With over 50 million cases per year, in the United States alone, headaches top the list of the most common afflictions in humans. More than 70% of headache sufferers never consult a doctor because they assume that little can be done to help them.
While it’s true that not every headache can be cured, there are proven ways of controlling them. This website has been prepared so that you might better understand headaches: their nature, which symptoms to take seriously, and the various types of headaches and their possible causes and treatment.
As with any other medical condition, a
consultation with a health professional is recommended before beginning a
headache control program.
Headaches are caused by two different
categories of biological happenings: either by muscle contractions, or by
vascular irregularities (the alternating constriction and expansion of
arteries). Certain conditions such as brain tumors, arterial inflammation,
and irritation of the facial nerves also cause headaches, but these are
The attributes causing the pain are two
mechanisms relating to muscle contraction: nerve compression within the muscle
caused by poor posture, spinal misalignment, or physical and emotional stress;
and nerve irritation caused by a buildup of metabolic wastes resulting from
decreased blood and lymph circulation due to poor diet, constipation, or other
digestive problems, and in women, pelvic irritation.
These types of headaches include migraines,
cluster headaches, and caffeine withdrawal headaches, that account for less than
10% of all cases. With vascular headaches, the alternating constriction
and expansion of the arteries of the head exerts pressure on arterial nerves and
causes sharp pain.
Although it’s rare, headaches can be caused
by serious disorders, such as brain tumors or meningitis. That’s why you
should never ignore chronic headaches and hope they’ll go away on their
own. If any of the following symptoms occur, consult your family physician
or neurologist as soon as possible.
While a biological condition may make you
more susceptible to headaches, certain factors called “triggers” are what
actually set them off. Therefore, an important step toward solving your
headache problem is to analyze what was happening right before your head began
to hurt. What were you doing? Were you sunbathing? Did you
skip a meal? Were you having an argument? A trigger can be almost any
change inside or outside the body that can provoke a headache - something we
see, feel, smell, hear, or eat. Each headache sufferer has different
sensitivities, so not all triggers provoke a headache in all sufferers.
Headaches may be produced by one particular trigger, sometimes by a combination
of them. Because something is a trigger, however, doesn’t mean it will
always result in a headache; frequently, it may not. Only by looking for
possible patterns will you be able to identify your personal triggers and avoid
them in the future. The most common headache triggers, in order of their
Proper treatment of headaches involves careful
diagnosis to locate the disturbance actually causing headache pain. It is
very important to keep track of your headaches so your doctor can properly
diagnose your headache pain, type, and causes. One of the most important
tools in headache prevention are is the headache diary. It is used in
determining the underlying causes and patterns related to your headache. Use the
diary to record on the
days you get headaches:
In order to help alleviate your pain, you
first need to recognize what type of headache you are having.
Approximately 90% of all headaches are classified as tension-type (sometimes
referred to as muscle contraction headaches). Another 8% are migraine or
other types of headaches. Only about 2% of headaches are potentially more
serious - that is, secondary to an underlying illness or other medical
A dull, steady, non-throbbing pain, usually on both sides of the head is common. The pain can be mild to severe. Sometimes it feels as if your head is in the grip of a vise or that you are wearing a tight band across your forehead and temples. Pain may also extend into the neck and shoulder area.
Occasional tension headaches can last from 1 - 2 hours, to all day, or longer. They often occur in the late afternoon or evening as a result of accumulated stress during the day. Chronic tension headaches may occur every day, or almost every day, for months or years. They may last from several hours to all day.
Emotional stress is the leading trigger of
tension headaches, particularly among chronic sufferers. But tension
headaches may also be triggered by physical causes such as arthritis, poor
posture, or staying in one position for long periods of time.
Tension headaches may be effectively treated
with over-the-counter (OTC) pain as well as non-medicinal therapies. An
extensive listing of such therapies is listed under the “headache treatment”
section. If chronic tension headaches occur everyday or almost everyday,
it is important that you consult a physician immediately.
These headaches are termed “sinusitis”. They are an inflammation of the lining of the sinus cavities. There are two types of sinusitis:
The symptoms of both types of sinusitis vary with the particular sinus or sinuses involved. In general, the basic symptom is a constant or recurrent deep, dull headache, which is usually around the nose, forehead, eyes, or ears. Facial pain, sinus tenderness and pressure, stuffy nose, yellowish discharge from the nose, persistent cough, loss of smell, and pain in the upper jaw, cheeks and even the teeth may also occur. There may be swelling of the eyelids and excessive tearing if the sinuses over the eyes are involved. Another symptom of sinusitis is drainage of mucus behind the nose and down the back of the throat - also called “postnasal drip”. The pain from sinusitis often worsens when you bend over. In almost all older children and in about half of adults, fever is present.
Anyone can have sinusitis. In fact, sinusitis is one of the five most common health complaints in the United States. However, certain groups of people may be more likely to develop sinusitis.
