Defining headaches

“I have a headache.” When is a headache something to worry about?

A sign that something isn’t working properly in the body, headaches may be a symptom you need to pay attention to. It can be as simple as a sign of emotional distress, lack of sleep, poor nutrition, or a stressful situation you may be going through. It can also be as a result of a medical condition such as high blood pressure or anxiety. Not every headache is a sign of a serious illness, but it is important to understand the cause so that you are able to treat it effectively.

A common ailment, headaches can affect anyone at any time, at any age, and are typically defined as a pain felt in any region of the head (in one or both sides of the head). Pain is felt for a variety of different reasons and as such may require specific types of treatment.

Pain may be sharp, dull or throbbing, and can develop suddenly or gradually, lasting for up to an hour or for several days at a time. Pain may begin in the head or upper neck, originating from the periosteum (tissue surrounding the muscles and bones, encasing the skull, ears, eyes and sinuses). This thin layer of tissue covers the surface of the spinal cord and brain (meninges), as well as the veins, nerves and arteries in the head. Pain signals inflammation and irritation, and can be constant, intermittent, mild or intense (severe).

How are headaches classified?

Did you know that there are over 150 different types of headaches? Headaches are typically classified according to their cause and fall into three main areas which determine their type:

Primary headaches

Primary headaches are not classified as a symptom of an underlying medical illness. Pain-sensitive structures in the head (including nerves and blood vessels) can become overactive, irritated or inflamed. Occasional headaches resolve easily with basic treatment (fluids, rest and a pain-relieving medication), while others can be somewhat debilitating.

Primary headaches are not typically life-threatening, but can be severe and intense enough to even mimic symptoms of serious conditions such as stroke.

Some of the most common primary headache types include:

  • Tension headaches or tension-type headaches
  • Cluster headaches
  • Migraine with aura (accompanied by sensory disturbances) or without aura
  • Trigeminal autonomic cephalalgia (TAC) – cluster headaches and paroxysmal hemicrania (a severe unilateral pain affecting the area around the eye, causing a headache)

Less common primary headache types that have distinct features of an underlying medical condition include:

  • Cough headaches (triggered by coughing and other types of strain such as sneezing or nose-blowing)
  • Chronic headaches (daily) – these include chronic migraine, and chronic tension-type headaches)
  • Exercise headaches (these occur during or after intense exercise)
  • Sex headaches (following sexual activity / orgasm)

Other factors and lifestyle habits can also trigger primary headaches and include things such as:

  • Stress
  • Changes in sleeping patterns or a lack of sleep
  • Alcohol consumption (particularly red wine) and certain foods (such as meat containing nitrates)
  • Skipping daily meals
  • Poor posture

Secondary headaches

These headaches typically result as a symptom of an underlying medical condition or problem in the head or neck, which varies in severity. A very broad group of conditions fall into this classification of headache, ranging from a mild infection (of a tooth) or sinus problem to something more severe such as bleeding in the brain or infections like encephalitis or meningitis, which can be extremely life-threatening.

Secondary headaches types can include:

  • External compression headaches (due to pressure-causing headgear such as helmets or goggles)
  • Rebound headaches (due to pain medication overuse)
  • Sinus headaches (due to congestion in the sinus cavities or inflammation)
  • Spinal headaches (due to volume of cerebrospinal fluid or low pressure)
  • Thunderclap headaches (sudden, severe headaches associated with a group of disorders that have multiple causes)

Some possible causes include:

  • Dehydration
  • Dental problems and infections
  • Middle ear infection
  • A hangover (due to excessive alcohol consumption and dehydration)
  • Flu (influenza)
  • Hypertension (high blood pressure)
  • Panic attacks / panic disorders
  • Acute sinusitis
  • Blood clots in the brain (venous thrombosis)
  • Brain tumour
  • Concussion and post-concussion syndrome (traumatic headaches)
  • Brain inflammation such as meningitis and encephalitis
  • Stroke
  • Arterial tears (vertebral or carotid dissections)
  • Brain aneurysm (a bulge that occurs in an artery in the brain)

Facial pain and cranial neuralgias (nerve pain)

When one of 12 cranial nerves, that control muscles in the brain and carry sensory signals, like pain, to and from the neck and head, becomes inflamed neuralgias (‘neur’ – nerve and ‘algia’ – pain) can occur. These types of headaches can lead to intense facial pain as a result of inflammation or irritation.

