Headache treatment in Jordan

Treating a headache starts with diagnosing which headache it is, because the single word covers conditions that differ completely in cause and treatment. Primary headaches are those in which the headache itself is the disease, including tension-type headache, migraine and cluster headache. Secondary headaches are a sign of something else: a sinus, dental, neck or eye problem, blood pressure, a medicine, or an intracranial process that needs urgent attention. No single painkiller suits all of these, which is why so many self-directed attempts fail. Diagnosis depends on the history far more than on any test: how long attacks last, where the pain sits and how it feels, whether a visual warning precedes it, whether it comes with light and sound sensitivity or nausea, what worsens and relieves it, how many headache days you have each month, how many days you take painkillers, and your sleep, stress, caffeine intake and menstrual pattern. **No blood test diagnoses a primary headache**, and imaging is not requested for everyone: it is ordered when there are worrying features or when a long-standing headache pattern changes, and a normal scan does not mean the headache is imaginary. Treatment has two arms. Acute treatment uses a medicine appropriate to the headache type, taken early and limited to a defined number of days. Preventive treatment is taken regularly by people whose headaches are frequent or disabling. Both are combined with trigger management: regular sleep, meals that are not skipped, adequate hydration, gradual reduction of caffeine, treatment of neck tension and poor desk posture, an eye test, and stress control. Keeping a headache diary for a few weeks is one of the most useful tools available, because it reveals patterns the patient has not noticed. The most important misconception to correct is this: **overusing painkillers is itself a common cause of chronic daily headache**. Someone who regularly takes headache painkillers on more than roughly two to three days a week can enter a cycle in which the medication drives the headache, and the way out is a planned, supervised reduction combined with a preventive strategy, not a higher dose. The limits are clear too: prevention reduces the number and severity of attacks rather than abolishing headache altogether, it does not replace trigger management, and it may take weeks before its effect shows. Go to the emergency department immediately for a sudden, explosively severe headache, headache with fever and a stiff neck, headache with weakness, slurred speech, seizure or altered awareness, headache after a head injury, headache that worsens with coughing or lying down or wakes you with vomiting, a new headache after the age of fifty, or headache with a painful red eye and changed vision. Suitability for any medicine is decided by clinical examination, not by reading.