Why we get headaches
Headaches are one of the most common health complaints in the world, with approximately one in six Americans suffering chronic episodes each and every year. For some they may be a passing nuisance, but for others they have a serious impact on their lives – making it difficult to concentrate, work and generally get by.
But what exactly is a headache, and why do we get them?
The brain itself cannot sense pain, so a headache is actually sensed in the nerve and muscles surrounding it, in the head, neck and meninges (the membranous covering of the brain and spinal cord).
Just as the type and severity of headaches can vary greatly from person to person, so too can the reason why we get them in the first place. Broadly speaking, there are two main reasons we get headaches – often categorised as primary and secondary. Let’s start with primary headaches, which are not the result of an underlying medical condition. These are likely caused by environmental factors which may include:
Stress: Or rather, relaxing after stress. Many people complain of headaches at the end of a long and stressful day, this is because when tension in the body subsides, stress hormones drop, causing a rapid release of neurotransmitters, which tell our blood vessels to constrict and dilate.
Anger: When we hold on to anger, the muscles at the back of the head and neck tense up, causing a tight sensation around the forehead like a rubber band.
Smell: Ever got a headache after doing the housework? This is most likely down to the fact that the top ingredients of many household cleaners – and even some perfumes – can overload the neurons in the nasal passage, causing a sensory overload and triggering a headache.
Pressure changes: High humidity, soaring temperatures and even storms can all bring about a headache, as they trigger chemical and electrical changes in the brain which irritates the nerves.
Bright lights: Lights, particularly those that flicker, are known to lead to chemical changes in the brain which can activate the migraine centre.
Now on to secondary headaches. These have no external cause, and are associated with underlying medical conditions such as a viral infections, fever and hypoglycaemia – or more serious issues like increased pressure in the skull and sinuses, and even brain tumours.
What types of headache are there?
Now we have explored what is behind that throbbing pain in our skull, let’s look at the different types of headache we can experience.
Migraines: The most well-known, and often most debilitating variety of headache, is of course the migraine. Migraines, which often run in the family, are caused by reduced blood-flow to the cerebral cortex. They can last anywhere between four and 72 hours, and are symptomized by throbbing, often severe one-sided pain, nausea, and sensitivity to both light and sound. Approximately one-fifth of those who experience migraines also report visual distortion, dizziness and numbness of the extremities.
Tension headaches: While migraines may take the headlines, the most common type of headache is in fact the tension headache. These are caused by the straining and contracting of the muscles in the head and neck – often in response to stress – and are usually characterised by a dull, steady ache on both sides of the head. Tension headaches have been known to evolve into migraines and many experts believe the two are very closely related.
Cluster headaches: A less discussed but common category of headache is the cluster headache – which tend to affect men more than women and recur in cycles. Cluster headaches can come on very suddenly and are known to cause severe pain on one side of the head, along with restlessness, watering of the eyes and in many cases a runny nose. The specific causes of cluster headaches are not clear-cut, and they often do not respond to over-the-counter headache pills – which is one reason why many medical professionals believe there to be a genetic cause behind them.
Viral headaches: Finally there are sinus or viral headaches, caused by an underlying infection in the sinuses. These headaches tend to be accompanied by a fever and, much like cluster headaches, are not treatable with standard headache tablets – instead requiring an antibiotic or antihistamine.
Keeping headaches at bay
Of course the main thing most people want to know when it comes to headaches is how to get rid of them. This really depends on the type of head pain you are experiencing. Treatments that will work to stave off a migraine may in fact be useless when in the throes of a tension headache, for example. With that in mind, let’s take a look at the different types of treatments and remedies for the most common types of headache, starting with migraines.
The key to dealing with a migraine is to spot the early signs and take action – for many this can simply be lying in a dark room, applying a hot or cold compress or taking a couple of paracetamol, aspirin, or ibuprofen. For many a cup or two of coffee will often do the trick.
However, these medications are unlikely to have any effect once the migraine has taken hold (that is, if the migraine is far enough along, it may be too late for these types of medications). It should also be noted that painkillers are not effective at all for many people, and frequently taking headache medication can, in fact, lead to more headaches – an irony not at all appreciated by those who suffer the all-encompassing pain of chronic migraines.
The good news is, there are other options, such as triptans – available as a tablet, injection or nasal spray – which cause the blood vessels around the brain to contract and, in effect, reverse the changes in the brain that cause migraines. Anti-nausea medication has also been shown to successfully treat migraines in some cases, even if there are no symptoms of nausea or vomiting present. Again, as with the painkillers these need to be taken at the earliest sign of a migraine.
And yet another effective method in treatment of migraines in general is to take magnesium threonate daily, which some sufferers credit for a reduction in overall migraines by 50%.
The key to dealing with a migraine is to spot the early signs and take action
In more extreme cases, transcranial magnetic stimulation (TMS) or pulsed electromagnetic field therapy (PEMFT) is also an option (PEMFT is available at my clinic). Exactly how this helps to treat migraines is not entirely clear, but extensive studies have shown it to be effective in reducing the severity of attacks.
When it comes to the more common tension or cluster headaches, standard over-the-counter medications do the trick for many, but there are plenty of alternative remedies for those who do not wish to pop too many pills. With stress often being the cause here, alternative therapies aimed at reducing our stress levels can be very effective in reducing or eliminating these types of headaches.
Meditation, for example, not only alleviates the symptoms of headaches as they occur, but was also credited in a recent US study for reducing the frequency of headaches by almost 40%, and eliminating them altogether in some individuals over the long term.
Regular massages and gentle stretches have also been proven to help, as they work to relax the muscles in the neck and back of the head – the main culprit when it comes to tension headaches.
Finally, cognitive behavioural therapy (CBT) – a method of learning to spot key headache triggers in order to take evasive action – is gaining popularity for the treatment of common headaches, with a recent study showing it to reduce headache episodes in up to 60% of patients.
Ultimately, there is no cure for the common headache, but clearly there are plenty of things you can do to lessen the frequency and severity of any attacks, and I will stress again that the key is to intervene at the earliest sign. If you are someone who gets headaches a bit too frequently, you will want to try some of the remedies mentioned above.
And while on most occasions headaches are nothing too serious, they are also not something you should ignore if you are getting them quite regularly. Do visit you doctor to work out a professional course of action anytime your headaches are interfering with your life, and of course as a precautionary measure to rule out anything more serious.
- – -
Graham Simpson, MD is Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah. Dubai. He graduated from the University of the Witwatersrand Medical School in Johannesburg, South Africa, and is board certified in Internal Medicine and Emergency Medicine. As a founding member of the American Holistic Medical Association (AHMA) Dr Simpson is also a licensed homeopath.