Illustration of some of the most common headaches and pain location

Common causes

When the nerves in blood vessels and muscles in the head change due to inflammation or irritation, pain develops. Some of the main reasons why this happens include the following:

  • Stress: Any kind of strain on the body can cause headaches, particularly tension headaches. Causes include mental health and emotional problems such as depression, excess alcohol consumption, overuse of medications, eyestrain or strains in the back and neck. Skipping meals and changes in sleeping patterns can also cause tension headaches, placing the body under stress.
  • An illness or injury: Signs of an infection in the body often include headache. The common cold, flu, fever, or sinusitis (sinus inflammation) are some of the most common illnesses with symptoms of headache. Throat and ear infections are also common culprits causing headaches. Sometimes a headache may be one of the first signs of a more serious medical condition. If not caused by an illness, head injuries can also result in headaches.
  • The environment in which you live and work: Factors around areas your frequent, such as your home, school, areas you like to socialise in or place of work can also cause irritation, bringing on a headache. Irritant causes can include tobacco smoke, perfume or fragrances, household chemicals and other strong smells or pollution. Others include noise, weather changes and lighting.
  • Genetics: Migraines are thought to run in families, especially if both parents of a child have a history of these types of headaches. The exact cause of migraines is not yet entirely known but these do appear to be triggered by unusual brain activity which may be linked to genetic problems in specific areas of the brain.

Common types of headache explained

The most common types of headaches include the following:

  • Tension headaches: As previously mentioned, stress and tension headaches go hand-in-hand. Tension headaches can be experienced daily (come and go through periods of a person’s lifetime) as a chronic ailment and are the most common type among teens and adults, with pain levels ranging from mild to moderate.
  • Cluster headaches: When pain is accompanied by a burning, throbbing or piercing sensation behind the eyes, cluster headaches occur. Pain can be intense, but this type of headache is not all that common. It is, however, typically a severe type of headache. This type occurs in groups, whereby they are experienced several times a day, for up to a few weeks in a row or even months, often appearing to ‘go away’ for some time (sometimes months or years) and then return.
  • Migraine: This type of headache is a bit of a nasty experience, often associated with a pounding or throbbing pain. Pain can last anywhere from around 4 hours to 3 days, and can occur multiple times in a month. Symptoms, such as nausea and vomiting, a sensitivity to noise, smells and light, loss of appetite, as well as pain in the abdomen or an upset stomach are experienced with this type. Children experiencing migraine may also appear pale, have blurry vison, a fever or feel a little dizzy too.
  • Mixed headache syndrome: This type is also known as ‘transformed migraines’ and is typically a mix of tension headaches and migraine. This type affects both children and adults.
  • Acute headaches: Typically, this type affects children and begins rather suddenly and then clears after a short period of time. This type is mostly caused by a respiratory or sinus infection, but can also be as a result of a nerve problem.
  • Hormonal headaches: This type typically affects women when hormone fluctuations in the body occur. Changing hormone levels occur during a woman’s monthly menstrual period, menopause or pregnancy. Hormone changes can also be triggered when using birth control pills, bringing on regular headaches.
  • Sinus headaches: When sinuses (cavities in the head) become inflamed, a deep and constant pain can be felt in the forehead, cheekbones or bridge of the nose. Other symptoms which often accompany this type of headache include fever, a runny nose, facial swelling and a feeling of fullness in the ears.
  • Chronic progressive headaches: This type is also known as ‘traction’ or ‘inflammatory headaches’. This type, although rare, generally worsens and happens more frequently over time and may be as a result of a brain (or skull) disorder or illness.

