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A lot of people get migraines — about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.

Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

* Alcohol
* Allergic reactions
* Bright lights
* Certain odors or perfumes
* Changes in hormone levels (which can occur during a woman’s menstrual cycle or with the use of birth control pills)
* Changes in sleep patterns
* Exercise
* Loud noises
* Missed meals
* Physical or emotional stress
* Smoking or exposure to smoke

Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:

* Any processed, fermented, pickled, or marinated foods
* Baked goods
* Chocolate
* Dairy products
* Foods containing monosodium glutamate (MSG)
* Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
* Fruits (avocado, banana, citrus fruit)
* Meats containing nitrates (bacon, hot dogs, salami, cured meats)
* Nuts
* Onions
* Peanut butter

This list may not be all-inclusive.

True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.

Symptoms

Vision disturbances, or aura, are considered a “warning sign” that a migraine is coming. The aura occurs in both eyes and may involve any of all of the following:

* A temporary blind spot
* Blurred vision
* Eye pain
* Seeing stars or zigzag lines
* Tunnel vision

Not every person with migraines has an aura. Those who do usually develop one about 10-15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand.

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:

* Feel throbbing, pounding, or pulsating
* Are worse on one side of the head
* Start as a dull ache and gets worse within minutes to hours
* Last 6 to 48 hours

Other symptoms that may occur with the headache include:

* Chills
* Increased urination
* Fatigue
* Loss of appetite
* Nausea and vomiting
* Numbness, tingling, or weakness
* Problems concentrating, trouble finding words
* Sensitivity to light or sound
* Sweating

Symptoms that may linger even after the migraine has gone away include:

* Feeling mentally dull, like your thinking is not clear or sharp
* Increased need for sleep
* Neck pain

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Here’s an idea you may be happy to get your head around: Doctors have more ways than ever to relieve headaches. That’s just as well, considering that the National Institutes of Health estimates that 45 million Americans suffer chronic headaches.

Headaches result when muscles and blood vessels outside your skull put pressure on your nerves, sending a “pain message” to your brain.

Try these tips

Get A Good Night’s Sleep: Your nervous system requires sleep to function properly. A regular schedule of seven to nine hours of sleep a night will keep your body’s sleep-wake cycle in order. Changes to your sleep schedule can cause cluster headaches, which occur without warning and are characterized by a sudden, sharp pain that can reach maximum intensity within minutes of onset.

Reduce Tension: Muscles in the neck, shoulder and scalp tighten and contract as a response to stress. This anxiety-induced reaction can lead to tension headaches. I use breathing exercises to reduce stress. To rid your body of tension, try this: Take slow, deep breaths to clear your mind.

See Your Doctor: Go to the emergency room for headaches that start after a head or neck injury or cause difficulties with speech. If headaches occur at least three times a month, or you experience an abrupt, severe headache, see your doctor.

Save Money

If the cost of treating your headaches is adding to your tension, consider this: There’s a health care discount program that offers savings on prescriptions, vision care, dental care, complementary and alternative health care treatments, vitamins and supplements by mail and more than 1,500 fitness clubs nationwide. Called HealthSaver, the program is not an insurance product or service and it’s offered by Affinion Group, a leader in membership, insurance and loyalty marketing businesses.

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Last year, during my freshman year in college, I got headaches at the end of the semester and during exam periods. I felt a constant pressure in my forehead that made it hard to study. Was I having migraines? Is there anything I can do to stop my headaches from coming back this year?

A: If you are getting bad headaches during times of stress, you are probably suffering from tension headaches. A study published in the journal Headache showed that stress is the most common cause of tension headaches. Other possible triggers include skipped meals, lack of sleep and fatigue, all of which may plague college students writing papers and cramming for exams at the end of a semester.

Tension headache is the most common type of headache. It affects three out of four people at some point in their lives. They can strike at any age, but women are more prone to them than men.

For most, the throbbing starts in the afternoon. The pain can be mild or moderate. It may wrap around your head like a tight band, or the pressure and tightness may be limited to the forehead or to the back or top of your head. The intensity of the pain may vary, but it usually isn’t severe enough to interrupt sleep or cause other symptoms.

