Posted by: Madelein | 2007/07/16

Please help

Dear Dr,

Im requesting your assistance. i'm 27 years of age. since i fell pregnant with my daughter - now 4 years of age i have started getting terrible headaches - could be migraines.
since the 7th of this month (July), i have a terrible headache (migraine). i innitially thought that it might be my sinus that is the cause of the problem and the headaches but it seems that i am wrong even though i do suffer from sinus, but the pain is too severe as to link it to my sinus. i have taken over the counter medication (migraine kit) that knocks me out completely only to find when i wake up that the headache is gone but comes back within a time of +- an hour after waking up. it is mostly on my right side and affects my right eye and ear - sometimes the pain is so bad that i sit and cry, i cannot stand up or walk as it then feels as if the pain is shooting through my whole right side.
please help and advise me what might be wrong and what i can use as it is really starting to affect my personal life as well as my work...

looking forward to your response. thanking you in advance.

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Our expert says:
Expert ImageHeadache expert

Dear Madelein,

You are most probably correct about the sinuses not being the cause. Although the sinuses can play a part in the headache process, it is not nearly as common as people think. Research from headache clinics throughout the world shows that “sinus headache” is the most common misdiagnosis. Just because the pain is in the area of the sinuses, or because the patient has a post-nasal drip or blocked nose when the headache strikes, doesn’t mean that the sinuses are responsible. In fact what often happens is that when the underlying cause of the headache is treated, the sinus problems often clear up.

Headaches have causes that can be diagnosed, so the first step is to have a proper diagnosis of the cause/s of your pain.

To get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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