Young woman experiencing symptoms of headache

Other common types include:

  • Rebound headaches (due to excessive or regular use of medication to treat headaches more than once a week)
  • External compression headaches (due to continuous pressure on the forehead or scalp, often experienced by sportsmen and women who wear tight eyewear, headbands or helmets)
  • Ice-cream headaches / cold stimulus headaches (a brief, but stabbing pain experienced when consuming a very cold or frosty foodstuff, or beverage, or exposing your unprotected head to very cold temperatures, like ice cold water)
  • Cough headaches (due to straining such as coughing, sneezing, laughing, blowing your nose or during a bowel movement)
  • Spinal headaches / post-lumbar puncture headaches (these occur in at least 40% of patients who have experienced a spinal tap or lumbar puncture procedure if any spinal fluid leaks through the puncture site)
  • Hunger headaches (skipping meals can cause a dip in blood sugar levels which leads to blood vessels in the brain going into spasm and causing a headache.)

What are the signs and symptoms?

Symptoms of some of the common types of headache include:

  • Tension headaches: Mild to moderate pain or pressure affecting the top, sides or front of the head. Pain typically begins gradually, varying in intensity, and can last between 30 minutes to several days at a time. A chronic tension headache may come and go over a prolonged period of time and also varies in intensity throughout the day. Other associated symptoms along with head pain may include chronic fatigue, sleep disturbances (difficulty falling asleep or staying asleep), concentration problems, irritability, muscle ache, and a mild sensitivity to noise or light.
  • Cluster headaches: Pain is intense and felt on one side of the head (behind the eye), often described as burning, piercing or throbbing. Pain typically lasts for a short period of time (between 30 and 90 minutes), but can recur later in a day. Many experience cluster headaches between 3 and 8 times a day or night, and on a regular basis. Sometimes a sufferer may be awoken during the night with this type of headache.
  • Migraine: Pain is typically felt in a variety of combinations – it may be a pounding or throbbing ranging from moderate to severe and affecting the entire head, or shifting from one side to the other. Pain can also be accompanied by a sensitivity to noise, smells and light, as well as with other symptoms such as nausea and vomiting, blurred vision, abdominal pain and stomach upset, warm or cold sensations, fatigue, dizziness, a pale complexion, loss of appetite, and sometimes fever. Many experience migraine with aura, which involves vision changes or disturbances such as bright, flashing dots, blind spots or jagged lines as well as facial tingling or numbness and difficulty in speaking (aphasia).
  • Mixed headache syndrome: Pain (intense throbbing) is severe, normally accompanied by nausea and vomiting, and can occur daily.
  • Acute headaches: Pain develops quickly and is described as sharp, aching or throbbing, and felt in the head or upper neck (or both). Pain is felt on one or both sides of the head and is often accompanied by fever, nausea and vomiting. Acute headaches are often described as “the worst headache of my life” because of the severity. These headaches can sometimes be assessed and diagnosed as thunderclap headaches or migraines.
  • Hormonal headaches: When oestrogen levels drop or fluctuate, a hormonal imbalance occurs, causing a headache. A drop in oestrogen is typical just before a woman’s menstrual period or for those using birth control pills (oral contraception) for instance and affects the head and neck. Pain can range from mild to moderate or even a full-blown migraine.
  • Sinus headaches: Pain is felt in the forehead, cheekbones or the bridge of the nose and typically intensifies with any sudden movement or straining. A runny nose (sinus discharge), facial swelling, fever and a feeling of fullness or pressure in the ears normally accompany the pain.
  • Chronic progressive headaches: Typically, these headaches are as a result of an underlying illness, such as a brain tumour, subdural haematoma, infection or a wide variety of other intercranial disorders. Pain is often felt suddenly (sometimes in the middle of the night or early in the morning due to increased pressure on the skull or head), and may be accompanied by vomiting. Other symptoms can include a worsening of pain when under strain (sneezing, coughing or during a bowel movement), as well as experiencing other neurological discomforts, such as numbness, vision impairment or loss, body weakness, behavioural changes and difficulties with walking.