Once a diagnosis of sinusitis is made, your doctor will probably prescribe a course of treatment to clear up the source of infection and relieve your symptoms.
Treatment of sinusitis involves:
Antibiotics may be prescribed to eliminate the
infection that is causing sinusitis. As the infection subsides, so should
the pain. However, antibiotics may take several days to work, so your
physician may also recommend over-the-counter decongestant and analgesic to help
relieve sinus pain and re-establish proper drainage.
To help lessen the discomfort that
accompanies sinusitis, it may help to apply warm, wet compresses or a hot water
bottle to the painful area. Inhaling steam from a vaporizer or bowl of
steaming water and using a humidifier may also make you more comfortable.
The pain is a mild of moderately dull pain around the front and back of the head; and it may be continuously present.
These headaches may occur 3 or 4 hours after a medication wears off. They may occur daily or almost daily and last from 6 hours to a full day.
Rebound headaches are a result of overuse of
over-the-counter medications and sedatives, resulting in a tolerance/dependence
cycle. Research by Dr. Simon Ellis, of the North Staffordshire
Infirmary in England, indicated that when people take pain medication too often,
they develop tolerance; when the drug wears off, the headache recurs.
Migraines involve a throbbing or pulsating
pain, often worse on one side of the head.
International Headache Society (IHS)
Migraines vary widely in duration, from a few hours to 3 days. On average, migraine sufferers experience about one attack a month. Auras typically last about a half hour and then subside before the pain begins. What’s more, incidence of migraine appears to be on the rise. The National Center for Health Statistics reports that during the past decade, migraines have increased by as much as 77% in women under age 45 and by 64% in men of comparable age. Migraine is believed to be a hereditary condition. About 70% of sufferers have other family members with the condition. Migraine affects women more often than men . . .approximately 75% of sufferers are women.
Although migraines have been recognized for
thousands of years, no one knows for certain what causes them. Today,
however, medical science has a theory that may explain why an attack
Migraines are not like other kinds of
headaches; they have very specific physical causes, and a unique group of
“triggers”. Triggers do not actually cause migraines. If a person
does not have a physical predisposition for migraines to begin with, a trigger
will probably have no effect. But for people who do have a physical
predisposition, a trigger is the catalyst that may set the attack in
Triggers for migraines vary from individual to individual. Below is a list of common migraine triggers:
Caffeinated foods and drinks: coffee, tea, chocolate, colas/soft drinks
Alcohol: especially red wine, vermouth, champagne, beer
Dairy products: aged cheese, sour cream, whole milk, butter
milk, yogurt, ice cream
Breads: sourdough, fresh yeast, some types of cereals
Vegetables: some types of beans (broad, Italian, lima, lentil,
fava, soy), sauerkraut, onions, peas, pickles, olives
Snacks: Nuts, peanuts, peanut butter, pickles, sesame seeds
Meats: Organ meats, salted meats, dried meats, cured meats,
smoked fish, meats with nitrites (such as hot dogs, sausages, packaged
Fruits: Most citrus fruits, bananas, avocados, figs, raisins, papaya, passion fruit, red plums, raspberries, plantains, pineapples
Monosodium Glutamate (MSG): a flavor enhancer often used in restaurants, found in seasoned salt, instant foods, canned soup, frozen dinners, pizza, potato chips
Soups: soups containing MSG, soups made from bouillon cubes
Desserts: chocolate, licorice, molasses, cakes/cookies made with yeast
Seasonings and Flavorings: soy sauce, some spices, garlic powder, onion powder, salt, meat tenderizers, some marinades
Hunger: missing meals, dieting
Sight: bright lights, glare
Sound: loud noises
Smell: strong odors
Weather: changes in temperature, humidity, wind, barometric pressure
Atmospheric pressure: changes in altitude, air travel
Motion from riding: trains, planes, automobiles,
Some vitamin supplements: Recent studies have shown a link between migraines and low levels of the mineral magnesium. Research by Dr. Burton Altura, of the State University of New York Health Science Denter at Brooklyn, New York, found that 42% of people who suffered with intermittent migraines had low magnesium levels. And in tests using imaging techniques to measure metabolic shifts in the brain during migraine attacks, it was discovered that in some patients magnesium levels drop right before or during an attack.
B vitamins: While the link has not been clinically proven as with magnesium, there is some evidence to suggest that people who suffer with migraines may have a lifelong deficiency of some B vitamins.
Prescription medications: some high blood pressure medications, nitroglycerin, OTC pain relievers, and analgesics
Birth control pills
Medicinal Therapies: Migraine
sufferers experience such headaches that it is quite understandable why they
might turn to quick pill-popping remedies. Although over the-counter
medications might meet the need for quick pain relief, the result if often an
“analgesic rebound headache” triggered by the high amounts of caffeine in
Be Smart, Check with Your Physician
Non-Medicinal Therapies: For an extensive list of such
therapies, see our “headache treatment” section.
