Don’t ignore that holiday headache, experts say

There’s no doubt the COVID-19 pandemic adds stress to the hectic holiday season.

In addition to the extra cooking, cleaning, gift-buying and decorating, Americans may have to worry about scheduling coronavirus tests before travel or ordering extra masks for family members.

The to-do list seems all the more daunting when a pestering headache just won’t go away. Health experts urge people not to dismiss headaches, because they could be migraines that require treatment.

“Migraine is one of the most commonly misunderstood, misdiagnosed and mistreated disorders on the planet,” said Dr. Christopher Gottschalk, professor of clinical neurology and director of headache medicine at Yale School of Medicine.

Though there’s no evidence to indicate migraines occur more frequently during the holidays, experts say, they can influence some of the most important activities and cherished moments.

“They may be getting a headache while they’re doing their Thanksgiving preparation and try to wish it away until it’s so bad that they can’t function, and then they’re in trouble,” he said. “No one has let them in on the secret that you can treat a migraine if you have the right tools.”

The most common type of headache is called a tension-type headache, said Dr. Jan Brandes, director and founder of the Nashville Neuroscience Group and a member of the National Headache Foundation board of directors.

The foundation defines this type of headache as a dull, nonthrobbing pain involving both sides of the head in which the degree of severity remains constant. They can be triggered by multiple factors layered together such as lack of sleep, increased stress, hunger, medication overuse, alcohol or too much caffeine, Brandes said.

A tension-type headache should not be debilitating or interrupt routine activities, and they usually go away when treated with over-the-counter pain relievers such as ibuprofen.

If traditional interventions don’t work, Brandes said, that headache may be mild migraine.

“A lot of the times, it’s the mild migraine that masquerades as a tensiontype headache,” she said. “If that’s treated early, it could prevent it from escalating and eliminate a lot of pain.”

A migraine is defined as at least five headache attacks lasting four to 72 hours, according to the National Headache Foundation. Migraines can cause severe throbbing pain or a pulsing sensation usually on one side of the head and often are accompanied by nausea, vomiting or sensitivity to light and sound.

A migraine occurs when excited brain cells trigger a nerve to release chemicals that irritate blood vessels and cause them to swell on the surface of the brain, the foundation said.

Migraines most commonly occur in women ages 25-55, health experts say; fluctuations in estrogen before or during menstrual periods, pregnancy or menopause may trigger headaches.

A migraine attack also can be triggered by a change in sleep-wake cycle, missing or delaying a meal, medications, bright lights, excessive noise, stress or underlying depression, according to the headache foundation.

Some people experience migraines with aura, visual or sensory symptoms such as flickering lights or feeling numbness or difficulty putting words together.

But not everyone who has a migraine experiences those symptoms, experts say, which often leads people to dismiss their migraine until their pain worsens.

“In about 40% of migraines, it’s like a tension-type headache that involves both sides of the head,” she said. Visual or sensory change “is seen in about 20% to 25% of individuals, and they don’t have it with every attack, but it’s the most talked-about thing when it comes to migraines.”

Some people believe fatigue or dehydration can cause a migraine, Gottschalk said. But evidence shows these symptoms may be warning signs of an oncoming migraine.

The symptoms of the first stage of a migraine can be confused for a migraine trigger. Other signs include mood changes, neck stiffness, food cravings, fluid retention and constipation.

It’s important to learn your individual warning signs, Gottschalk said.

“The headache reliably causes these symptoms first before the pain starts, so recognizing those symptoms becomes an opportunity to intervene,” he said. “Pay attention to the warning signs, take a headache seriously, and don’t let it get out of control.”

Chronic migraines are defined as occurring 15 days or more in a month, health experts say. They urge Americans who experience such symptoms to see their doctor for treatment, which often involves medication.

Other strategies can help reduce stress and prevent a migraine, Gottschalk said. He recommends breathing exercises, meditation, a 30-minute walk, stretching exercises, reading a book or preparing a relaxing bath.

“When a migraine gets triggered, it’s important to control stress,” Brandes said, especially during the holidays.

The National Headache Foundation estimates more than 37 million Americans suffer from migraine, and health experts say many spend decades dealing with the pain instead of seeking medical attention.