Young woman experiencing symptoms pf migraine

When should you worry about a headache?

Headaches that occur suddenly or are incredibly intense (severe) may be signalling something which needs medical intervention. While common, the majority of headaches you’ll experience in a lifetime will generally clear up without causing any further medical concerns or health problems. Most headaches are not life-threatening.

If you experience headaches that suddenly occur more often than they did before, are more severe than usual, don’t appear to clear up with appropriate use of pain-relieving medications (or worsen), or impact your ability to participate in normal activity (working, sleeping habits etc.) and are causing you distress, see your doctor for a thorough check-up.

Chronic headaches, migraines and even cluster headaches are often not typically considered a sign of a severe or debilitating illnesses and medical conditions. A physician may be able to help you determine a cause or set of triggers, and assist with being able to treat them a little better. These headaches may not necessarily be a sign that there is an underlying cause that could be life-threatening.

Emergency warning signs

If you experience any of the below symptoms along with headache, it is best to seek medical attention and treatment immediately. In some instances, headaches are a sign something serious may be going on in the body. Symptoms to take note of include:

  • Feeling faint
  • A high fever
  • Confusion
  • Problems understanding speech or speaking
  • Difficulties with writing or understanding written words
  • Paralysis on one side of the body
  • Numbness or weakness
  • A stiff neck
  • Unexplained nausea and vomiting (i.e. if you are not able to associate these symptoms with anything else you’ve recently done or experienced such as a flu infection or a hangover)
  • Problems with vision
  • Problems with walking

Other warning signs that require medical attention immediately include:

  • Thunderclap headaches: Pain is extreme and this is a severe type of headache that occurs suddenly (within 60 seconds). These are typically caused by bleeding in the brain and are often as a result of a stroke, head injury or aneurysm.
  • Headaches following head trauma: Any head injury, including a concussion following a minor fall or bump to the head, that results in a headache must be taken seriously and immediate medical attention sought out. If any bleeding occurs in the brain and isn’t checked, this can be life-threatening.
  • Headaches with unusual or unexplained symptoms: If headaches suddenly appear after the age of 50, suddenly change in severity, location or frequency, become consistently worse or seem to be accompanied by personality changes or hallucinations, it is best to seek medical attention as soon as possible.

Diagnosing and treating headaches

Young woman with head pain in consultation with her doctor

How is a diagnosis made?

Accurately diagnosing a type of headache can be tricky, but is best done by a medical professional so as to ensure effective treatment. Once a cause has been established, diagnosis and treatment can be that much more accurate and effective.

In many cases, special diagnostic tests may not be necessary. When you find that your symptoms aren’t easily explainable or you feel that you are unable to clear or control them, it is advisable to see your doctor (general practitioner or GP) for a consultation.

He or she will talk you through your symptoms in more detail, asking questions relating to levels of severity (as well as what appears to worsen or clear your headaches), frequency and potential triggers and influences which may be causing your headaches, as well a detailed history (if relevant).

It’s important that you disclose as much information about your symptoms as you can as this can help your doctor to better determine a root cause.

Questions that may be asked include:

  • How long ago / how old were you when your headaches first began?
  • How frequently do you experience headaches?
  • Do you experience a specific type of headache or multiple types?
  • Do certain things, such as foods, medications or situations trigger your headaches?
  • Are you experiencing stress at work, school or home?
  • Where do you feel pain and how would you describe it?
  • Would you describe the pain as mild or severe? (Usually rated on a scale of 1 to 10)
  • How long do your headaches normally last?
  • Does pain occur suddenly (without warning) or gradually?
  • Do you experience any other symptoms?
  • Do you experience any changes in your vision before or during your headache?
  • Have you been treated for headaches in the past?
  • Have you previously had tests done for headaches? If so, which ones have been done?
  • Do you take any over-the-counter pain relievers, supplements or prescribed medications?

