Are my severe headaches a sign of something serious?

Hallo Dr.
I get severe headaches that come with chills and sometimes the headache is throbbing or like a sharp pain on one side and disappears within three seconds. Should you suggest I visit a neurologist or have a CT scan?

Thank-you
Mukami 

Dear Mukami,

Almost everybody gets headaches at some point, and the causes are very diverse. In many cases, headaches are a symptom of an underlying issue.

The most common type of headache is a tension headache. Usually, the pain is on both sides of the head and it may feel as though there is a tight band around the head. It occurs due to tightening of the muscles around the neck and the scalp.
 
It may be triggered by fatigue, dehydration, hunger, light exposure (too little or too much), noise, congestion, stress, too little or too much sleep, or even poor posture. 

Tension headaches are usually not very severe, and resolve within an hour or so, with or without painkillers.

To prevent them, then you need to figure out what your triggers are and address them such as rest, take enough water, eat regularly, get adequate sleep, avoid noisy or congested surroundings, wear ear muffs if you work in a noisy place, reduce screen time (computers, tablets and phones), make sure you work in well-lit areas, practise good posture and stress management. Sometimes taking a warm bath may also reduce the headache.

There are cluster headaches, which occur for several weeks at a time, and are very severe and do not respond well to painkillers. The pain is usually concentrated around one eye, and there may be redness and tearing from the eye or a blocked or running nose.

There are also migraine headaches, which are severe headaches, usually affect one side of the head, and may be accompanied by increased sensitivity to light and sound, nausea and vomiting.

Headaches may also be caused by hormonal changes, medications, too much alcohol, exposure to carbon monoxide, flu, sinusitis, and almost every illness, especially those affecting the head and neck region.

In most cases, headaches are not a serious problem, but if they persist or become worse with time, if they are very severe, if they are as a result of a head injury, or if they are associated with other symptoms like fever, drowsiness, confusion, slurred speech, stiff neck, vomiting, convulsions, then you need medical attention so that the exact cause may be identified and dealt with.
Since the list of possible causes is long, usually the doctor will start with tests that are easier to do, and targeting the most common causes of headache. The tests get more complicated as you go down the list. If a specific cause for the symptoms is identified, then it is treated. There is medication that helps to prevent recurrent headaches and painkillers can help with the pain. If regular painkillers do not clear the headaches, there are much stronger medications that are prescribed by neurologists.

You also need to identify triggers (such as hunger, dehydration, heat, congestion, noise, motion, fatigue) that may start the headache and the easiest way to avoid the symptoms is by avoiding the triggers.

Dear Doc,

My mum has been complaining of periodic pain in her right leg from the thigh area downwards. She is in her early 50s. Sometimes when the pain is too much, walking becomes tedious for her and she even limps. She went to hospital but she was put on painkillers, which helped ease the pain for a while but it's back. Sometimes this pain drives her to tears and I can't stand it. What could be the problem?

Frankline

Dear Frankline,
It is likely that your mother is suffering from sciatica, which is pain spreading along the sciatic nerve. The sciatic nerve exits the spine at the lower back and travels down through the buttocks and thighs, giving branches that go all the way to the toes. It usually happens because the nerve is compressed by a bulging disc, narrowing of the spine, muscle contractions or arthritis along the vertebrae. 

You can get numbness and tingling, burning pain or pain like an electrical current. When the sciatic nerve is compressed, the pain starts either in the lower back, or at the hip or buttocks, spreading down the thigh, leg, sometimes even to the toes.

For many people, the symptoms are mild and manageable with self-care. For a few people, the pain can get severe and they can also develop weakness in the affected limb and problems with bowel or bladder control.

For self-care, she should exercise regularly, maintain good posture, maintain healthy weight, avoid sitting for too long, do stretching exercises, and be careful when lifting heavy objects (hold the objects close to the body, bend the knees and lift with the back straight). She should avoid excessive physical exertion, and she can use hot or cold packs to ease the pain.
She needs to see an orthopaedic specialist so that physical examination and some tests like xrays and MRI scan can be done to find out the exact problem. Treatment includes medications for pain, both oral, and injections; stretching exercises, physiotherapy, massage or surgery, if required.

Hey Doc,

Sometimes my sister's eyes get swollen just like that without any external force. Our preliminary examination revealed that when she takes 'blueband' this issue must occur. 
Can there be any underlying disease or it's normal and so she should avoid blueband?

Epaphras

Dear Epaphras,
An individual can be allergic to anything, so it is possible that your sister is allergic to margarine. However, if she regularly takes margarine, maybe every morning at breakfast, but gets a swollen eye once in a while, then it is highly unlikely that the margarine is to blame. Taking margarine can predispose some people to develop allergy symptoms in the respiratory system.The swollen eye maybe due to allergies, especially if it is also accompanied by red, teary eyes. It may be due to allergic reaction to dust, pollen, smoke, animal fur, mold or chemicals. This can be managed with anti-allergy eye drops.

The eyes can also look swollen due to eye infection, blocked tear duct, injury, viral infection, thyroid disease, kidney disease, inadequate sleep, crying, smoking, or taking too much salt that leads to fluid retention. It would be good for her to be evaluated by a doctor to identify the cause of the swelling so that she can get the correct treatment.

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