A headache may not be ‘just a headache’

World Headache Society (WHS), a global body formed in 2020 to promote headache medicine, teaching and advocacy, has recently started operations in India. It introduced a one-year certification course for clinicians treating headaches, earlier this year, which had more than 300 doctors from across the world, and 150 from India, enrolling. Set to launch a two-year course in 2022, which will be in a hybrid format — combining online and offline training — the WHS plans to tie up with other medical societies in India, to promote a better understanding of headaches, its study and treatment.

Dr Pravin Thomas, the founder and chairman of WHS and Headache Neurologist at Narayana Health in Bengaluru, says with the launch of the WHS Academy, there has been an increased interest in headache medicine education in the country.

Pandemic headache

Promoting headache medicine is all the more relevant in these times, as there has been a rise in the number of headaches being reported worldwide during the pandemic. According to a recent study published in the scientific reports in Nature, a multidisciplinary science journal, there has been an increase in the incidence of headaches since the pandemic. The study involving 47,910 patients showed that 44 % reported headaches during the period.

About two years of work-from-home has led to longer hours in front of the computer, changes in lifestyle and handling various stresses, which could have contributed to triggering headaches. “Headache, like a fever, is a symptom of a disease. There are hundreds of causes of headaches. All of them involve several parts of the brain, adding to the complexity of the condition,” Pravin says.

The World Headache Foundation is involved in training clinicians on diagnosis and management of head, neck and face pains. Pravin feels headaches are not studied in India as much as they should be. “We have one fourth of the world’s population and many headaches are due to diseases of blood vessels that are high in India. They contribute to disability and death, especially in young people. There are headache disorders where headaches may not even be a prominent symptom. These may present as dizziness, brain fog or behavioural problems,” he says.

The WHS creates programmes comprising clinical work, research and teaching. It would also organise activities that would help guide the general public in terms of self-help and create patient advocacy groups, which could go a long way in supporting patients who have been dealing with headaches. “Some headache disorders can be associated with anxiety, depression and psychosis due to the unbearable or relentless pain and because of involvement of the regions of the brain controlling emotions,” says Pravin. “It is important to recognise the finer nuances of headache neurology and decentralise headache care by training GPs and family physicians, and actively involving families. Employers also need to be sensitised about the disabling nature of some of the headaches,” Pravin adds.

Headache journal

While self-diagnosis of headaches is not advisable, Pravin says it would be ideal to maintain a journal to log in the details of the headache — onset time, offset time, associated symptoms, severity, response to treatment and such. This would help give accurate information to the clinician.

The WHS has also created a clinical tool classification system for head, neck and face pains which was published in its journal ‘Headache Medicine Connections’. This would help clinicians in identifying the extended spectrum of migraine and other headaches. “As a general rule, any new headache — headaches associated with other symptoms, a changing pattern of headaches, worst-ever headaches and headaches refractory to treatment — requires a headache neurologist’s evaluation,” Pravin says.

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Printable version | Jan 24, 2022 5:51:59 AM |

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