From there your doctor may request a physical exam to either check for or rule out potential causes, or assess any other accompanying symptoms such as abdominal or digestive discomforts.

Some signs your doctor may lookout for during your consultation include:

  • Breathing, pulse or blood pressure abnormalities
  • Infection or fever
  • Mental confusion or inappropriate behaviours (personality changes)
  • Fatigue
  • Numbness or tingling sensations
  • Difficulties with speech
  • Problems with balance or dizziness
  • Muscle weakness

A neurological exam may be recommended if your doctor feels the need to potentially rule out known conditions of the nerves or brain that may be the underlying cause of the headaches being experienced. Some conditions your doctor may have in mind to rule out or determine as a cause include a brain infection or abscess, tumours, brain haemorrhage, bacterial or viral meningitis, intracranial pressure (Pseudotumor cerebri), Lyme disease, hydrocephalus, encephalitis, blood vessel abnormalities or clots, sinus blockage or disease, an aneurysm or even signs of a potential head injury or trauma.

Young man with a stressed facial expressionIf stress or other stress factors (such as a mental health concern) is determined as a major factor during your consultation, you doctor may suggest a psychological evaluation.

Once all evaluations and exams are complete, your doctor should be able to determine the underlying cause and type of headache you are experiencing. If there is a sign of a more serious medical abnormality or condition, appropriate testing may be recommended.

In rare instances a diagnostic test may be required. This may involve an MRI or CT scan which assists your doctor with detailed images of your brain, and other areas of the body. If there are any abnormalities, such as swelling or bleeding, these tests will pick this up. Imaging tests are useful if you are experiencing headaches frequently (almost daily or daily).

Your doctor may even refer you to a specialist where he or she feels it may be more beneficial or necessary. In most instances, laboratory tests are not likely to be helpful in diagnosing tension and clusters headaches or migraine.

If tests are necessary, others which may be recommended include:

  • Urinalysis and blood chemistry: Used to determine or rule out the possibility of thyroid problems, an infection or diabetes.
  • Sinus X-ray: Used to pick up a sinus problems, but this is more often than not seen in more detail in an MRI or CT scan.
  • Spinal tap / lumbar puncture: If it is determined that there is any sign of fluid build-up in the brain or spinal cord due to an infection, a spinal tap is performed to remove this from the spinal canal (situated in the back).
  • Electroencephalogram (EEG): If a person experiences seizures or loss of consciousness, this scan may be useful for determining a possible medical condition.
  • Eye pressure test: You may be referred to an ophthalmologist for this test if there is possibly pressure on the optic nerve or signs of glaucoma.

Treatment for headaches

Unless your headaches are intense and occur fairly frequently or are diagnosed as part of an underlying illness, little treatment may be required. For the most part, treatment advice and recommendations will depend on the underlying cause and type of headache.

Many won’t require much medical intervention at all, but your doctor will assist with a treatment plan, including lifestyle adjustments (if necessary) to help alleviate your symptoms. Sometimes this plan will involve pain-relieving medications (over-the-counter or prescribed), stress management, biofeedback (techniques to assist you with gaining control over involuntary functions) and even counselling.

If medications are recommended, it is very important that you follow the dosage instructions. Some pain-relief medications are known to cause rebound headaches which can cause problems with withdrawal if discontinued inappropriately. If you take any over-the-counter medications, it is advisable to run these by your doctor beforehand to ensure that you don’t experience any adverse interactions with any other medications or supplements you are taking, or with stimulants such as caffeine for example.

