What’s causing your headache?

Source: Best Health magazine, March/April 2013; Image: Thinkstock

Whether it’s a slight pressure or a piercing throb, once your head starts hurting you have only one thing on your mind: stopping the pain. Headaches are extremely common’47 percent of adults get at least one per year’and there are actually hundreds of different types. Some are classified as secondary headaches, which are caused by other conditions. But most are classified as primary headaches, which can include tension-type headaches, migraines and cluster headaches. Symptoms can range from a dull ache to a sharp pain; occur in any region (across the head, on one or both sides); come on suddenly or gradually; and last from a few minutes to a few days.

Most people’about 40 percent of Canadians’get tension-type headaches, says Dr. Werner J. Becker, a professor in the department of clinical neurosciences at the University of Calgary and the founding director of the Calgary Headache Assessment and Management Program (CHAMP). Usually, the pain is mild to moderate, involving a sensation of tightness or pressure across the forehead. Despite the name, muscle tension is not always the cause, adds Becker. ‘In a lot of patients, there isn’t any increase in muscle contractions. We don’t have a good understanding of where the pain comes from, just that the brain’s pain systems are not quite functioning the way they normally do.’

What causes headaches?

Stress is a big trigger for tension-type headaches; others include hormonal changes (such as during menstruation), dental problems (such as jaw-clenching), poor posture, skipped meals, fatigue, anxiety and depression. Women are 15 percent more likely to get them than men, with the incidence peaking in the 40s and declining thereafter.

Lifestyle changes such as getting more sleep and exercise, and practising good posture, may help. Relaxation techniques such as deep breathing can counter the stress that may set off a headache. Maggie Pattillo, a naturopathic doctor at the Halifax Naturopathic Health Centre, looks at dietary links, too. ‘If you’re getting a lot of headaches, certain foods should be avoided, including coffee, chocolate and alcohol‘particularly red and white wine,’ she says. ‘Dehydration and low blood sugar can also be factors.’

The occasional tension-type headache usually is not a cause for concern or a doctor’s visit unless it becomes chronic. Up to three percent of adults suffer from this condition, defined as daily or near-daily tension-type headaches that last for more than 15 days per month for at least three months. Chronic tension headaches also put sufferers at risk for another problem: medication-overuse headaches, experienced by up to five percent of the population. ‘If you are taking medicines like ibuprofen for headache more than 15 days a month, they can change your brain chemistry and make the pain more frequent,’ says Becker.

When to see the doctor

Schedule a doctor’s visit if you think you could be at risk for a medication-overuse headache, if you are a chronic tension-type headache sufferer, or if your headaches are preventing you from participating in your daily activities or sleeping. You should also seek help if you get migraines. About 12 percent of Canadians experience migraines, which are best managed with a combination of prescription treatments and lifestyle adjustments.

Call 911 or go to the hospital emergency room if you have a sudden, severe headache or a headache accompanied by confusion; fainting; high fever (above 39°C); numbness, weakness or paralysis on one side of your body; a stiff neck; nausea; vomiting; or impaired vision, speech or walking. These can be signs of a serious condition such as a stroke, meningitis or encephalitis (acute inflammation of the brain).

Otherwise, it is safe to use an over-the-counter remedy. Although your symptoms can last up to one week, if you haven’t experienced at least some improvement after three days of treatment, be sure to talk to your doctor.

This article was originally titled "What a pain…" in the March/April 2013 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!