MORE: 7 Weird Headache Triggers “Some people are born with biology that makes them headache prone,” explains Joel Saper, MD. For these people, headaches are a chronic problem. An estimated 28 million Americans—nearly 10% of the population, and most of them women—suffer from migraines. Not “just a headache,” migraine is a complex disease that causes severe and often disabling head pain, usually located on one side of the head, often accompanied by nausea, light and noise sensitivity, and other symptoms. “Migraines can be crippling,” says Patricia Solbach, PhD. So much so that they cause a loss of more than 157 million workdays each year. For the migraine-prone, lots of things can set off an attack. Among the most common triggers are changing hormone levels, poor eating or sleeping habits, dehydration, stress, chemicals in food, perfume, weather changes, seasonal changes, altitude, or low blood sugar.
Home Headache Prevention
People who get headaches know that an ounce of prevention is worth a pound of cure. Here’s what our experts advise.
Keep A Headache Diary
The first step in preventing headaches is to identify what triggers them. You are the one in the best position to recognize what habits and factors bring on your headaches. A headache diary does that by providing a daily log of factors that might relate to your headaches. Doctors at the New England Center for Headache suggest you record time of onset, intensity and duration, what you ate, medications you took, and any factors that might have triggered the headache. The American Headache Society offers free printable daily, weekly, and monthly headache diaries on its website.
Exercise Prevention
“Exercise is useful as a preventive measure,” says Solomon. It’s a good way to chase away a tension-type headache. Daily exercise may also decrease your migraine attacks—but don’t exercise during a migraine. An exercise schedule that involves some aerobic activity such as walking, running, cycling, or swimming 5 days a week for 20 to 30 minutes can make a big difference in reducing headaches and in promoting a general sense of improved well-being.
Don’t Oversleep
Sleeping in may feel relaxing, but it’s not a good idea. So no matter how tempting, avoid sleeping late on the weekend, says Ninan T. Mathew, MD. “You’re more likely to wake up with a headache.” Same goes for napping. (Here’s how much sleep you really need.)
Stand Tall, Sit Straight
Poor posture creates muscle tension that puts pressure on the nerves that cause headaches, says Seymour Diamond, MD. For people who work at computers, a posture problem called forward head posture can develop. Every inch that your head moves forward feels like 10 extra pounds to the muscles in your upper back and neck, keeping them in constant contraction. Try this technique to correct forward head posture: Align your eyes over your shoulders. When you do this you will automatically straighten up. (Try these 5 yoga fixes for bad posture.)
Sleep Like A Baby—On Your Back
Sleeping in an awkward position, or even on your stomach, can cause the muscles in your neck to contract and, consequently, trigger a headache. “Sleeping on your back helps,” says Diamond. (Here’s what your favorite sleep position says about you.)
Watch Your Caffeine Intake
If you drink too much caffeine on a daily basis—3 or more cups of coffee or large amounts of soda—your caffeine intake can cause or worsen your headaches. Moreover, suddenly stopping your caffeine will surely bring on a headache. But if you’re not a regular caffeine consumer, one cup can go a long way toward providing headache relief. “Caffeine constricts the dilated blood vessels around your temples,” says Alan Rapoport, MD. “It also increases the efficacy of pain medicines. That’s why it’s in most headache medications.” MORE: 16 Highly Effective Migraine Solutions
Don’t Miss A Meal
Fasting or skipping a meal can cause a dip in blood sugar and bring on a headache. To keep your blood sugar constant and minimize the effects of a missed meal, doctors at the New England Center for Headache recommend eating frequent mini meals throughout the day.
Protect Your Eyes
Bright light—be it from the sun, fluorescent lighting, TV, or a computer screen—can lead to squinting, eyestrain, and, finally, headache. Sunglasses are a good idea if you’re going to be outside. If you’re working inside, take some rest breaks from the computer screen and also wear some type of tinted glasses, Diamond suggests.
