Getting Headaches Over the Age of 50

There's good news and bad news about headaches as you get older. The good news first: if you've been a migraine sufferer all your life, your migraines will usually diminish in your fifties and older. The same goes for "cluster" headaches. The bad news: many medications we take for age-related conditions--high blood pressure, depression, cardiac problems, menopause--can cause some headaches to get worse.

Even more worrisome are headaches that begin at age 50 and older; some of these can signify serious disease. By arming yourself with headache information, you'll be more confident in reporting your symptoms to your doctor and have a greater chance of successful treatment.

Changing headache patterns

Headaches that you've suffered from in your younger years are apt to change:

-Migraines (throbbing pain usually on one side of the head, often accompanied by nausea, vomiting and sensitivity to light and sounds), lessen in frequency and severity. However, the aura which often precedes migraine may still occur as people age--but without the ensuing pain.

-Never had a migraine? You're unlikely to suffer one after the age of 50.

-Cluster headaches (stabbing, boring or piercing pain in or around one eye) come in attacks lasting days or weeks. It's unusual to start getting them over 50.

-Tension headaches (may be episodic or chronic) are the most common type of headache among older adults. About 10 percent of people over 50 experience a tension headache for the first time.

-Hypnic headaches occur only at night, usually waking you at the same time each night. These uncommon headaches develop almost exclusively after age 50.

Serious headaches

"About one of four headaches in people over 50 can signify serious underlying conditions," says Frederick G. Freitag, D.O., Associate Director, Diamond Headache Clinic, Chicago. These may include:

-sleep disturbances, especially sleep apnea

-rheumatoid arthritis, especially of the cervical spine (neck)

-high blood pressure

-cerebral hemorrhage (stroke)temporal arteritis (now called Giant Cell Arteritis)-inflammation of the temporal artery-which can lead to blindness if not treated; also associated with a condition called polymylagia rheumatica which produces muscle weakness and pain

-trigeminal neuralgia- severe facial pain and headache (rare before 50)

-Paget's disease -a bone disorder that can affect the skull

-Depression-which can result in a chronic daily headache

There are several medications often prescribed for people over 50 that may cause headaches as a side effect. "The most common culprits," says Dr. Freitag, "include nitroglycerin [for angina], calcium channel blockers, some arthritis medications, drugs for erectile dysfunction and hormonal treatment, especially estrogen."

When should you see your doctor about a headache? "The main thing to look for is a changing pattern of headaches," says Dr. Freitag. "If your headaches start occurring daily or nearly every day or if your headaches are no longer relieved by simple analgesics (aspirin, Tylenol), see your doctor". Look for these other signs:

-headache associated with neurological symptoms--blurred vision; dizziness; weakness (may indicate stroke or bleeding in the brain)

-headache brought on by coughing, sneezing or physical exertion (may indicate cardiovascular disease)

-headache that you would describe as the worst headache you've ever had

-headache that interferes with your daily activities or work

Headache treatments

If you remain a headache sufferer as you get older, medical treatment may change for your headaches. If headaches are a symptom of an underlining condition, treating the condition is the first way to go. That's why it's so crucial to determine what may be causing your headaches, especially if they are new in your life.

The medicines used to prevent and treat headache in earlier years are the same ones used in people over 50. There's one major exception--naproxen and other anti-inflammatories that can cause gastrointestinal bleeding. In general, people over 50 can get away with lower dosages of the medicines they are currently taking.

You and your doctor must be careful with adding new headache medication to any existing drugs that you take for other conditions. When you get a new prescription, always ask your doctor or pharmacist if it could interfere with any other prescription or over-the-counter medications you take.

Research is always coming up with new medications to treat migraine and other headaches. "Trexima, which is a new combination of two commonly used migraine medications, will likely receive final FDA approval sometime this summer and will be available by prescription in the fall," says Dr. Freitag.

You can do it!

The National Headache Foundation http://www.headaches.org/consumer/

has declared June 3-9, 2007, as National Headache Awareness Week. Here are several simple steps the Foundation suggests to improve your communication with your doctor about your headaches:

-Stay focused on the most important questions you have. At your first visit, decide what you need to know at the moment--and what questions you can save for a later visit. If you're very worried that you have a brain tumor (quite uncommon), tell this to your doctor who may reassure you

-Make sure you understand your diagnosis. Ask your doctor specifically what is causing your headaches. Realize, however, that this make take some time to figure out based on your pattern of symptoms, medical history, physical exam, and tests. Taking time to come up with a diagnosis does not necessarily mean that your headaches are caused by a serious condition.

-Give a detailed report of your headache symptoms. Keep a headache diary of your symptoms: when and how long they occurred, what the pain felt like, if you had any other symptoms at the time (blurry vision, nausea), what your mood was like at the time, any foods or allergens that may have triggered your headache and what remedy you tried.

-Make sure you understand your treatment plan. Bring along a friend if you think you won't remember your doctor's recommendations. Get written instructions on taking your medications. And ask your doctor for the best time to reach him or her with questions that arise after your visit.

Source:

This material originally appeared on Eons.com, a website empowering people over 50 to get the most out of life. This article reprinted with permission of Eons.com.