SIX OF THE BEST

If you suffer from headaches, you’ll know just how debilitating they can be: you can’t think straight, you can’t sleep, you can’t work, you snap at the people you love – you know the story. So why do we get them – and, crucially, what can we do about it?

49 Common types of headaches and their triggers

MIGRAINES

If you get migraines, you’re one of the 15% of the world population who do. You were probably painfree until puberty, which is usually around when they start – if only they ended as abruptly!

Unfortunately, there is no specific cure for migraine, and because they are so varied they can also be quite tricky to diagnose definitively. The pain can often be very disabling and frightening, although the vast majority are not due to life-threatening disorders.

Migraines can vary greatly from person to person and can range in intensity from mild to extremely severe. Typically lasting anywhere from two to 72 hours, they usually affect only one side of your head, and the pain is often described as ‘throbbing’ or pulsating. Some people – but not all – also experience nausea, vomiting and visual disturbances, and some may also get a stuffy or runny nose or teary eyes.

Light affects some sufferers, as do sound and smell, and around one third of people will have ‘an aura’ just before the headache kicks in: the perception of a

strange light, unpleasant smell, or even confusing thoughts or intermittent disorientation. This aura can last from a few minutes to an hour, but usually disappears after 15–30 minutes. Migraine without an aura is much more common. Women get migraines two to three times more than men, and the bad news is, the headaches tend to get progressively worse in middle age. There are a variety of factors that are thought to contribute to their occurrence, frequency and severity:

• stress and fatigue

• extreme temperatures

• sleep disturbances

• not eating

• specific odours

• diet

• obesity

• alcohol

• smoking

• caffeine

• chocolate

• oral contraceptive pill

• menstruation

• hormonal imbalances

• neck pain

• certain medications

• specific lighting or sounds

• sexual activity

• pregnancy

• menopause

• underlying medical or mental health conditions

Lying down in a quiet, dark room can sometimes bring relief, but if you notice a significant change in the nature, quality and duration of your headache, if you’re pregnant or breastfeeding, or if your first attack happens when you’re older than 50, you should see your doctor.

As a migraine sufferer, you’ve probably worked out how best to deal with them. Treatments range from over-the-counter painkillers to more sedating and stronger drugs, and there are also preventative interventions including medication, dietary supplementations, lifestyle modifications, botox and/ or surgery. Consult with your doctor to find which works best for you.

You could also try regular acupuncture; physiotherapy, yoga and chiropractic medicine – all of them have proved beneficial when used in conjunction with medication.

TENSION

Tension headaches are often misdiagnosed or mistreated as migraines, even though they are far more common. You’ll usually feel this type of mild to moderate headache on both sides of your head, causing a feeling of pressure and tightness. You may feel as though there’s a circular band around your head, or pressure behind your eyes.

Sometimes tension headaches are associated with neck pain, but interestingly, even though your head and shoulder muscles are often in spasm, exercise won’t make your headache any worse.

Think hard about what you’ve been doing recently – tension headaches often have an identifiable cause, and once you’ve identified what that is you can take steps to eliminate it. They can even be caused by hunger, stress or not getting enough sleep. Unlike migraines, tension headaches don’t have other associated symptoms like nausea, vomiting or visual disturbances. Common or garden painkillers are probably your best bet in terms of treatment, but if they recur too often or are more debilitating than that, you may have to look at the bigger picture. Are you too stressed? Sitting badly at work? Too much screen time? Fixing these areas will certainly help.

MEDICATION

This is a very common – and woefully under-reported – cause of repeated headaches: overuse of medication. Taking too much medication results in chronic headaches that need higher dosages of medication to go away… In the end, dangerously large doses have little or no effect on your actual headache. It’s a vicious cycle but can be remedied with early treatment.

If you have a headache for around 15 days each month for a period of at least three months, that’s defined as ‘a chronic daily headache’, and there are various ways to treat it. But you really will need to talk to your doctor about this, and you will need to be very honest about what medications – and how much – you take. Self-medicating (especially with over-the-counter drugs) will only make your headache worse and cause you more distress. There is a solution, but you will need help.

CLUSTER

Cluster headaches begin quickly, often without any warning – and often while you’re sleeping. They reach their peak within a few minutes and are usually deep-seated, with an ‘explosive quality’. They are excruciatingly painful – so painful that people have banged their heads against a wall to alleviate the pain. Clusters can happen up to eight times a day, each one lasting fifteen minutes to three hours, and are more common in men than women. The pain usually starts in or around your eye or temple, but sometimes it may even start in your face, neck, ear or the side of your forehead. This pain is

always on one side. People with cluster headaches are often restless, pale and sweaty during an attack, and can easily become agitated or angry. Some also have red, watery eyes and a blocked or runny nose.

Like migraines, cluster headaches can make you sensitive to light, but one of the distinguishing features is that, unlike migraines, you’ll have periods of remission between clusters – sometimes days, months or even years. They can start at any age, and there seems to be some sort of genetic link: if either of your parents suffered from them, you may too.

There are things that can help, like steroids and other drugs, but none of these are over-the-counter solutions and all require medical supervision.

DEHYDRATION

All that stuff that your mother said about drinking enough water? She was right: keeping well hydrated is the best way to keep some headaches away. Your brain needs water to perform its functions, and if you don’t drink enough it literally contracts from lack of fluid, and that’s what causes the headache. It is water you need – not tea or coffee, no matter how herbal, un-milked or decaffeinated they may be. Tea and coffee are both diuretics, meaning they actually dehydrate you.

So drink water, slowly and regularly, and your headache will go away.

EXERTION

Exertion headaches usually happen right in the middle of exercise – when you’re cycling, running or, quite commonly, lifting weights. It may be your body’s way of telling you you’re overdoing it: if you warm up beforehand and let your heart rate increase gradually, it can help.

Exertion headaches have also been linked to blood pressure and the supply of blood to your brain – they often happen when you’re exercising at a higher or lower altitude than you’re used to.

The reason you get them when lifting weights can actually be more about the angle of your head and neck during the exercise than your blood pressure, so make sure you’re moving and holding yourself correctly. Drink a lot of water, don’t overdo it, and listen to your body. Otherwise, over-thecounter painkillers can help. If the headaches persist despite all these interventions, see your doctor.

If you have frequent and/or severe headaches, it may help to keep a headache diary over the course of one month to see exactly what’s going on: what kind of headaches you’re getting, what your triggers are and what helps you. Also, this kind of record is invaluable to your doctor when you’re planning an ongoing treatment path.

What you may not know is that there are one billion other people in the world right now in exactly the same position as you. It may be your body’s way of telling you you’re overdoing it: if you warm up beforehand and let your heart rate increase gradually, it can help.