Headache Causes and Control

What Causes the Pain of a Headache?

We have all had a headache at some time in our life, but what each of us feels when we have a headache may be quite different. That is because there are so many different causes of headache pain that result in varying symptoms. The pain of headaches is caused by nerve fibers that are located over the scalp, in the face, mouth and throat, in the muscles of the head and/or in blood vessels found along the surface and base of the brain. These nerves can be prompted to send out pain signals by triggers such as stress, muscle tightness and/or dilated blood vessels.

Which Headache Symptoms Should Prompt Me to Visit a Doctor?

• Sudden, severe headache
• Headache with fever
• Headache with seizure
• Headache with confusion or loss of consciousness
• Headache following a blow to the head
• Headache associated with pain in the eye or ear
• Persistent headache in a person who normally doesn't get headaches
• Recurring headaches in children
• Headaches, which interfere with activities of daily life
• Headaches which occur more than three times in a week, or that require pain relievers to be taken daily

Understanding Different Types of Headaches

Tension Headaches

• A steady ache, rather than a throbbing type headache. Usually felt in the temples, with tightness and pressure sensations around the head, and tight head and neck muscles.
• May be in response to a stressful or hectic day, poor posture, arthritis, eyestrain, teeth or jaw misalignment, noise or abnormal lighting.
• May be chronic (occurring frequently) or episodic (occurs once in a while).
• Usually begins between the ages of 20 and 40 and occurs more often in women than in men.

Migraine Headaches

• The pain of migraine is typically throbbing and occurs on one side of the head in about 60% of cases.
• Nausea, with or without vomiting, as well as sensitivity to light and sound often accompany migraines.
• About 6% of men and up to 18% of women experience a migraine headache at some time.
• About one in five migraine sufferers experience an "aura" before the headache. An aura consists of disturbances in vision that may involve brightly coloured or blinking lights.

Cluster Headaches

• Headaches occur in groups (one to four headaches a day). Pain arrives with little warning (usually on one side of head) and is often more severe and intense than other headaches (described as piercing, burning, throbbing, and pulsating). Usually lasts for 30 to 45 minutes, but may last for several hours.

Headache Management

It's always best to address the cause of headaches rather than to automatically reach for the medication. Regular exercise and relaxation techniques such as biofeedback and meditation can help reduce the muscle tightness that often causes tension headaches. Adopting a nutritious, well-balanced diet and eating at regular intervals can help you avoid some headaches as well.

Before you treat a headache with medication, it is important to understand the benefits and precautions associated with the large array of pain relievers that are available without a prescription. Your Sobeys Pharmacist will be happy to assist you in this.

Benefits of Non-Prescription Pain-Relievers

• The occasional tension-type headache will usually be relieved with mild painkillers such as ASA, ibuprofen or acetaminophen. Acetaminophen rarely causes stomach problems, but it does not relieve inflammation as well as ibuprofen or ASA. Talk with your PROfile Pharmacist about the pain reliever best suited to your needs.
• Anti-inflammatory medications may also be used for the pain of migraine as well as medications that help to reduce the dilation of blood vessels that cause migraines. These are discussed in more below.

Some Precautions for Non-Prescription Pain Relievers

• Many non-prescription pain relievers are also contained in other medications you may be taking. You risk taking too much of the drug if you mix the two types of medication.
• Anti-inflammatory pain relievers (such as ASA and ibuprofen) can cause an stomach upset or even lead to stomach ulcers and bleeding if overused. ASA should never be given to children or adolescents without first talking with your doctor.
• Using pain relievers on a regular basis can lead to a condition called "rebound headache." If you find yourself needing medication on a daily basis, you should talk with your doctor.

Management of Migraine Headaches

Migraine "Triggers"

Most people who get migraine headaches have certain "triggers" which put the headache process in motion. Triggers may include stress, fatigue, glaring or flickering lights, changes in the weather, and certain foods. Keeping track of triggers and avoiding them is usually easier said than done, but is one of the best ways to prevent migraines.

Medications for Migraines

Medications for the treatment of migraines are aimed at either preventing the headache or treating symptoms after they occur.

Treatment for Migraines

• ASA, ibuprofen, other nonsteroidal anti-inflammatory medications (NSAIDs) or acetaminophen in combination with caffeine may relieve the pain of mild to moderate migraines.
• Triptans - For more severe migraines, your doctor may prescribe medication that acts directly on the chemicals in the brain to relieve dilation of the blood vessels that leads to the headache pain. These medications (for example, sumatriptan, naratriptan, rizatriptan, zolmitriptan) are taken at the first sign of the headache with explicit directions on when another dose may be taken (talk with your PROfile Pharmacist).
• Ergotamines - Ergotamine and dihydroergotamine also stop the dilation of blood vessels that cause migraines. These medications must not be used more than two days a week at prescribed doses.

Prevention of Migraines

When taken on a regular basis, the following medications may reduce the incidence of migraine headaches:

• Beta-blockers (e.g., atenolol, metoprolol, and propranolol)
• Calcium channel blockers (e.g., verapamil, flunarizine)
• Anti-seizure drugs (e.g., valproate, divalproex sodium)
• Tricyclic antidepressants (e.g., amitriptyline, doxepin)
• Serotonin Inhibitors (e.g., pizotifen, methysergide)
• Others (e.g., lithium)

Headache Relief Suggestions

• Advil^TM Tablets
• Aspirin^TM (coated)
• Compliments Acetaminophen
• Compliments ASA (coated)
• Tylenol^TM Caplets

More Information About Headache Management

World Headache Alliance
E-mail: info@w-h-a.org
Web site: www.w-h-a.org

National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
P.O. Box 5801 Bethesda, MD 20824
Phone: 1-800-352-9424
Web site: www.ninds.nih.gov

American Council for Headache Education
19 Mantua Road, Mt. Royal, NJ 08061
Phone: 1-800-255-2243
E-mail: acheq@talley.com
Web site: www.achenet.org

National Headache Foundation
820 N. Orleans, Suite 217
Chicago, Illinois 60610
Phone: 1-888-643-5552
E-mail: info@headaches.org
Web site: www.headaches.org

Your Sobeys Pharmacist has many resources for health education and is always available to discuss your health concerns!