Painful situations - First Aid

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First aid

First aid

Painful situations

Sudden headache Back pain (low back pain) Sciatica (lumbar disc herniation) Stiff neck and neck pain The "whiplash" Chest pain Abdominal pain Ear pain Sore throat
  • Sudden headache
    • What to do
    • Headache in the child
    • What to do
  • Back pain (low back pain)
  • Sciatica (lumbar disc herniation)
  • Stiff neck and neck pain
  • The "whiplash"
  • Chest pain
  • Abdominal pain
  • Ear pain
  • Sore throat

Sudden headache

Headache represents the neurological symptom most frequently associated with any pathology. Fortunately, most headaches are of benign origin: in fact, about 90% of outpatients who complain of headaches have tension headaches or migraines. A careful history, a scrupulous physical examination and the use of instrumental tests are fundamental to make a correct diagnosis and to exclude pathologies dangerous for life.

An individual presenting with a cephalalgic symptomatology should ask:

  • Is it the first time you have a headache?
  • How long have you been suffering from it?
  • is this an unusual headache, more intense than those you have always suffered from?
  • How did this disorder start?
  • in what context did it arise?

These questions can help distinguish what is the first manifestation of a primary headache (generally migraine or cluster headache) from episodes attributable to secondary forms, usually referred to as the most painful attacks the patient has ever suffered. About 20% of those who go to the emergency room for the "worst headache of their life" have subarachnoid hemorrhage. However, the triggering causes of a recent onset acute headache are manifold.

Headache can arise within hours of a head injury; there are headaches triggered by exercise, by exertion, by an increase in blood pressure and by sudden movements of the head which may be indicative of an increase in intracranial pressure. A headache associated with fever, ingestion of toxic substances, caffeine, alcohol, tobacco or nitrates, must instead make you think of a disorder due to infectious, chemical, toxic or metabolic causes.

When multiple people in the same place complain of headache, the possibility of carbon monoxide poisoning should be considered. Pain related to stress, fatigue, hunger, concentration, excitement, ingestion of chocolate or the use of oral contraceptives or estrogen suggest a primary headache such as migraine.

Depending on the location of the pain, different pathologies can be diagnosed:

  • pain in the occipital region: infratentorial pathology;
  • pain in the frontal region: supratentorial pathologies or the presence of structural lesions that obstruct the outflow of CSF into the infratentorial ventricular system;
  • the headache unilaterally, which over time becomes bilateral, could be due to the increase in intracranial pressure;
  • eye pain: presence of an injury that causes traction on the sickle or on the structures of the midline;
  • painful symptoms in the area behind the ear: tumors of the cerebellum-pontine angle;
  • pain in the inner ear area: lateral sinus injury;
  • severe, throbbing, retro-orbital pain: could indicate a cluster headache, an inflammatory lesion of the orbital structures or an expanding aneurysm of the Willis circle;
  • migraine attacks in two thirds of cases are unilateral, although the location may vary in subsequent attacks;
  • tension headache generally presents as chronic pain in the vertex or with a circular distribution around the head;

A continuous, generalized headache that increases over several weeks, exacerbated by bending over, bending over, coughing, defecating and sexual activity, may be due to an increase in intracranial pressure. A pulsating headache (synchronously with the radial or carotid pulse) is most likely of vascular origin.

A sharp stabbing or deep and terebral pain localized in the retro-orbital area is typical of cluster headache. A stab-like pain in the area of ​​distribution of the fifth cranial nerve often indicates a trigeminal neuralgia. A constant, dull, gravitative pain, on the other hand, suggests a form of tension headache.

All adult subjects with a history of previous headache who claim that the attack is similar to the previous ones in terms of intensity, duration and associated phenomena must be subjected to evaluation of vital parameters and neurological objective examination and, subsequently, assessed at a specific clinic or headache treatment center for long-term follow-up.

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What to do

Given that the causes of headaches are many, and that each of these must be treated ad hoc, here are some simple tips to relieve pain, waiting for more general medications or therapies to have their effect.

  • Relax: it is important to relieve tension, for example with a hot bath (but not too much), with yoga or stretching exercises or with even more specific techniques. Even strong emotions such as anger or anger must be "discharged", perhaps with not too demanding physical activity.
  • Take a coffee: the vasoconstrictor power of caffeine is known, but be careful not to overdo it, you could get the opposite effect.
  • Abstain from alcohol, even from a simple glass of wine with meals: the tyramine, contained mainly in wine, but also in foods such as cabbage and potatoes, promotes headaches.
  • Do not consume frozen foods and drinks: the cold stimulates the sensory nerves of the palate, promoting headaches.
  • Ventilate the rooms well, especially those where you sleep: the stale air favors headaches, and thus also traffic pollution.
  • Avoid intense physical exertion, which increases blood pressure too quickly, promoting headache.

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Headache in the child

The child cannot and can always describe his headache: it is therefore necessary to pay attention to his behavior. They can be signs of headaches in the child:

  • agitation and irritability up to two years;
  • state of prostration, apathy and sadness, which tends to determine a condition of passivity from two to six years;
  • strange postures assumed by the child; in fact, he tries to adopt a position, perhaps even an uncomfortable one, that helps him to relieve the pain; avoids contact with the painful area, observes the movements of those who intend to move it very carefully and anxiously, reacts by defending or crying when the doctor or parents themselves want to examine the head.

According to the most recent data, painful crises affect about 25-30% of the population in school-aged children and in the most serious cases these episodes undermine the subject's school or social skills. If the pain occurs after the child has watched television, or after a period of reading and concentration, it could be a state of eye fatigue: a defect in vision, such as nearsightedness or farsightedness, can induce headache.

In children, headaches can be part of a picture that also includes fever, loss of appetite, pallor, apathy, vomiting associated with a possible ongoing infection: flu, sinusitis (inflammation of the paranasal sinuses) or meningitis (inflammation of the meninges) . The headache can also be due to trauma, following falls or small head injuries or headache symptoms related to tooth decay.

Very often, in children as in adolescents, the problem does not resolve itself over time and is of psychosomatic origin; difficulties at school and in the family are the cause. Migraine sufferers with a very high probability will have migraine sufferers. Headaches greatly affect the quality of life of children who suffer from them: it limits their possibilities for play, fun, influences school performance and social life.

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What to do

If the child shows signs of suffering, some precautions must be followed:

  • do not underestimate or play down the child's symptoms;
  • reassure him that it is nothing serious and that the pain will pass quickly;
  • contact the pediatrician with serenity as soon as the first symptoms appear;
  • as far as treatment is concerned, it is always advisable to contact the doctor, who will advise the most suitable therapy according to age, weight and type of disorder.

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