By Hrachya Nersesyan, MD
For most people, headaches are nothing more than a rare, uncomfortable inconvenience. For many others, however, frequent tension headaches, brutal migraines, or excruciating cluster headaches interfere with their ability to function. If you suffer from these crippling headache disorders, you may feel helpless against the pain, but you should know effective treatment is available. While these headache disorders cannot be cured, they can be managed effectively.
If frequent or severe headaches are disrupting your life, there are some simple steps that you should take to manage headaches and improve your quality of life:
- Avoid relying too regularly on over-the-counter medication because it can lead to medication overuse headache
- Track your headaches
- Identify and avoid your triggers, if possible
- Seek the help of a specialist for effective acute and preventive treatment plans
Avoid medication overuse headache
Usually, people manage their headaches with whatever they can obtain over-the-counter. Relying too often on over-the-counter headache medications, though, causes recurring headaches to become more frequent, stronger, and no longer responsive to over-the-counter treatments. This is called medication overuse headache. People who suffer from regular tension headaches are most vulnerable to this disorder because their headaches are typically not painful enough to prompt them to seek the advice of a doctor. Instead they just keep taking whatever they can get easily at the pharmacy. As a general rule, a person should take over-the-counter medications no more than 14 days per month to minimize the risk of medication overuse headache.
Track your headaches on a calendar
If you suffer from regular headaches, severe headaches, or both, you should start tracking your headaches on a calendar. This will help you identify the behaviors and qualities of your headaches.
Headaches have triggers and aggravators, and tracking your headaches on a calendar will help you and your doctor identify them. Also use the calendar to track any medications you take, like ibuprofen or aspirin, to treat your headaches. A lot of people with frequent headaches do not even realize how much medication they are taking.
Tips for keeping a headache calendar
- Mark every day you have a headache with an H for regular headache, M for migraine, C for cluster.
- Rate the pain at its worst that day using the following pain scale:
- 1-2: Headache is in the background. Can still function and carry out daily activities. May even forget about the pain for periods of time.
- 3-5: Headache may be distracting, but can be ignored if you are busy with activities.
- 6-7: Headache is starting to interfere with daily activities. Pain may make it difficult to concentrate. May have nausea, light sensitivity, or both.
- 8-10: Cannot engage in daily activities. May find yourself agitated or crying. Accompanied by any or all of the following: nausea or vomiting, light sensitivity, dizziness, weakness, numbness, or tingling in any body part.
- Try not to treat headaches that are rated less than a five with medication. Use any other means that may provide with relief, like massage, heat, cold, rest, or distraction.
- Write down whatever headache medication you took that day, how much you took, and when you took it.
- Write down any possible triggers to which you may have been exposed.
- Mark all menstrual period days with a P.
- Bring your calendar to your next appointment with a doctor
Possible triggers and aggravators
A trigger is not a cause, it is something that turns on the headache, like flipping a light switch. An aggravator is something that, over time, influences the behavior of headaches and makes them more frequent, more intense, or changes their qualities.
- Diet
- Alcohol
- Aspartame
- Caffeinated beverages
- Nitrites/Nitrates from processed meats
- Stress
- Crisis
- Moving
- Relationship difficulties
- Loss or change
- Hormones
- Menstrual period
- Ovulation
- Sensory stimuli
- Strong or flickering lights
- Odors
- Loud sounds
- Changes in environment or habits
- Weather
- Travel
- Change of season
- Schedule change
- Sleeping patterns
- Skipping meals
To help reduce the frequency of headaches, there are several universal things you can do:
- Maintain a good quality of sleep
- Stay hydrated
- Eat regularly
- Maintain a healthy diet
- Avoid excessive amounts of caffeinated drinks
- Engage in regular physical activity
- Manage weight
Seeking care from a specialist
If you suffer from regular headaches, severe headaches, or both, a headache specialist can help you find the best preventive treatment to reduce occurrences and also help you find the optimal treatment to relieve an acute headache attack.
As a general rule, if you have a headache needing treatment with an acute medication more than five days per month, it is a good idea to seek evaluation and treatment from either your primary care physician or a specialist. If the headache management plan is simple, the doctor will give some simple directions, and you will never need to worry about it again.
People with less than four headaches per month probably do not need to see a specialist unless the headaches are either severe migraines or cluster headaches that prevent the sufferer from participating in daily activities.
People who have more than 15 headache days a month for more than two months, regardless of the type of headache, most definitely need to see a specialist.
Hrachya Nersesyan, MD, is a neurologist and the director of the Illinois Neurological Institute’s Headache and Craniofacial Pain Program. Learn more about the services INI provides at www.ini.org or call 309-624-8500.