According to the American Headache Society (AHS), roughly 1 out of every 7 Americans is affected by severe headaches or migraines each year, with women more likely to be affected than men. Almost half of all adults worldwide are estimated to have a headache in any given year. There are headaches, and then there are migraines, which are due to a chronic condition. Headaches vary in type, frequency and intensity, while migraines tend to cause severe, debilitating pain. Headaches are actually only one symptom of migraines, which can last several days.
“Migraine is a brain disorder that’s commonly associated with head pain,” says Dr. Patricia Mayes, a neurologist with TPMG Neurology in Williamsburg, Va. “However, you can have a migraine without pain. [Migraine sufferers] may experience visual disturbances or vertigo as well as fatigue, cognitive impairment, difficulty concentrating, depression and irritability.”
The Most Common Types of Headaches
The AHS classifies headaches as primary and secondary, which is caused by other health conditions. The most common types of headaches include:
- Migraines with or without auras
- Tension headaches
- Cluster headaches
- Primary cough headache caused by the strain of coughs
- Exertional headaches related to exercise or sex
- Allergic headache
- Sinus headache
- Headache caused by injury or trauma
- Headache caused by depression or anxiety
- Hormonal headache
- Withdrawal headaches related to alcohol, caffeine or drug use
Though these types of headaches are the most common, headaches can have many other causes, too, like strokes, tumors and nerve damage. Sometimes headaches can be caused by problems with your teeth and jaw, or with your neck — a cervicogenic headache. If you have chronic, severe headaches, a neurologist can help you uncover the cause and find relief.
Tips For Avoiding Headaches And Migraines:
Keep a Regular Schedule
A regular schedule can help you avoid stress and fatigue, which are common migraine triggers. Mayes recommends going to bed the same time each night and waking up at the same time each day, even on weekends. You should also try to eat food around the same times each day and exercise regularly.
Identify Your Headache Triggers
Keep a headache journal to help identify what triggers your headache. Your journal should include information such as:
- When you slept and how well you slept
- Any alcohol you consumed
- What foods you ate
- Any medicines you took that day
- Any stressors you faced that day
- Any other activities you took part in that day
- What day of your menstrual cycle it is
- What symptoms you had in addition to pain
- Where head pain was located and its severity
Over time, a headache journal may reveal patterns in your headaches. For instance, you may get a headache any time you get fewer than four hours of sleep or on the same day of your menstrual cycle each month. Once you identify triggers, you may be able to avoid them completely or find a treatment that will prevent headaches related to these triggers.
Change Your Diet
Some foods are more likely to cause headaches or migraines than others. Alcohol and caffeine — including chocolate — are common headache triggers, but you might also experience headaches after eating aged cheeses, artificial sweeteners, Monosodium Glutamate (MSG) and nitrates in processed meats.
Try removing these foods and drinks from your diet to see if your headaches improve. Mayes recommends removing caffeine in particular for at least two to three months. In addition to removing foods, you should also be sure to eat regularly. Never skip a meal, and always eat when you are hungry. Hunger is a common headache trigger. Also, make sure you’re drinking enough water, as even minor dehydration can be another trigger.
Manage Your Stress
Stress is a common cause of both migraines and tension headaches. While it’s not always possible to avoid stress, you can learn techniques to better manage stress to reduce how many headaches you experience. Try to remove stressors by not over-scheduling yourself, and make sure you’re exercising regularly. You might also want to try meditation or guided imagery.
In the long-term, better stress management can help improve headaches and your overall health. Seek professional therapy or counseling to learn how to manage stress.
Don’t Take Too Much Pain Medicine
Over-the-counter pain medicines — such as aspirin, ibuprofen, naproxen sodium and acetaminophen — can actually trigger headaches if you take them too often.
“I see medication-overuse headache all the time,” Mayes says. “By the time patients come to see me, they may be taking medicine every day. If they try to stop taking the medicine, the headache may get worse. It’s a vicious cycle of constant headaches.”
Medicines should always be taken as directed on the label. If you need to take medicines more than twice a week for headaches, see your physician before beginning to take any more.
See a Headache or Migraine Specialist
The American Academy of Neurology recommends that you see a neurologist for headaches if you meet the following criteria:
- Three or more moderate to severe headaches each month that don’t respond to medicines and affect your daily life
- Six to eight headaches per month, even if they do respond to medicines
- Disruptive symptoms, such as visual or mood disturbances, even if they are not frequent
- Migraines that severely affect your life even if you take medicines or try to avoid triggers
- Risk for medication-overuse headache
- Certain types of headaches and symptoms may require more immediate attention
“If you have a severe headache that does not improve with medicines, you should see a physician,” Mayes says. “If you have any symptoms like vision loss or paralysis, go the emergency room.”
Mayes also recommends seeing a doctor if headaches occur more often at nighttime, which may indicate a tumor. If you suddenly get the worst headache you’ve ever had in your life, head to the emergency room. In addition, pregnant women who have no history of headaches should also see their doctor about any migraines, and people over age 65 who have never had headaches should see their physician if one develops.
Take Medicine as Prescribed
A neurologist can prescribe preventive medicines to help you better control migraines and severe headaches. These medicines may include:
- Antiseizure medicines
- Anti-nausea medications, such as beta blockers
- Blood pressure medicines
- Botulinum toxin injections
- Calcitonin-gene related peptide (CGRP) inhibitor injections
CGRP inhibitors are the latest medicines to treat chronic headaches and migraines and received approval from the Food and Drug Administration (FDA) in 2018. These monthly injections help block CGRP, a protein that can cause migraines. Studies showed that patients who took these medicines experienced fewer migraine days each month.
Natural Remedies That May Ease Head Pain
Some people choose to try natural remedies with varying results. Here are some worth trying:
- Essential oils, such as lavender
- Hot and cold compresses
- Biofeedback therapy
- Herbal supplements — such as butterbur and feverfew
- B-complex vitamins
- CBD oil