Sinusitis - Associated Headache :
Sinuses are air-filled cavities within the bones of the skull. Although infection of the sinuses can certainly cause headache, this is not a common cause for chronic headache. It is not too difficult to diagnose this type of headache, as generally there is low-grade fever, a thick, coloured discharge from the nose or at the back of the throat, tenderness over the sinus area-frontal or maxillary i.e around the eyes and cheeks.

TM Joint Syndrome :
The temporomandibular joint or 'TMJ' is the hinge – like joint just in front of the ear canal, where the lower jaw attaches to the skull. When this joint is diseased, there may be pain and discomfort in chewing. This pain can sometimes radiate to the head. Usually, the headache is just on one side and continuous. The clue to the correct diagnosis is tenderness and pain centered over the TM joint itself or the nearby muscles, and there is worsening of the pain during chewing or yawning.

Temporal Arteritis :
This is a type of headache that affects older persons. Here headache is caused by an inflammation of the temporal artery, resulting in a jabbing, burning pain in the temple and around the ear. It is important to seek medical help because serious complications may develop and this headache can be specifically treated.

Eyestrain Headache :
This headache can be felt in the forehead or around the eyes. The trigger usually is as the term suggests eyestrain. Persistent eye strain can be caused by untreated vision problems, astigmatism, working in conditions of poor or fluorescent lighting, long periods of focused visual work. Most headaches are wrongly misattributed to or misdiagnosed as Eyestrain headaches. Remember, all headaches do not need an ophthalmologist.