Just as there are many different types of headaches, there are many different types of treatment. What works for one person, may not be as effective for another. Overall, the best form of treatment is certainly prevention of the headache in the first place. Be aware of your own personal headache triggers and attempt to avoid them. Having said that, we realize that avoidance of triggers is not always possible and may not always be the answer. The following list of treatment alternatives, whether used separately or together, should be of assistance to you when a headache does strike.
Cold therapy: The Doctor’s Book of Home Remedies by Rodale Press, Inc. suggests an ice pack as one of the most effective non-drug treatments. The earlier you use an ice pack to treat your headache, the better. Besides applying it to the painful area, try placing it on the back of the neck, forehead, and temples.
Warm therapy: Using heat to
foster relaxation increases blood flow and relaxes your muscles.
Take a warm shower, letting the water beat down on your head, neck, shoulders,
and back. Hot tubs and heating pads can have a similar result.
Be cautious not to burn yourself - warm is better than boiling hot.
Time out: Remove yourself from a stressful situation by taking a walk or by taking a few minutes to concentrate on something relaxing. Concentrate on the relaxing quietness. A five-minute time out “vacation” is a quick and easy stress reducer.
Transcendental meditation: TM is a technique that purports to facilitate the body’s natural healing ability. Patients sit comfortably with their eyes closed for 15 to 20 minutes twice a day, concentrating on a “mantra”, a word or sound. Their minds become progressively more tranquil, until they reach a point of “transcendental consciousness”, and gross physical experiences (such as pain) are transcended (overshadowed).
Creative Imagery: This process uses the mind to visualize images that relieve pain. For example, patients may close their eyes and imagine themselves on a tropical beach, a cool sea breeze blowing away their headache. Or the image may be more literal. Instead of the beach, the patient may imagine his or her headache being caused by dilated blood vessels in the brain. The patient then imagines these blood vessels constricting, thus relieving the cause of the headache.
Guided visual imagery: Proven
especially effective in controlling the pain accompanying migraine
headaches, it is most useful if you use guided visual imagery in the
beginning stages of your headache. But even in the midst of the most
painful attacks, patients have been able to take their mental focus away
from the pain through this technique. To use guided imagery, close
your eyes and compare your pain to a physical event. For
example, you may see your migraine as a raging forest fire. View this scene in
your mind and feel the pain it brings. Next, bring the scenario to a
happy ending. Picture this forest fire being drowned by torrential
rain. Tell yourself that as the fire goes out in your scene, so does
Progressive relaxation: This is a technique that attempts to relax the body until it reaches a state of detachment and well-being. With progressive relaxation, each part of the body is alternately tensed for about 20 seconds, then relaxed. When all the parts of the body have gone through this process, the patient lies in this detached state for periods of five minutes of more.
Deep breathing: Take deep,
slow breaths, concentrating on breathing from your diaphragm. Hold
your breath for several seconds, then slowly exhale, completely emptying
your lungs. Repeat several times. As you inhale, your chest
and stomach areas should expand; and as you exhale, these areas should
Stretching and exercising: Gentle neck and shoulder exercises may be used to relax and stretch strained, shortened muscles. This can reduce tension and decrease the risk of headaches triggered by muscle irritation. For some people, strengthening exercises are also recommended. The following basic exercises, recommended by headache experts, are effective for both tension and migraine headache sufferers.
For best results, be sure to breathe deeply and stretch slowly and gently. DO NOT PUSH! If you have any neck, shoulder, or back injuries, consult your physician before trying any of these exercises.
For more information about neck and shoulder exercises, or if you feel you would benefit from a customized exercise routine, ask your physician for a referral to a registered physical therapist who has expertise in treating headache patients. A physical therapist can evaluate and educate you about your specific condition, select the appropriate exercises, demonstrate them for you and design a personalized exercise program that you can do at home or at work. Usually this is preceded by an in-office treatment.
Aerobic exercise: While an excellent countermeasure against the effect of stress, it’s important that the exercise you select is something you enjoy and that fits your schedule, as well as your level of skill. If stress if a problem for you, you may want to avoid highly competitive sports. Many people find that non-competitive forms of exercise such as swimming, cycling, walking, or calisthenics are better choices. And when you do have a headache, if it’s not too severe, go for a walk. Aerobic exercise not only helps you relax, but also increases your levels of endorphins, a naturally occurring brain chemical that diminishes pain. Always check with your physician before beginning any exercise program.
Massage: A good neck and shoulder massage can relieve the muscle tension caused by stress, and it can improve circulation inhibited by constricting blood vessels. Both of these changes can ease the pain of a mild headache. A professional massage therapist administering Swedish massage can often provide pain relief as well as aid in the prevention of pain.