You may be advised to keep a record of your headaches and note any changes or patterns (particularly the type of pain and timing or pattern or headache attacks), as well as what appears to be helping to alleviate pain or discomfort and what may be worsening your symptoms. You will also be advised to steer clear of any determined triggers such as certain environments, smells or foods.
Your doctor will also likely encourage healthy habits, such as getting enough sleep, regular exercise, a nutritious diet, and request follow-up appointments to assess how you are managing or coping with your headaches.

Who is at greater risk for headaches?

You may be more susceptible to suffering frequent headaches if:

  • You are female – women are 3 times more likely to experience migraines and various headache types. Other types of headaches tend to affect males during childhood more so than females (before puberty). Hormonal changes in the body affect females more often, which may lead to the development of headaches (before menstruation, during pregnancy or menopause).
  • You experience or suffer from depression or anxiety
  • You are obese
  • You experience trouble with your sleeping habits
  • You snore (when asleep – 24% of chronic headache sufferers are habitual snorers, although it is unclear if snoring causes headaches or vice versa)
  • You overuse medications (such as pain-relievers) or consume excess caffeine
  • You have a family history of migraines (one or both parents)

Common complications

If headaches are frequently occurring, it can have an effect on job productivity and overall quality of life. Chronic headaches, whatever the type, can affect a person’s ability to live and move freely, forcing an individual to retreat in order to recover and heal.

If your ability to function normally is impaired because of headaches, it is important to seek medical advice to determine the underlying cause and effectively treat your condition, so as to avoid any debilitating effects on your lifestyle.

What are the different phases of a migraine?

The symptoms of migraine can be complex in that symptoms typically change over a period of a few hours or even days. These changes can be broken down into phases:

  • Prodromal phase (before a migraine): Early warning signs can occur a few hours before a migraine attack. You may feel irritable and depressed, or unusually excited and energetic, crave certain foods, feel thirsty and the need to urinate frequently, or find yourself fatigued and sleepy (and yawning quite a bit).
  • Aura phase: During this phase, you may begin to feel a little strange. This tends to happen either just before a headache develops or along with it. Not everyone who suffers migraines experiences this phase, but it is common with this type of headache. Aura affects vision and can result in a jagged or flickering arc of light (sometimes on the left or right side of a person’s vision) and enlarge within a few minutes. Along with flickering, you may also experience a blind spot, making it very difficult to focus your vision. Other symptoms include tingling sensations on the body (‘pins and needles’), numbness (particularly in the face and hands), develop trouble speaking (or writing) and expressing thoughts, or understanding written and spoken words. You may also feel confused and find it difficult to concentrate.
  • Attack phase: Once the headache develops, an attack can linger for as little as a few hours and up to a few days. Normal activity is difficult and it is best to rather rest quietly. Headache pain typically develops above the eyes, and moves to either one side of the head or affects the entire head. Pain can also be felt in the lower facial area and neck. Pain is typically a throbbing sensation and tends to worsen if you are physically active or moving around. You may also experience continued sensitivity to light, smells and sounds, develop a horrid case of nausea and vomiting, as well as feel a little lightheaded or faint. This phase can be quite debilitating and may leave you feeling unwell for a day or two (depending on the severity of the migraine attack).
  • Postdromal phase (after a migraine): Once the worst of the migraine attack begins to clear, you may feel symptoms of sluggishness and extreme fatigue, a little confusion, and some head pain when you move quickly or lean over. During this phase, you’ll need to take things a little easy as your body recovers.

Can exercise or sex cause headaches?

Female runner sweating after cardio exerciseYes, physical exertion can cause the muscles of the scalp, head and neck to require more blood for circulation. When more blood circulates, blood vessels dilate and can cause exertional headaches. An exercise headache is sometimes referred to as a ‘jogger’s headache’.

It has been noted that those who are most susceptible to migraine attacks typically experience these types of headache. Exertional headaches due to strenuous exercise or sexual activity are rare and shouldn’t always be taken too lightly. In some instances, these headaches could be a sign of a more serious medical problem, such as bleeding in the brain. If you notice frequent headaches following strenuous activity, it is a good idea to go for a check-up and discuss with your doctor in case there is reason to worry.