Know Your Food Triggers
“You can prevent migraine headaches at least 40% of the time just by making dietary changes,” says Frederick Freitag, DO. But to do this you have to avoid food triggers as well as eat healthfully. Fill up on whole, natural, unprocessed foods, especially vegetables and whole grains. Some foods known to trigger migraines are wine, cheese, citrus fruits, onions, tomatoes, and nuts. (Here are
Curtail The Cocktails
“Alcohol is at the top of the list of food factors that affect the most people with migraines,” says Rapoport. “It’s a vasodilator, meaning that it expands blood vessels, which can trigger migraine.” Although any type of alcohol can do it, red wine more than white, beer, champagne, and eggnog are most frequently mentioned. And dark-colored alcohols such as scotch, rye, whiskey, brandy, bourbon, sherry, and cognac seem to trigger headaches more often than light-colored ones such as gin, vodka, and white wine.
Avoid Amines
A hot fudge sundae studded with walnuts may sound like a midsummer night’s dream. For people who get migraines, it could turn out to be a nightmare. “Chocolate may be the second biggest offender,” says Rapoport. It contains an amine called phenylethylamine, which can cause your blood vessels to constrict and then dilate, triggering a headache. Experts believe the worst of the amines is tyramine, an amino acid found in aged cheeses, pickled herring, and liver. Other foods containing the dreaded amines include homemade yeast breads, lima beans, and snow peas.
Say No To MSG
Monosodium glutamate (MSG) may bring out all those subtle and spicy flavors in wonton soup, but if you’re one of the many people who are sensitive to this flavor enhancer, it might also bring on a whopping headache. Like other headache triggers, MSG launches its attack by dilating blood vessels and exciting certain nerves in the brain. If you get headaches and other symptoms from this aggravating additive, ask that MSG or seasoning salt (which contains MSG) be left out the next time you’re when ordering Chinese. Many products are loaded with it, so read the labels carefully for additives with names like hydrolyzed protein, glutamate, and caseinate, all MSG in disguise.
Pass On The Hot Dog
Pounding headaches caused by nitrites are commonly called hot dog headaches. So stay clear of meat products that contain nitrates, such as hot dogs, bacon, ham, and salami, and stick to fresh, unprocessed meat. Nitrites dilate blood vessels, which can mean big-time head pain, says Dr. Mathew. Try these basic stress reducers from several of the experts.
Breathe Deeply
Deep breathing is a great tension reliever. “You’re doing it right,” Sheftell says, “if your stomach is moving more than your chest.”
Do The Body Scan
Sheftell suggests checking yourself for signs that you are tensing up and inviting a headache: clenched teeth, clenched fists, hunched shoulders.
Go With The Flow
Maybe older people are better at this. “We see more headaches in younger individuals,” says Diamond. “And they’re under more stress—trying to make a living, supporting a family. But it’s important to not overdo.” Decreasing your expectations, both of yourself and others, wouldn’t hurt, adds Sheftell.
Relax With Imagery
“Imagine the muscle fibers in your neck and head to be all scrunched up,” says Sheftell. “Then begin to smooth them out in your mind.”
Have A Sense Of Humor
“If people take life too seriously—and you can see who those people are—they’re likely to be walking around with their faces all screwed up,” says Sheftell. And probably wondering why they have another headache.
Say No To Cologne
“Strong perfume can set off migraines,” says Solbach.
Seek Quiet
Excessive noise is a common trigger for tension headaches.
Forget About Gum
The repetitive motion of simply chewing gum can tighten muscles and bring on a tension headache, says Sheftell. (Here’s 6 gross side effects of chewing gum.)
Go Easy On The Salt
High salt intake can trigger migraines in some people.
Try Fish Oil
A small study at the University of Cincinnati found that taking fish-oil capsules reduced frequency and severity of migraines compared with taking a placebo. While preliminary, these findings add to the mounting evidence of benefits from the omega-3 fatty acids in fish. Eating approximately 2 ounces of fatty fish daily would supply the amount of omega-3s used in the study. Vitamin B2 may help prevent migraines. A European study found that high doses of vitamin B2 (riboflavin), over time, reduced the frequency of migraines. But Diamond cautions, “We need longer and larger studies before we can recommend the use of vitamin B2 in this dosage.”
