By Hallie Levine Skylar
Feel better fast by making these simple adjustments to your routine.
Everyone knows a sinus infection or a major work project can make your head throb. But headaches can also be triggered by seemingly innocuous everyday activities like sleeping in on Saturdays or cleaning your apartment. With so many culprits, it’s no wonder that one in five women suffer from migraines and nearly half of women in their 30s endure tension headaches. But if you think popping a pill is the only way to ease the symptoms, you’re wrong. We consulted the experts, and they revealed some unexpected causes of headaches, as well as how you can stop the pain for good.
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KICKING BACK ON THEWEEKENDS
You put in 14-hour days Monday through Friday, only to wake up midmorning on Saturday with pounding pain in your temples. “So many of my patients tell me that they can work all week in a high-stress environment without a problem, but the minute they start relaxing,they get a migraine,” says Lisa Mannix, M.D., medical director of Headache Associates in Cincinnati. The reason? As tension dissipates, levels of stress hormones,such as cortisol and or adrenaline, decrease. This causes a rapid release of neurotransmitters,the nervous system’s chemical messengers. These send out impulses to blood vessels,making them constrict and then dilate, in addition to releasing other pain causing chemicals.
Although it’s tempting to sleep in on weekends, you’re setting yourself up for trouble. In a survey conducted by the National Headache Foundation, 79 percent of headache sufferers reported that they wake up with a headache after snoozing for more than eight hours. Also, if you enjoy an 8 a.m. cup of joe during the week, try to have coffee at the same time on the weekend. Caffeine withdrawal also causes blood vessels to dilate, which can give you a “grande”-size headache. You should try to factor decompression time into your workweek, too. If you don’t have a consistent fitness program, start one now, aiming for at least 30 minutes of exercise three times a week. One study found that this amount of activity reduces headache frequency by 50 percent. “Exercise buffers the effects of stress and releases endorphins, the body’s natural painkillers, which help prevent the chemical changes that trigger a migraine,” says David Buchholz, M.D., associate professor of neurology at Johns Hopkins University and author of Heal Your Headache.
Also consider incorporating relaxation techniques into your schedule, such as meditation, yoga, or biofeedback, which teaches you to control involuntary body responses like muscle tension and heart rate. Studies show that using these therapies, either alone or in combination, can improve symptoms in up to 80 percent of patients suffering from headaches, says Alexander Mauskop, M.D., director of the New York Headache Center.
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SELF-TREATING YOUR HEAD PAIN
Taken too frequently (more than two or three times a week on a regular basis), the over-the-counter acetaminophen, ibuprofen, or naproxen you depend on to quell the throbbing may be hurting you instead of helping. It can cause rebound headaches, a condition estimated to affect 2 percent of all adults. “A woman may start taking pain relievers a few times a week to treat her tension headaches,” says Alan Rapoport, M.D., clinical professor of neurology at the David Geffen School of Medicine at the University of California, Los Angeles. “Soon the headaches become more frequent, so she starts taking these medicines more often. Before long, she has headaches every day.”
These drugs affect the pain-control systems in the brain and can lower levels of the feel-good chemical serotonin, explains Rapoport. Young women also seem to be more susceptible showed that about 75 percent of rebound-headache sufferers are women, most commonly in their 30s.
Occasional use of OTC medicine is fine, but be sure to follow the label instructions exactly. Taking a higher than suggested dose increases the odds of getting a rebound headache.
If you suspect that your pain is related to self-medicating, ask your primary care physician to refer you to a headache specialist. The only solution is to stop taking your OTC pills, a remedy that may be painful at first. “I wean patients off them gradually,” says Merle Diamond, M.D., associate director of the Diamond Headache Clinic in Chicago. “For example, if a woman is taking eight pills a day, I’ll advise her to take six a day the following week, and four a day the week after that.”
To help you through this withdrawal period, your doctor may prescribe temporary measures like triptans, a class of powerful migraine drugs that stimulate serotonin receptors, resulting in reduced inflammation and constriction of blood vessels in the head. The frequency and intensity of your headaches should improve in one to three weeks, but it may take up to three months before your brain’s pain control system returns to normal.
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YOUR PERIOD
About 60 percent of all female migraine sufferers experience their migraines just before or at the start of their periods, according to the National Headache Foundation. “These hormonally driven headaches typically occur with the drop of estrogen levels right before menstruation, which affects your body’s serotonin levels,” explains Diamond. The frequency and severity usually improve during pregnancy, when hormone levels stabilize, and worsen during perimenopause, when estrogen levels start fluctuating even more.
Many doctors, including Rapoport, will treat menstrual-related headaches with a prescription triptan, such as Frova. Your doctor may recommend taking triptans either a couple of days before your period starts or continuously during your period, depending on the severity and frequency of your migraines.