What types of foods are known to trigger headaches and migraines?

For many, there are often very specific triggers for headaches, including migraines. A common culprit is often certain foods, or specific substances in food. There isn’t a set diet for ‘avoiding headaches and migraines’, but there are some common food triggers many will consume sparingly or not at all so as to avoid developing pain or attacks. Many sufferers of migraine soon become well aware of any food triggers and stay well clear of these in their diets.

Common food triggers linked to headaches and migraines include:

  • Alcohol: This is a common trigger for many with headaches and migraine attacks. Tyramine is an ingredient in red wine and other alcoholic beverages, such as sparkling wine or champagne and whisky, that is a known trigger. Sulphites are used in alcohol, especially wine, as a preserving ingredient, and can trigger headaches. Alcohol, in general, boosts blood flow to the brain, which leads to aggravated pain. Alcohol also causes the body to dehydrate. This lack of moisture and nourishment in the body can trigger headaches and migraines too. If you’re going to indulge in a glass of your favourite alcoholic beverage, it is best to follow it up with a glass or two of water to combat dehydration and help flush out any aggravating ingredients that may cause head pain.
  • Cheese: Aged-cheese, such as cheddar, parmesan, blue cheese or Swiss cheese also contain tyramine which triggers headaches and migraines in some.
  • Coffee cup and coffee beans on old woodCaffeine: If you are prone to chain-chugging beverages with a lot of caffeine, headaches and migraine can easily follow. Excessive consumption of beverages such as coffee, tea and various soda (carbonated) drinks can trigger head pain. If caffeine is a trigger for you, try not to stop consumption suddenly as this can stimulate withdrawal effects and lead to more headaches. Ease off caffeine gradually for better results. That said, it has been noted that caffeine in small doses can actually help ease pain in the body. Many non-prescription pain-relievers list caffeine as an ingredient and help treat headaches and other pain. If caffeine is a trigger, but you enjoy a cuppa or two, you can try and limit your coffee or tea intake to no more than 2 cups a day or every other day.
  • Food additives: Preservatives included in foodstuffs can also be a trigger. Additives and preservatives are put in foods to improve colour, taste and assist with keeping a product fresh for longer. Ingredients can include substances such as MSG (Monosodium glutamate), a common headache or migraine trigger. MSG is known to cause a pulsing pain on both sides of the head, a flushed complexion, abdominal pain, dizziness or a burning sensation in the neck, chest or shoulders. Other trigger ingredients are nitrates and nitrites which are often added to processed meats (such as salami, bacon, lunch meat or cold meats, hot dogs and pepperoni). These also serve a preservative function, making the product last longer. Those susceptible to these ingredients as triggers experience blood vessel expansion in the brain, which causes head pain. Sweeteners in soda beverages and yellow dye in drinks, certain packaged snacks and candy sweets are also known additive triggers. Tyramine can also be found in olives, pickles, nuts and bean products.
  • Other food triggers: Chocolate, figs, raisins, cultured dairy products (such as yoghurt, sour cream and buttermilk), avocados, doughnuts, pastries and yeast bread can also lead to headaches and migraine.

What about smoking?

Smoking is another known trigger for many who suffer headaches and migraines, and includes second-hand smoke containing nicotine. For those who smoke or are exposed to second-hand smoke, nicotine leads to a narrowing of blood vessels in the brain, which in turn triggers head pain and headaches.

Those who suffer cluster headaches are especially vulnerable to nicotine smoke exposure, also experiencing associated symptoms affecting their nose and eyes.

What can you do to avoid frequent headaches?

