What to do when your head aches: news, breakthroughs, and remedies to ease your pain - Good Medicine

Natural Health, Jan, 2004 by Shari Roan

Fifty million of us are gripped by chronic headaches. Yet most of us could get relief if our pain was identified correctly. Migraines, for example, are misdiagnosed more often than not by general physicians, according to the National Institutes of Health.

Putting a name to the pain might seem secondary when your head is pounding like a lead-filled maraca, yet knowing the difference between, say, a sinus problem and a cluster headache makes treatment a surer thing. It might help to avoid all possible headache triggers, but a life without stress, tension, anxiety, alcohol, hunger, dehydration, exertion, poor sleep, bright lights, dairy products, preserved foods, sex, and genetic predispositions might be tough to arrange.

To help us out, the International Headache Society has a new classification system that will more accurately pinpoint which type of headache is behind your misery. "There will now be worldwide agreement among specialists," says Robert B. Daroff, president of the American Headache Society. "And that will help patients."

People can help themselves, too. While there are serious drugs for serious head pain, "much of what you can do to control headaches is in your own hands," says David Buchholz, M.D., associate professor of neurology at Johns Hopkins University in Baltimore.

relieve your headache

type         symptoms               triggers

   tension   Dull, constant,        Stress,
             non-throbbing,         depression.
             usually on both
             sides of head;
             neck and scalp
             can tighten.

  migraine   One-sided              Certain foods,
             throbbing              hormonal
             nausea, sensitivity    changes, hunger,
             to light and           weather, lights,
             sound.                 stress.

   cluster   Severe pain in         Alcohol,
             vicinity of one        smoking.
             eye, tearing of eye
             and nose congestion;
             may develop
             during sleep.

condition-   Symptoms of            Underlying
   related   another disorder,      health problem.
             such as tumor,
             fever, high blood
             pressure, etc.

type         treatment              prevention

   tension   Rest, OTC pain         Limit stress;
             relievers,             use biofeed-
             ice packs              back, relaxation
             prescription           techniques or
             muscle relaxants.      antidepressants

  migraine   Medication             Biofeedback or
             such as                relaxation; beta
             triptans; ice          blockers,
             packs.                 calcium channel
                                    blockers, anti-
                                    convulsants.

   cluster   Inhaled oxygen;        Prescription
             medications            steroids, calcium
             such as                channel blockers,
             sumatriptan,           ergotamine,
             ergotamine.

condition-   Treatment of           None.
   related   underlying
             condition.

the migraine quiz

More than half of headache sufferers have migraines that aren't being treated as such. How do you know if your headache is actually a migraine? Doctors at the American Academy of Neurology designed the quiz by asking 443 random headache patients to answer a survey. An analysis of the answers revealed that three questions best predicted a migraine diagnosis. If you answer yes to two out of three of these questions, your headaches are probably migraines.

1. Has a headache limited your activities for a day or more in the last three months?

2. Are you nauseated or sick to your stomach when you have a headache?

3. Does light bother you when you have a headache?

rebound headaches

There was a time, recalls 33-year-old Sarah Smith (not her real name), when she would take over-the-counter pain medications several times a week for headaches. "Then I switched to a prescription drug," she recalls, "but I got little relief. I'd still wake up every morning with a headache."

Smith suffered for several years before finding a doctor who accurately diagnosed her rebound headache, one that recurs shortly after treatment. Experts believe that this common type of head pain is caused by several years of using headache medications, especially painkillers and sinus medications containing caffeine.

The cycle works like this: Blood vessels swell with a headache, drugs reduce the swelling, the drugs wear off and the vessels swell again to an even greater degree.

To stop the medication-pain cycle, cease using all caffeine-containing medications, says Buchholz, author of Heal Your Headache: The 1, 2, 3 Program for Taking Charge of Your Pain. At the same time, try to identify and eliminate headache triggers. Your headaches may worsen temporarily, but the idea is to endure short-term suffering to break the rebound habit.

Smith tried Buchholz's suggestions on giving up substances that triggered her headache, such as chocolate, caffeine, cheese and alcohol. And she made a point of not becoming overly tired or stressed. "It's difficult in the beginning" to avoid triggers and not take pain medication containing caffeine, she says. "But you get used to it. And it's worth it."