A nonsteroidal anti-inflammatory, such as ibuprofen, taken every day for the five to seven days around your period may also help reduce headache frequency. Experts used to believe that the birth control pill made migraines worse, but they’ve since concluded that the higher estrogen content of oral contraceptives a decade ago may have been to blame. Today’s pill may actually help. “Research shows that when female migraine sufferers take the pill, about one-third report an improvement in symptoms, one-third a worsening, and the other third no change,”says Mannix.
If you’re already on the pill,ask your doctor about taking it every day of the month (i.e.,skipping the placebo pills and starting a new pack immediately) to keep estrogen levels steady. A recent study published in the journal Headache found that women who used a continuous method had less severe headaches than those who stuck to the traditional 28-day pill cycle.
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HARBORING ANGER
Bottling up your feelings won’t do anyone—especially you—any favors. In fact, according to a study at Saint Louis University, this is the biggest emotional cause of headaches, even more so than depression or anxiety.
“When you’re angry, all your muscles tense up, including those in the back of your neck and scalp,” explains Allen Elkin, Ph.D., director of the Stress Management and Counseling Center in New York City. The prolonged contraction of the head and neck muscles causes a tight band-like sensation around your head, which is a classic sign of a tension headache.
The next time that you’re silently simmering, take in a larger than normal breath; hold it for three to five seconds while pressing together the thumb and index finger on one of your hands, suggests Elkin. Then exhale slowly through parted lips, until all the air has been drained from your lungs. Repeat two or three times. This soothing move stops you from tensing your neck and shoulder muscles, which has been shown to bring on a headache.
After you’ve cooled down, ask yourself how important the immediate issue is to you. Will you remember it in two months? Two days? The answer will help put the problem in perspective. “If you tell yourself to let it go for now, chances are even an hour later you’ll be able to deal with it better,” says Elkin. “Otherwise, you’ll just hold on to the anger all day and tense up even more.”
If you already feel a headache coming on, wrap a hot compress or a heating pad around your neck for a few minutes, making sure that it hits the base of your skull. This will relax your sternocleidomastoid muscles, which are key in tension headaches, says Jacob Teitelbaum, M.D., medical director of the Fibromyalgia & Fatigue Centers, which have clinics throughout the United States.
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YOUR LUNCH
A turkey sandwich with a slice of cheddar, a diet soda, and a small piece of dark chocolate may make for a waistline- friendly meal, but for headache sufferers, it’s a decidedly unhealthy combo. All these foods contain chemicals with the potential to trigger migraines. (Cheddar, as well as other aged cheeses, like Brie and Stilton, contains tyramine, while chocolate has theobromine and phenylethylamine.) In diet sodas, the culprit is the sweetener aspartame. In a study of migraine sufferers conducted at the Montefiore Medical Center Headache Unit in the Bronx, New York, a little more than 8 percent of patients linked their head pain to aspartame. While researchers aren’t exactly sure why this chemical causes pain, one theory is that it alters neurotransmitter levels. “I’ve had patients whose migraines have decreased dramatically just by giving up their afternoon soda,” says Buchholz. Other possible food triggers:MSG (a preservative) and nitrate containing processed meats and fish.
Keeping a food diary can be helpful in identifying potential headache triggers. Once you suspect a food may be to blame, try eliminating it from your diet and see whether it alleviates your symptoms. But be sure to eat regularly. “I tell my patients it’s more important that they eat than what they eat,” says Mannix. “If you skip breakfast, for example, you’ll have a drop in blood sugar, which can bring on a migraine.”
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YOUR CO-WORKER’S PERFUME
Even if you think it smells nice, just a little whiff can bring on head-splitting pain. In one study from the Headache Center of Atlanta, almost 50 percent of migraine sufferers attributed strong scents, such as perfume or household cleaners, to an attack. “Odors reach the center of your brain via direct nerve pathways from your nose,” explains Siddhartha Nadkarni, M.D., a neurologist at the New York University Medical Center. For scent-sensitive individuals, this causes a cascade of neurotransmitters that can initiate a migraine.
Unfortunately, many scents are difficult to avoid. “You can’t live in a bubble,” says Buchholz. “No matter how hard you try to stay away from strong smells, you’ll still end up in an elevator next to someone wearing heavy cologne.” But there are a few ways to keep odors at bay. First, try to keep your home and work spaces as ventilated as possible. “A patient of mine who is a supermarket-deli manager got so fed up with her heavily perfumed customers that she set up a fan at the back of her work area so it would blow scent away from her,” says Buchholz. Also, in your own home, use fragrance-free cleaning supplies, such as EnviroRite, and keep all doors and windows open.
If these strategies don’t work, combat one odor with another. A German study found that applying a drop of peppermint oil to the forehead was as effective as OTC acetaminophen in relieving some headaches.
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