Headaches are one of the most common complaints the world over. In fact, it’s estimated that over 90 per cent of people suffer from at least one headache a year, and many with regular, painful and debilitating headaches.
At any given time, around 15 per cent of the Australian population is taking pain relief medication for a headache. Interestingly, you’re more likely to suffer from headaches if you’re in the 25-44 age group, according to the Australian Bureau of Statistics.
But it can be extremely difficult to know what’s behind a headache when it occurs.
“There are hundreds of thousands of possible causes of headache,” says clinical professor of neurology and author of Managing Your Headaches Dr Mark Green.
“Frequent headaches seriously affect the lives of millions of sufferers. The result can be lost productivity and lost income, restricted activity, lower self-esteem and even social isolation.”
Many people simply put up with recurring headaches when they needn’t. If armed with the knowledge and understanding of exactly what you’re dealing with, headaches can often be prevented successfully, or at the very least, treated effectively when they arise.
What type of headache is it?
The two main categories of headaches are classified as primary and secondary. By far the most common are primary headaches. These include migraine, cluster and tension headaches. Of these, the everyday (sometimes literally) tension headache is by far the most common and one with which most people would be familiar.
Characterised by a band of pressure around the head and often neck or jaw tightness, a tension headache is generally associated with physical and/or emotional stress. It may also be caused – or aggravated – by dental problems, high blood pressure and eye strain.
For some people certain foods can trigger a headache reaction, as can fluctuations in blood sugar levels. Common culprits include MSG, red wine, caffeine, ice cream, cheese and some cured meats.
“Nitrates are added to cured meats to preserve their red colour, as in ham, bacon, salami and hot dogs,” Dr Green says. “Some people are sensitive to them, giving rise to the name ‘hot-dog headaches’.”
Cluster headaches, characterised by a stabbing pain around one eye, are less common and tend to affect men more than women.
“If you have been diagnosed with cluster headaches, you may note that with each attack, your eye gets red and tears,” Dr Green says. “That is part of the syndrome of cluster headaches, not an eye problem.”
The cause of cluster headaches is unknown, although alcohol and cigarettes can be major contributing factors for some people.
A secondary headache is one that is a symptom of another condition or disease, such as an infection (particularly sinus), head injury, eye disease, brain tumour or arthritis.
What is a migraine?
Migraines come under the broad banner of primary headaches but tend to be referred to as a separate entity entirely, and for good reason.
“It’s difficult to describe exactly what a migraine feels like to someone who has never had one,” says GP and author of Doctor in the House Dr Malcolm Clark.
“Most agree it’s the worst thing they have ever had to deal with in their lives. Not just because of the pain, which can be unbearable, but also because migraines drive them to the point where they are incapable of anything but clutching their heads in a darkened room.”
Around one in eight adult Australians suffer from migraines. They are more common between the ages of 25 and 35 and are two to three times more common in women than men.
Typically, migraines last between four and eight hours but in some cases can last much longer.
“The pain is often only on one side of the head,” Dr Clark says. “Throbbing or pulsing in nature, it may be associated with nausea, vomiting, light sensitivity or sometimes a sensation of pins and needles or numbness.”
For most sufferers attacks come on with little or no warning but around 20 per cent of migraines are preceded by ‘aura’ symptoms, such as flashing lights, a tingling sensation or an intolerance to loud noises.
There are multiple causes of migraine, with triggers varying from person to person. Some common triggers include flashing lights, loud noises, strong smells, stress, grinding of the teeth, alcohol, chocolate and coffee. For women, hormones can also be a major contributing factor.
“Many migrainous women experience worse attacks just before or at the beginning of their periods,” Dr Green says. “This is because of oestrogen withdrawal.”
Those who experience migraines during this time report that they are far more intense than migraines experienced at other times of the cycle.
When should you be concerned?
For many of us a mild headache can be easily explained by a stressful day and easily dealt with by taking mild over-the-counter pain relief or simply waiting for it to go away. But when headaches are more persistent or when they occur regularly, more than once or twice a week, it’s wise to consult your GP for a professional diagnosis.
Your GP will discuss the nature of your headaches and together try to determine the underlying cause or aggravating factors. They can help determine preventative action, offer advice on medications that are available and, importantly, establish whether or not there is any underlying condition or infection behind the headaches.
How can headaches be prevented?
Recognising what triggers your headaches as well as factors that exacerbate an existing headache is the first stage in preventing their occurrence.
“You should realise that most triggers are additive to each other,” Dr Green says. “When they occur together they may reduce your headache threshold sufficiently to actually bring on an attack. For example, eating hard cheese may not normally bring on an attack, but it might if you were otherwise stressed.”
If the mental strain and physical stress of work or family demands tend to be the trigger for the start of a headache you can employ useful relaxation strategies to help de-stress your mind and body when you feel the strain developing.
Practical strategies such as deep breathing techniques, taking a warm bath or getting your partner to give you a shoulder and neck rub can be effective ways of preventing the onset of a headache in times of stress.
Avoiding caffeine in the form of coffee and tea can also go a long way towards preventing headaches, often brought on by the withdrawal between doses.
When it comes to food and alcohol, be aware of how the consumption of a particular item precedes a headache and then cut back, particularly in times of stress. It may be wise to save chocolate, cheese and red wine for times when you are relaxed and happy. It’s also a good idea to eat regular meals, to ensure stable blood-sugar levels, and drink plenty of water.
For people who suffer from severe headaches and migraines it’s worthwhile ensuring you live and work in a well-ventilated environment, avoiding strong perfumes, exhaust fumes and cigarette smoke as much as possible.
For migraine sufferers a custom-made mouthguard worn at night may help avoid migraines brought on by grinding the teeth (a common cause).
Which medications are most effective?
Paracetamol, ibuprofen and aspirin are the big three over-the-counter pain relieving medications that so many of us reach for at the onset of a headache, for the very reason that they work. For severe migraines additional medication may be required.
“Taking three to four aspirins in combination with an anti-nausea medication called metaclopramide is probably the simplest and best drug treatment for migraine attacks,” Dr Clarke says.
“Non-drug measures like cold compresses and rest in a quiet, dark room will also help. Codeine is a godsend, quickly relieving the pain until the aspirin kicks in.”
Natural remedies may also be effective in some cases. Lavender, in the form of a lavender pillow or inhalation, can be effective in providing some headache relief.
There is also some evidence that magnesium deficiency may play a part in the development of some headaches.
“Magnesium supplementation has been shown to be of benefit in the treatment of migraine, but probably for those women who have migraines a few days before their periods and suffer from PMS symptoms,” Dr Green says.
Acupuncture too has been shown to have some effectiveness in treating migraine.
“Migraine is one of the sorts of problems acupuncture works very well for,” Dr Clarke says.
So you needn’t suffer silently – with a little knowledge and the right treatment, headaches can be prevented and healed.