Headaches are extraordinarily common, number seven on the list of reasons why people see their doctor. It is estimated that 45 million people suffer from chronic head pain. That doesn’t begin to include those who have occasional headaches. Yet for all that, the exact causes of head pain are not all that clear.
According to Joel Saper, MD, director of the Michigan Head Pain and Neurological Institute, the brain itself doesn’t feel pain. That’s why neurosurgeons can operate on the brain tissue while a patient is wide awake. So, a headache isn’t exactly the result of pain in the brain. We perceive head pain that may originate from the scalp, the skull, or the coverings of the brain. Muscles and nerves in the neck can also create discomfort that is perceived as a headache.
An occasional mild headache does not usually pose a serious problem. But a more severe headache, even if it occurs only once in a while, or a chronic headache, even if it is not extremely painful, deserves medical evaluation. Popping a couple of aspirin or acetaminophen pills just isn’t a good idea when the headache occurs several times a week. In fact, Dr. Saper says that using such over-the-counter (OTC) analgesics too frequently can actually cause the headaches you’re trying to treat. It takes an experienced headache doctor to help someone out of such a vicious cycle.
“I have suffered from headaches all my life. For the past 30 years, I’ve taken from 25 to 35 aspirins daily, in addition to sinus medication. My doctor doesn’t know about these large doses, but regular checkups reveal no damage to my liver or kidneys.â€
The trouble is that many physicians are not aware of how serious this problem can be. John Edmeads, MD, editorializing in the journal Headache, noted that “the daily use (or, more accurately, abuse) of analgesics actually worsened and perpetuated headaches.” He bemoaned the fact that so few physicians “know that chronic analgesic abuse causes chronic headaches.”328
The diagnostic dilemma for doctors is that they must distinguish between headaches brought on by overuse of pain relievers, headaches caused by some other medical condition, and headaches caused by a change in brain chemistry. If the headache is a consequence of an underlying condition like the flu, it will go away when the infection runs it course. Celiac disease is one condition that can cause recurrent headaches, among many other symptoms, although the underlying issue is actually a reaction to gluten in the small intestine. The treatment is to avoid any foods that contain gluten (wheat, barley, and rye).
Headaches are extremely common. Occasional uncomplicated (“garden-varietyâ€) headaches respond well to self-treatment with OTC analgesics. Severe or recurrent headaches deserve medical attention. A number of approaches have been developed to treat migraines, so it should be possible for most sufferers to get relief.
Anyone who is using a headache medicine of any type more than 2 days a week on a regular basis is flirting with the danger of converting a frequent headache into a chronic headache. This holds true whether the drug is an OTC pain reliever or a prescription migraine medication. In such a situation, the help of a headache specialist may be needed to break the vicious cycle and help find a headache management plan that works.
- Consider phasing off caffeine intake gradually to avoid caffeine withdrawal headaches.
- Try relaxation techniques for a tension headache.
- If you regularly take headache medicine more than 2 days a week, see a headache specialist for help. Such frequent use of medication can cause rebound headaches that become chronic.
- Keep a headache diary to discover your migraine triggers. Include details on exercise, sleep, diet, and weather.
- Experiment with riboflavin, magnesium, feverfew, or butterbur for natural ways to prevent migraine.
- Acupuncture may help reduce the frequency of migraines.
- Sip hot, spicy soup to stop a migraine that has just begun.
- For best results, treat a migraine as early as possible. Don’t wait to see if it will really turn into a headache.
- For mild to moderate migraines, try OTC treatment.
- Try a prescription triptan drug for moderate to severe migraines.
- Use prescription Topamax to prevent frequent migraines.
- Prevent menstrual migraines by taking NSAIDs for several days before the expected onset of menses.
- See a doctor if you experience a headache during sex or upon exertion. Serious problems need to be ruled out.
- Take an NSAID before making love to prevent benign sex headache.