Chiropractic: There is evidence that chiropractic treatment is effective in the management and alleviation of headache pain. A reason for this effectiveness seems to be that stiffness and pain in the cervical (the neck area) spine is a frequent and major factor of headaches.
Proper nutrition: Missing a meal and other improper eating habits can bring on a headache. If you haven’t had time to eat properly, get a healthy snack, such as a piece of fruit, or even a glass of water.
Acupressure: Many headache sufferers are doing this without even realizing it. The technique for acupressure remains the same regardless of the pressure point you use. Apply gentle, steady rotating pressure to the point with your index finger or thumb. Maintain pressure for 7 to 15 seconds, then release. Repeat every few minutes as needed.
Reflexology: the fleshy underpart of the big toe is the area of the foot believed to relate to the health of the neck area. Vigorously massaging the underside of the big toe is believed to open the constricted blood vessels in the neck that are causing the headache response. If you find that the pain of your headache is most intense in the back of your head, try massaging the underside of the middle toe for additional pain relief.
Recognized as a successful technique for pain relief, acupuncture uses
hair-thin needles to stimulate specific points of the body through which
an energy known as qi (pronounced chee) flows. Qi is believed to be the
body’s life force or vitality. The goal of acupuncture is to restore a
smooth flow of qi throughout the body. A more conventional
explanation of its effectiveness it that acupuncture stimulates nerves in the
skin and muscle that signal the release of chemical known as endorphins,
the body’s natural pain relievers.
Hypnosis: An accepted therapy for a host of conditions, and practiced by thousands of health professionals, hypnosis may be effective for headache sufferers. By placing patients in a hypnotic trance, then making therapeutic suggestions, the sensation of pain is able to be reduced. Although studies such as Dr. Karen Olness’, of Case Western Reserve University, show the effectiveness of hypnosis in treating children with migraine headaches, more and better controlled studies are needed before hypnosis’ effectiveness is scientifically proven.
Many herbal medicines claim to dull the symptoms of headaches. Being
used extensively in England, and despite the fact that many headache experts
in the United States regard its use as experimental, the herb feverfew has
received the attention of the National Headache Foundation. Recent
findings of the foundation report that continually taking feverfew
extracts decreases the occurrence of migraine headaches in certain
Psychotherapy: Because headaches can be caused or aggravated by stress, a variety of psychological therapies can be helpful in reducing the frequency and intensity of these headaches. All require the help of a professional therapist.
Sexual Activity: Making love may be a tonic for head pain. Research has shown that many people get full or partial headache relief from having sex. Sexual activity releases endorphins, the body’s natural pain killer .
Good Posture: Posture plays a key role in many tension headaches. Avoid leaning or tilting your head to one side (a problem for frequent phone users). Be aware of your posture as you sit at your computer/desk, drive your car, stand in line at the grocery store, or carry a bag/purse. Many of the positions we put ourselves in tighten neck and back muscles-- leading to tension headaches.
Biofeedback: One of the few
natural therapies endorsed by the Natinal Headache Foundation, and
commonly used in headache centers, biofeedback can reduce both the frequency
and severity of headaches. A machine is used to provide feedback to
sufferers about muscle tension (which is associated with pain) and blood
flow to the hands. Using this information, patients learn to
reduce muscle tension in their bodies and to increase the blood flow to
their hands. When blood is directed to the hands, it reduces the rush
of blood that has strained the vessels in and around the head area.
As these blood vessels become less swollen, the head pain subsides.
Studies have shown that up to 92% of the people who learn biofeedback
techniques can reduce the intensity of their pain. In fact,
biofeedback is often used to wean patients from their dependence on drugs to
natural and holistic forms of therapy.
Autogenic training: This
relaxation technique is actually a combination of guided imagery,
meditation, and biofeedback. The ultimate goal is to regulate the body’s
blood flow and bring it back to a normalized rate. Because headaches
are often triggered by irregular blood flow, improved circulation will
lessen the pain. Practicing autogenic training on a routine schedule
can serve to reduce the frequency of headache attacks.
Lie down in a comfortable position. Close your eyes
and attempt to shut out all other thoughts, especially those of your
headache. (Since autogenics relies on getting a message to your
unconscious mind, it is extremely important to concentrate on clearing the
lines of communication to your unconscious mind.) Next recite the following
six lines over and over in a slightly audible tone:
We realize that no website can provide all the answers for everybody, but we hope we’ve been able to help you answer some of your questions about headaches.
Please, DO NOT GIVE UP. Hopefully you
will work towards an alliance with your health and mental health care providers and together arrive
at a treatment plan that works for you. There are many myths about
headaches, but the most destructive of all is, “You just have to learn to live
with it.” Don’t accept it. We have come a long way in our
understanding of this disorder, and research continues today. Do not give
up and good luck!
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