Science

Headaches are a widespread disease: lack of knowledge among patients and doctors

High incidence of migraine
If not treated properly, headaches remain

Millions affected, billions lost due to job loss: headaches are a widespread disease. However, there is a lack of knowledge, both among victims and doctors.

Burning or pressing. Sporadic, regular, sometimes sudden. Headaches are a widespread condition affecting, at least temporarily, about 47 million adults. 25 million people suffer from tension headaches, 18 million suffer from migraines, says Hartmut Göbel, founder and chief physician of the well-known pain clinic in Kiel. Chronic migraines are especially dangerous: one to two percent of the population, that is, 1.66 million people nationwide, suffer from severe migraine pain at least 15 days a month, which can affect the entire body.

On European Headache and Migraine Day, experts point out that there is still a lot of room for improvement when it comes to knowledge about these diseases. “Migraine is the second most disabling disease in the world,” Goebel says. It mostly occurs between the ages of 40 and 50, and is two to three times more common in women than in men. But it is also increasingly common in children and young adults.

Lots of lost work due to headache

The neurologist and psychologist emphasizes that migraines and chronic headaches are among the most common causes of short-term disability. Especially in the case of chronic migraine, the level of suffering is enormous. And: “Only the inability to work due to migraines costs 3.1 billion euros a year in Germany.” Plus, the loss of productivity of unpaid work – at home, raising children or caring for relatives.

Pain leads to limitations in professional and social life, according to Charlie Gaul, general secretary of the German Migraine and Headache Society. You don’t see sickness in the affected, they retreat when attacked, often in a darkened room. Many are extremely sensitive to light, noise, and smells, and struggle with nausea, vomiting, dizziness, and poor circulation. Some of them are associated with disturbances such as flashes of light or blurred vision – an aura.

Chronically ill patients often put themselves under pressure, see themselves as “unreliable” and fear the next attack before important events become imminent, says neurologist Gall. Performance pressure tends to be high, “functioning” is expected.

Medications can’t cure migraines

However, migraines are less embarrassing than they were 20 years ago. “Those who have been affected feel they find more understanding when they communicate openly.” However, this state is not achieved everywhere. “Knowledge about the nature and course of migraine in everyday life is limited among those who do not suffer from it,” says Goebel, who has received numerous awards for his work.

There are many myths about migraines. The disease is associated with a flaw in the social world. At the same time, headaches and migraines, neurological, genetically determined diseases, have become more frequent. Yet: “Migraine is underrated and underestimated.” Another problem is that severe migraines also increase the risk of depression, heart attack, or stroke. Medicines cannot cure it, but they can help.

Chronic headaches due to taking too many painkillers

For frequent migraines, some preventive medications are very effective, Göbel explains. This includes a group of drugs that act like antibodies. In the case of chronic migraine, Botox injection has been approved as a preventive measure since 2010, and studies have shown “significant efficacy”. Medications for acute pain – such as triptans – should be taken less than ten tablets a month, otherwise you can even provoke pain, doctors warn. In case of overuse, there is a high risk that the pain will become chronic, pain doctor Gall warns. Vicious circle.

Approximately three percent of the population suffers from headaches as a result of this overuse, according to Goebel. The Society of Neurologists also emphasizes that headaches often persist after Covid-19 – even then taking painkillers too often is the wrong way to go. Behavioral therapy, relaxation exercises and physical activity are important for migraines, according to DMKG spokesperson Gall.

Cheese, lemons and chocolate are suspected as triggers

There are individually different migraine triggers – triggers – such as hormonal fluctuations, disturbed sleep-wake rhythms, weather changes, or stress followed by a drop in stress. “Everything is too fast, everything is too much, everything is too sudden, everything impulsively can trigger migraine attacks,” Goebel adds. In the past, certain foods, such as cheese, citrus fruits, or chocolate, were considered triggers. However, it has been shown that hunger for these foods is already a symptom of migraine.

Deficiency: Goebel regrets that, on average, information on the diagnosis and treatment of headaches in a six-year medical course worldwide is only about two hours. However, starting this winter semester, for the first time in Germany, a non-professional master’s course “Migraine and Headache” was held at the University of Kiel, developed in cooperation with the Goebel Pain Clinic.

(This article was first published on Monday, September 12, 2022)

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