Dr. Guillermo A. Pasarin, MD

• Migraines: one of the most prevalent types of headache, migraines typically last from two hours to three days, causing a throbbing pain on one side of the head. Nausea, sensitivity to bright lights, fatigue, and blurred vision all may accompany migraines. While migraines have no known cure, medications and lifestyle modifications may ease symptoms. Avoiding behaviors that may trigger migraines such as lack of sleep or loud, repetitive noises can improve headaches.
• Tension headaches: also known as stress headaches, these headaches are characterized by pain in the upper top part of the head and behind the eyes. Tension headaches are common and have no exact cause; however, certain practices may increase the likelihood of developing them. For example, wearing one's hair up in a tight hairstyle or wearing a restrictive hat can put pressure on the scalp, leading to a tension headache. Other causes of tension headaches may include alcohol or nicotine use, caffeine, teeth grinding, stress, overexertion, and eye strain. Some people find posture improvement, alternating sleeping positions, and neck exercise can alleviate tension headaches. Over-the-counter pain relievers such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve) may also reduce tension-headache pain.
• Sinus headaches: this type of headache causes pain in the sinuses, but may progress to pain and pressure in the eyes, forehead, and cheeks. These headaches are often accompanied by nasal congestion, fatigue, and ache in the upper teeth and may or may not be caused by sinus infections or sinusitis (sinus inflammation). Some sinus headaches are allergic headaches, which arise from allergic triggers such as seasonal allergies (pollen allergies) or hay fever, causing sinus pressure and facial pain. Other symptoms of allergic headaches include nasal congestion, irritated or watery eyes, runny nose, and sneezing. Allergic headaches may be treated with antihistamine medications such as cetirizine (Zyrtec). Allergic headaches are common during pollen season, which is usually around springtime.
• Cluster headaches: these headaches occur suddenly and cause stabbing, sharp pain from one eye down to the one side of the neck. They are often referred to as the most aggravating and painful type of headaches. Other symptoms of cluster headaches include nasal congestion, droopy eyelid, and enlarged pupil on one side of the face. In the past, it was widely believed that cluster headaches were caused by a bevy or "cluster" of multiple types of headaches, such as a combination of an allergic headache and a tension headache. Medical experts now recognize that cluster headaches are a separate and unique form of headache. Cluster headaches last for around twenty minutes to two hours. They may recur throughout the period of a day or several weeks, but usually dissipate within a month. Treatment for cluster headaches includes over-the-counter pain medications such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve). Prescription Prednisone can help with swelling and Verapamil may reduce pain by relaxing the blood vessels.

Living with headaches is challenging; headaches can prevent people from fully enjoying life. Medical treatment and care in avoiding certain triggers can help those with headaches begin to feel normal once again.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.