How To Manage Your Headaches
Got a headache? You’ve got plenty of company.
More than 45 million
people in the United States have chronic headaches, says the National Headache
Foundation, and 28 million of those suffer from migraines.
Headaches are
most common among 40-somethings and tend to decrease in frequency as people age.
In a 2004 study, 18 percent of people ages 18 to 44 had experienced a severe
headache in the previous three months, compared with only 6 percent of people
over 75. No matter what the age group, more women are affected.
The
economic impact of all those sore heads is huge. People who have migraines miss
more than 157 million workdays each year, says the American Academy of
Neurology.
And even those who don’t call in sick accomplish less on the
job. A 2002 survey found that 13 percent of the U.S. workforce lost productive
time at work because of pain during a specific two-week period. Headaches, the
most common malady, caused a mean loss of three and a half work hours a week.
This report will help you understand the common causes of headaches and
effective ways to lose the pain.
Types Of Headaches
All
headaches are not created equal. Here’s how to tell them apart:
- The most common form is the tension-type headache (TTH), affecting 75
percent to 90 percent of people who have chronic or frequent headaches. It’s
characterized by feelings of pressure or dull pain, like a band squeezing your
head. TTH is usually felt on both sides of the head and can last from a half
hour to a week.
- The pain of a migraine headache may be severe and often throbs or
pulses. It’s usually felt on one side of the head. A migraine may be accompanied
by other symptoms such as nausea, vomiting, and sensitivity to lights, sounds
and odors. It can last from several hours to three days.
Some people
experience an aura, or sensory warning, 15 to 30 minutes before a migraine
starts. Signs include flashes of light, blind spots in vision, or
pins-and-needles sensations in an arm or leg.
Up to 17 percent of women
and 6 percent of men have had a migraine. Fully 70 percent of migraine sufferers
are women, says Stephen Silberstein, M.D., of the Headache Center in
Philadelphia.
- Sinus headaches are the result of inflamed sinus passages or sinus
infection. They cause pain behind the brows and/or cheekbones.
- Cluster headaches are somewhat rare, affecting only about one in
1,000 people. Many more men than women have them. Pain may be sharp and severe
and is typically felt on one side, around or behind the eye. Cluster headaches
may be accompanied by symptoms such as runny or stuffy nose and redness or
tearing of the eye. They’re usually experienced several times a day for months
at a time.
Headache Triggers
The two primary kinds of
headaches – tension-type (TTH) and migraine – have different triggers. And
despite the fact that they’ve been around as long as mankind, scientists still
don’t have a complete understanding of their causes.
The consensus used
to be that TTH was simply the result of stress-induced tension in the muscles of
the head, neck and shoulders. But it may be that TTH is “a response by the body
to emotional strains and pressures rather than to excessive muscular tightness
and resultant constriction of the scalp arteries,” writes Manish Singh, M.D., of
the Medical College of Pennsylvania.
Migraines, on the other hand, are
known as vascular headaches because they’re related to abnormal function of the
blood vessels of the brain. Interestingly enough, people with high blood
pressure have fewer migraines, probably because their blood vessels are stiffer.
Triggers for tension-type headaches include:
- Sleep deprivation
- A long, stressful workday
- Poor posture or body position (such as holding the phone between your
shoulder and your ear)
- Poor sleep position
- Hunger
- Eyestrain (for example, from staring at a computer for hours on end)
- Anxiety and/or depression
- Arthritis or other degenerative disease of the neck or spine
- TMJ (temporomandibular joint) disorder, often characterized by clenching the
jaw
Migraine triggers include:
- A drop in estrogen level, as happens just before and during the first two
days of a woman’s monthly cycle
- The use of oral contraceptives or hormone-replacement therapy
- A long list of foods that include amino acids such as tyramine, which can
affect blood vessels, (for example, beer, red wine, chocolate, cheddar and other
ripened cheeses, soy sauce, monosodium glutamate, lima beans, sour cream, figs
and raisins, sausage and other processed meats, chicken livers, and fermented or
pickled foods, to name a few)
- Skipping meals
- Stress
- Intense physical activity
- Bright lights or sunshine
- Changes in weather
- Sleep deprivation or oversleeping
For some people, vigorous
exercise such as running, rowing and weight lifting can trigger a headache,
especially in hot weather or at high altitude. Most of the time such headaches
are harmless, but occasionally they point to a serious underlying cause such as
a tumor or blood vessel abnormalities.