You can give your body a helping hand against irritation and inflammation by making conscious efforts to avoid (or reduce) known triggers that cause pain. Some steps you can take include:

  • Identifying headache triggers: A journal or diary can be a useful tool if you suffer frequent headaches. You know your body better than anyone and are in a prime seat to notice changes affecting your overall health condition. You will be able to note foods, stressful events, weather changes and physical activity which may trigger head pain. You can also note characteristics of your headache, such as the nature of pain and how it feels, what time it started, when it cleared and how you were able to heal it. Your journal will likely begin to take shape and allow you insights into particular headache patterns. With these insights, you will be able to determine ways to avoid triggers and lead a happier, healthier lifestyle.
  • De-stress: Stress is a common aggravator for most types of headaches, particularly tension headaches and migraine. Not every aggravator of stressful situations will be within your control, but there may be certain things you can do to better manage situations you may find yourself in through your response. You could find relief in activities such as yoga or meditation practices and massage. Whether it be exercise or another healthy means of stress management, if it helps you to better problem-solve, relax and recharge, it’ll be better for keeping head pain at bay.
  • Limber up: Exercise to de-stress can also be physically beneficial, especially when you engage with the more active variety. Any activity that allows you to loosen up and stretch your legs, such as walking or jogging (running) can help to relax muscles in the neck and shoulders. Stress can build knots in these areas and cause head pain. Loosening these up will help you unwind and also keep you in ship-shape. Physical therapy can also be beneficial for keeping muscles from knotting up. It has the added benefit of helping you to improve your posture too – another great way to keep headaches from developing and prevent knots.
  • Woman with fruit and water in a glass bottleNourish your body: When the body is poorly nourished, dehydration and hunger headaches can become problematic. You know what your body needs – sometimes 3 healthy meals a day is sufficient enough to fuel you up and keep your blood sugar levels where they should be. Sometimes more frequent, smaller meals work better for you. You’ll also need to ensure that you get in enough fluids to avoid dehydration. Remember, caffeine beverages like coffee do tend to dehydrate the body, so opt for plenty of healthier options such as juice and water to keep head pain from having the chance to develop. You shouldn’t go for more than 2 hours without water, especially if you suffer frequent headaches. If you lack magnesium in your diet, you may also be more susceptible to headaches, especially migraines with aura. Your doctor will be able to assess if you are lacking this nutrient and best guide you with a supplement and a dosage which will be comfortable for your system. Magnesium supplements can sometimes lead to problems with diarrhoea.
  • Learn to understand how pain-relieving medications work: Yes, pain-relievers (over-the-counter and prescribed) can cause headaches (namely, rebound headaches), as well as treat pain. Most doctors will guide you on the best ways to use medications, and it’s a good idea to keep your physician in-the-know about everything you are taking, including supplements. Any medication or supplement you take can have side-effect or interact with another substances in the body. If you find that you are taking pain-relieving medications, such as ibuprofen, naproxen or aspirin on a regular basis (almost daily or daily or for more than 3 or 4 days at a time), overuse can lead to rebound headaches. The body then becomes dependent on the medication (i.e. once the medication wears off in the body, headaches return). If you require that much medicinal treatment to alleviate pain, rather consult your doctor for help with your headaches.
  • Young woman sleeping or resting on the bedGet enough rest: A lack of sleep or too much sleep can trigger headaches too. Try and keep a regular sleep schedule that allows you to get enough rest (7 to 8 hours every day). During a consultation, your doctor will look for signs of poor sleep as means to either diagnose or rule out an underlying problem such as insomnia or sleep apnoea, which can also experience headache symptoms. For the most part, if you are able to get enough rest each night, make the effort and you’ll find that you may begin to have fewer headaches.
  • Take care of yourself: When in pain, it’s not worth powering through it. Your body needs to heal. Try and remain in a calm environment that does not aggravate symptoms, especially if you are suffering more severe headaches. Cool, damp cloths, heat or ice packs can be placed on your forehead to help provide soothing relief. You will need to avoid extreme temperatures. Massaging the scalp / head can also provide relief. The better your care for yourself, the less chance irritation and inflammation has to cause pain or damage.

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