Headache FAQs

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?

Yes, 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.
• Caffeine: 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.
• Nourish 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 other 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.
• Get 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.