See your doctor if you have an
exercise-induced headache. Get help immediately if you also experience vomiting,
double vision or rigidity of the neck.
Headache Medication And Other
Therapies
Over-the-counter (OTC) meds are often effective against
garden-variety tension-type headaches. On the shelves you’ll find
single-ingredient drugs such as acetaminophen, aspirin, ibuprofen and naproxen
as well as combination medications (e.g., those containing acetaminophen,
aspirin and caffeine).
If tension headaches are chronic, though, see a
doctor to rule out more serious problems and discuss whether prescription
medicines are necessary. Your physician may prescribe an antidepressant or other
drugs.
Migraine sufferers may get sufficient relief from the OTC drugs
listed above. If not, your doctor may prescribe drugs such as ergot alkaloids,
triptans, antidepressants or opiates. Or she may recommend a combination of
drugs, for instance, sumatriptan and a nonsteroidal anti-inflammatory such as
naproxen.
Whether you’re using prescription or OTC drugs, you run the
risk of rebound headaches by overusing pain relievers. If you take something for
a headache more than two or three times a week, talk to your health care
provider.
Treating headaches caused by sinusitis depends on whether the
underlying problem is a sinus infection, allergies or both. Therapies may
include antibiotics to treat the infection, and nasal sprays and prescription or
OTC decongestants. If your sinus cavities have structural problems that tend to
cause sinusitis, you may need surgery.
Some patients find that
complementary and alternative therapies provide relief for all headache types.
Options range from deep-breathing exercises, yoga, and guided meditation with
visual imagery to acupuncture, biofeedback and hypnosis.
Low-tech
commonsense approaches can also help:
- Resting in a dark, quiet room
- Applying an ice pack or moist heat
- Taking a brief nap
- Stretching
- Doing progressive-relaxation exercises
When To See A Doctor
There’s no need to make a medical appointment for occasional headaches. But
when they become chronic and interfere with your life and work, it’s time.
Schedule a visit if your headaches are increasing in intensity. See a
physician right away if you’re over 50 and having headaches for the first time.
They could be the result of a condition called temporal arteritis, which can
cause blindness.
The National Institute of Neurological Disorders and
Stroke advises seeking immediate help if you experience any of the following
danger signals:
- A headache that strikes suddenly, with especially severe pain
- A headache that follows a head injury
- A headache that’s accompanied by fever, confusion, rash, stiff neck, double
vision, seizure, numbness, difficulty in speaking, or pain in the eye or ear
Build Health To Reduce Headache Pain
Experts agree that
simple health-enhancing behaviors have the potential to reduce the frequency of
headaches.
Start by getting plenty of sleep, preferably going to bed and
getting up at about the same time every day. And don’t skip meals, as hunger can
be a potent trigger.
Coffee is fine, but don’t go overboard. People who
drink more than four to seven cups a day may be more prone to headaches and
irritability, the Mayo Clinic says. And if your doctor has recommended you cut
back on caffeine, do it gradually. Going cold turkey can cause intense
withdrawal headaches.
Keep a journal to get a fix on the causes of your
discomfort. Record when you have pain, when it begins and ends, what you’ve
eaten that day, how well you’ve been sleeping, whether you’ve been under stress,
and whether medications are helping. Note suspected triggers such as foods,
hormonal changes and weather. If you see a doctor for relief, the journal will
help her make better treatment decisions.
If you have employees,
encourage them to get up from the computer at least once an hour to stretch and
refocus their eyes. Walking breaks are another good way to reduce stress and
muscular tension.
For employees who have frequent headaches, provide a
quiet spot where they can turn off the lights and take a short break.
For More Information
To learn more, visit these Web sites.
Medline Plus headache page
www.nlm.nih.gov/medlineplus/headache.html
National Headache Foundation’s consumer information sheets
www.headaches.org/education/Headache_Topic_Sheets
Mayo Clinic headache center
www.mayoclinic.com/health/headaches/HE99999