What's really causing your headache?

By Colette Harris

Health

07 March 2011 10:02

 

If you suffer headaches frequently, finding out the cause can help you identify the right treatment. A headache diary – noting the time, severity, symptoms and what you were doing beforehand – can really help you and your GP. And our low-down on the most common kinds of headaches should point you in the right direction.

Tension-type headaches...
Are felt as a constant ache or pressure, perhaps a ‘tight band’ around your head, with neck stiffness and pressure behind your eyes. They usually last one to six hours.

What causes them?
Triggers can include stress, poor posture, squinting, tiredness, noise and bright sunlight. An uneven bite, or teeth grinding at night can also cause strain in your jaw and neck, triggering a headache.

Beat them!
* Nip it in the bud – take paracetamol or ibuprofen as soon as your headache starts. * Try applying a hot flannel to your forehead or neck.
* Relieve tension by going for a walk, doing yoga, or massaging your shoulders and neck.
* Work out your triggers and avoid them.
* Recurring tension-type headaches can be treated with an anti-depressant called amitriptyline prescribed by your GP. 
* Acupuncture could help reduce the frequency of tension headaches and migraines, to find a qualified acupuncturist contact the British Acupuncture Council (020 8735 0400 or visit www.acupuncture.org.uk).

Dehydration headaches...
Can give pain at the front, back or just on one side of the head, or throughout your entire head. Bending your head down or moving it from side to side often makes it feel worse.

What causes them?
Too little water, and too much alcohol, which makes your body flush out water and electrolytes (minerals such as sodium, potassium and calcium) that maintain the balance of fluids in your body.

Beat them!
* Drink more water – especially if you’re exercising or spending time in centrally heated or air-conditioned places. The average adult loses around 2.5 litres of water a day simply by sweating, breathing and eliminating waste, says experts from the world famous Mayo Clinic.
* Drink even if you don’t feel thirsty. As you get older, your body's ability to conserve water is reduced, and your thirst sense becomes less acute.

Migraines...
Are usually felt as a severe throbbing pain at the front or on one side of the head, sometimes with nausea and sensitivity to light. A third of migraine sufferers get classic migraine warning signs such as flashing lights or a stiff neck (known as an aura) beforehand.

What causes them?
Migraines are triggered when chemicals in the brain cause blood vessels to spasm. Triggers include: stress, shock, excitement, lack of sleep, poor posture, hunger, strong smells, noises, lights, a flickering screen and even changes of climate. Specific foods such as citrus fruits, chocolate, caffeine and alcohol can also act as triggers. Some scientists believe hormones influence this change in chemicals, as menstruation, menopause and HRT have all been linked to migraines.

Beat them!
* Identify and avoid your triggers to reduce the number of attacks.
* Lying down in a darkened room can help immediately and try taking ibuprofen.
* Visit your local pharmacy for painkillers especially formulated for migraines, such as Migraleve, with ingredients that relieve nausea and sensitivity to light as well as pain. Or try Migracap (01685 387788 www.migracap.co.uk), a light-blocking lycra cap filled with cooling gel patches or Migrastick (020 8763 1414) a roll-on with cooling essential oils that massages your temples as you use it.
* See your GP, who can prescribe treatments to try and reduce attacks as well as stronger painkillers to help during an attack. If your migraines still don’t respond your GP can refer you to a specialist migraine clinic.

Too many painkillers...
Can leave you with a frequent daily headache, but only if you use the painkillers to treat headaches – strangely enough, people using them for conditions such as back pain or arthritis don’t get overuse headaches. “Up to one in 10 people who have frequent headaches do so because they take painkillers too often,” says Dr Fayyaz Ahmed, consultant neurologist at Hull Royal Infirmary.

What causes them?
“If you take painkillers for headaches more than twice a week for more than three months you'll be at high risk of getting rebound headaches – even if you aren’t taking more than the recommended dose,” says Dr Ahmed.

Beat them!
* Avoid codeine. All common painkillers – paracetamol, aspirin, ibuprofen and triptans – can cause this problem, but codeine painkillers are more likely to.
* Avoid painkillers for headaches on more than two days a week, and for two or more consecutive days.
* If your GP diagnoses medication overuse headaches, you need to stop taking the medication, but do so only with their advice as you may need to do it gradually. 

When to see a doctor
Usually, there’s no need to visit your GP if you only get occasional headaches. But see your GP if:
Your headaches are frequent or severe
They come on suddenly and are unlike anything you have had before
They are accompanied by a stiff neck, fever, nausea, vomiting and confusion
Your headache followed an accident, or a blow to your head
You also experience weakness, numbness, slurred speech or confusion


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