Headaches: A universal pain in the neck
Chronic condition may need stronger relief
Relax, take a deep breath …
stop that headache
Help your doctor help you … and keep a headache diary
Although it is not always possible to prevent a headache, it may be possible to reduce its frequency by determining and avoiding what cause it. Triggers are factors that spark a headache. Most triggers arerelated to migraines but may be related to cluster and tension-type headaches as well.
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Not just any headache! |
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Help your doctor help you … … and keep a headache diary |
In order to pinpoint your type of headache, which will help to diagnose and treat it correctly, pay close attention when it surfaces.
Discuss any frequent headaches with your doctor, who can recommend appropriate treatment.
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A closer look
A contradiction in terms
Do pain relievers treat a headache,
or cause a headache?
Yes
Regular use of pain relievers — including nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen — can actually cause headaches. “Rebound” or medication-overuse headaches can occur when the medication is taken more than two to three days a week or more than the recommended dosage. For reasons not fully understood, a drop in the level of drugs in the blood precipitates another headache, which in turn precipitates another dose. The cycle continues resulting in chronic daily headaches with more severe and frequent pain. Rebound headaches can occur with prescription drugs as well.
Questions & Answers
Michele David, M.D., M.B.A., M.P.H., F.A.C.P.
Associate Professor of Medicine
Co-Director, Haitian Health Institute
Boston Medical Center
(David Keough photo)
1. Are headaches hereditary?
Heredity does play a role in headaches, but it is not yet known what specific abnormality or genes are responsible. According to the National Headache Foundation, 80 percent of migraine sufferers report a family history of migraines. The foundation further reports that a child has a 50 percent chance of having migraines if one parent suffers and a 75 percent chance if both parents suffer.
2. Why do some foods, such as aged cheese, trigger headaches in some people?
Tyramine is a form of protein found naturally in many foods, and is believed to precipitate headaches. Tyramine is found in aged cheeses, fermented sausages, sour cream and wine, to name a few. Experts theorize that certain foods cause constriction of blood vessels followed by expansion, which may contribute to throbbing pain. Regardless of the mechanism, it is important to pay attention to what you eat to identify potential foods that trigger headaches and avoid those specific foods.
3. Is it possible to cure a person of headaches?
Headaches cannot be cured, but can often be prevented with certain medicine as well as non-medicine techniques. For instance, biofeedback teaches patients to reduce stress by controlling the physical changes that lead to headaches. Other relaxation practices are deep-breathing exercises, progressive muscle relaxation, which involves contracting then relaxing different muscle groups, and yoga.
4. Are over-the-counter medications, like aspirin, effective against headaches?
If the headache is not severe, over-the-counter medicine like acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin, ibuprofen (Motrin) and naproxen (Aleve) can be effective. NSAIDS reduce pain, inflammation and fever. Aspirin is also a blood thinner, which is why it is often recommended to reduce the risk of heart attacks, strokes and blood clots. Frequent severe headaches, however, should be evaluated by a doctor.
5. At what point should a person seek medical care for a headache?
You should seek medical care if you have chronic severe headaches. If over-the-counter-drugs are not effective, prescription drugs are available that have proven to be very effective in not only treating headaches, but preventing them as well. Your primary care physician should be the first line of approach. However, for persistent, stubborn pain, a referral to a pain specialist, such as a neurologist or anesthesiologist, may be warranted.
6. Is it possible to prevent a headache?
Yes. Headaches can often be prevented by making sure you get an adequate amount of sleep, avoid the factors that trigger the headache and engage in moderate regular exercise. Stress management techniques are also helpful. For those with severe chronic headaches prophylactic medications are available to reduce the intensity, frequency and duration of headaches. Examples of preventive medications include antiepileptic medications, antidepressants, beta-blockers and calcium channel blockers — both used to treat cardiovascular disease.
7. Is there a link between depression and headaches?
Yes. Depression is more common among people with headaches than those without headaches. Women with severe headaches are four times more likely to be depressed. Depression and headaches may share a strong genetic link. Common genetic pathways may underlie both diseases, rather than one illness causing the other.
8. Is caffeine a headache treatment or a headache trigger?
It can be both. Caffeine added to pain relievers makes them more effective in treating headaches by helping the body absorb the pain medicine more quickly, thereby speeding the action of the drug. On the other hand, too much caffeine — regularly consumed in coffee, tea and soda — can cause a withdrawal or rebound headache when you stop drinking it. The maximum amount of caffeine tolerated varies by individuals, so it’s up to you to determine your acceptable limit.
9. Are headaches life-threatening?
It depends. Some headaches are caused by an illness or condition which can be life threatening. For example, if the headache is accompanied by weakness or numbness on one side, double or blurry vision or difficulty speaking, it may signal a stroke. A headache accompanied by fever, rash, mental confusion and stiff neck could be related to meningitis. In general, any severe headache that is out of the ordinary or one considered “the worst headache ever” should be evaluated by a doctor.