Assessment and management of the client with headaches

Headaches are considered the most common type of pain; more than 40 million Americans seek medical help each year for this complaint. In order to adequately assess and manage the client with headaches, a clear understanding of the types and possible causes of this pain is essential. The purpose of this article is to provide information to assist the primary care practitioner in this process. Headaches can be categorized as either primary or secondary to an underlying (and usually treatable) problem. Most headaches fall into the primary group, which includes migraine (and variants), cluster and tension-type headaches. However, headaches secondary to an underlying cause must be identified so that further investigation, treatment and/or referral may be initiated. Several reference tables are included with this article to aid in the identification of the causes of headaches and to assist with the assessment and management of the client with this complaint. A headache questionnaire is also included to help facilitate this process.