Cluster, Cluster Go Away
But please don’t come back another day. Unfortunately, cluster headaches do tend to come back, even after long periods of remission. These headaches, which afflict about 1 million people—90% of them men—hit the unfortunate person with heavy-duty pain, typically around or behind one eye. Cluster attacks may occur every day for weeks, or even months at a time. The cause is yet unknown, but “it’s probably either hormonal or genetic,” says Solomon. The male hormone testosterone is currently being studied for possible connections to cluster headaches. Meanwhile, doctors have been able to isolate a common denominator. “For reasons we don’t completely understand, men who have cluster headaches are typically heavy smokers,” says Solomon. So quit smoking, or at least cut back drastically. Then, maybe when the cluster headaches go away, they’ll stay away.
Home Headache Relief
If, despite your best efforts, your brain is throbbing, here are some expert-recommended ways to get rid of the pain in your head.
Catch It Early
Don’t ignore the early signs of a headache. At the first hint of pain, take the appropriate dose of aspirin, ibuprofen, naproxen sodium, or acetaminophen. Most pain relievers become less effective as the headache progresses, says Diamond.
Avoid Overuse
It’s easy to overuse headache medication, and many headache sufferers do just that. Unfortunately, it can lead to rebound headache, a condition that requires medical attention. If you take over-the-counter or prescription pain medication 3 days a week, you are at risk for developing analgesic rebound headache, advises Sheftell.
Hydrate
At the first twinge of pain, drink a cup or two of water. This tactic alleviated the headaches of 65% of sufferers within 30 minutes, reports a study in the journal Headache.
Sleep
A lot of people sleep a headache off, says Mathew. MORE: The 10 Most Painful Conditions
Go Hot Or Cold
“During a headache, some people like the feeling of cold against their foreheads or necks, and for them it seems to help,” says Solbach. “But others prefer hot showers or heat on their necks.”
Use Your Hands
Both self-massage and acupressure can help, according to Sheftell. Two key pressure points for reducing pain with acupressure is the web between your forefinger and thumb (squeeze there until you feel pain) and under the bony bumps next to the ears on the back of the head (use each thumb to apply pressure there).
Pretend It’s A Rose
“Put a pencil between your teeth, but don’t bite,” says Sheftell. “You have to relax to do that.” The relaxation—and distraction—could help ease the headache.
Wear A Headband
“This old business of Grandmother tying a tight cloth around her head has some merit to it,” Solomon says. “It decreases bloodflow to the scalp and lessens the throbbing and pounding of a migraine.”
When to Call a Doctor
Occasionally headaches are warning symptoms for serious disease. Here are the red flags to signal you to call your doctor:
You’re older than 40 and have never had recurring headaches. Your headaches have changed locations. Your headaches are getting stronger. Your headaches are coming more frequently. Your headaches do not fit a recognizable pattern; that is, there seems to be nothing in particular that triggers them. Your headaches have begun to disrupt your life; you’ve missed work on several occasions. Your headaches are accompanied by neurological symptoms, such as numbness, dizziness, blurred vision, or memory loss. Your headaches coincide with other medical problems or pain.
Panel Of Advisors
Seymour Diamond, MD, is director and founder of the Diamond Headache Clinic and the inpatient headache unit at St. Joseph Hospital in Chicago. He also is executive chair of the National Headache Foundation and has written several books on headaches. Frederick Freitag, DO, is associate director of the Diamond Headache Clinic in Chicago. Ninan T. Mathew, MD, is director of the Houston Headache Clinic in Texas. He also is president of the International Headache Society. Alan Rapoport, MD, is cofounder and codirector of the New England Center for Headache in Stamford, Connecticut. Joel Saper, MD, is director of the Michigan Head Pain and Neurological Institute in Ann Arbor. He also is author of Handbook of Headache Management. Fred Sheftell, MD, is director of the New England Center for Headache in Stamford, Connecticut. Patricia Solbach, PhD, is a neuroscience scientific liaison for Ortho-McNeil Pharmaceutical, a division of Johnson & Johnson in Lawrence, Kansas, and former director of the Headache and Internal Medicine Research Center at the Menninger Clinic in Topeka. Seymour Soloman, MD, is professor of neurology at Albert Einstein College of Medicine at Yeshiva University and director of the headache unit at Montefiore Medical Center, both in Bronx, New York.