Migraine headaches have different triggers. For example, they can be caused by certain foods, such as aged cheeses and red wine. Genes and hormonal changes can also play a role. Migraine headaches are often accompanied by other symptoms, such as nausea, vomiting and visual disturbances. They can also wake someone from a sound sleep.

Experts believe that tightness in the muscles of the scalp and the back of the neck leads to tension headaches. Exactly how factors like stress and missed meals lead to muscle tightness isn’t exactly clear, but doctors often advise patients to make lifestyle changes to reduce fatigue and stress and promote overall health. Research has found that poor sleeping and eating habits not only trigger tension headaches, but also aggravate headaches already in progress.

Because tension headaches are so common, people often think that taking over-the-counter or prescription pain relievers will cure the problem. However, the muscle tightness that distinguishes tension headaches is difficult to alleviate.

That’s because the drugs focus on relieving the pain, not the underlying cause: muscle tension and contractions. In fact, excessive use of pain relievers may sometimes increase tension headaches.

Instead, your best bet is to avoid straining muscles in your head and neck. Maintaining good posture and avoiding repetitive motions can help. These suggestions may help, too:

• Don’t rest your chin on your chest when reading.
• Don’t use your shoulder to hold the telephone to your ear.
• Keep your computer monitor at eye level; sit up straight to avoid neck strain.
• Try not to clench your jaw.

You can also try various physical therapies to prevent tension headaches. The easiest way to relax muscles: apply a heating pad to your neck or shoulders. Exercising neck and shoulder muscles also helps stretch and strengthen them. Massages are another good way to relieve tension headaches. Your doctor may have some other suggestions or give you a referral to a physical therapist.

Relaxation therapies may also loosen tense muscles. In autogenic training, for example, you learn to focus your attention on different parts of your body, and then imagine them becoming warm and heavy in order to relax them. During biofeedback, a therapist attaches electrodes to your skin to detect electrical signals from your neck and shoulder muscles. When you become tense, the biofeedback machine will give a signal. This helps you learn to recognize when you are becoming tense and find ways to relax before you develop a tension headache. These techniques work only if you practice them regularly, preferably every day.

People who experience severe, chronic tension headaches should get a checkup and consult a doctor about tests and other treatments. For example, he or she may prescribe muscle relaxants, certain antidepressants or local anesthetic injections.

With a little effort, you can take pain — or at least some of it — out of studying.

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While you may use medicine to treat or prevent tension headaches, adding stress management therapies may help reduce the frequency of your tension headaches. Talk to your doctor about trying:

* Biofeedback, a relaxation method to help you learn to control a body function that is not normally under conscious control, such as muscle tension.
* A relaxation exercise during which you focus on relaxing each muscle group. Relaxation exercises can help with tension headaches. When relaxation exercises and antidepressants are used together as treatment, the results are even better.3
* Acupuncture, which involves putting very thin needles into the skin at certain points on the body to produce energy flow along the body’s meridians. Evidence specifically for tension headaches shows that acupuncture is no better than sham acupuncture (when needles are put into the skin, but not at the right points).4
* Transcutaneous electrical nerve stimulation (TENS), which may help reduce pain.
* Cognitive-behavioral therapy or problem-solving therapy during counseling sessions. Cognitive-behavioral therapy and problem-solving therapy can help with tension headaches. When cognitive-behavioral therapy or problem-solving therapy and antidepressants are used together as treatment, the results are even better.3
* Yoga.
* Meditation.
* Peppermint oil. There is some evidence that peppermint oil rubbed on the temples or on the tight muscles in the head, neck, and shoulders may help relieve tension headaches.

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Combining stress management therapies with drugs can be an effective way to manage most headaches, including migraines or tension headaches. People react differently to various drugs and stress management therapies. Finding the right combination may help you prevent and manage your headaches.

Medicines to treat frequent or severe headaches include pain relievers (both prescription and nonprescription) as well as antidepressants, seizure medicines, or beta-blockers. Educating yourself on the type of headache you have and best treatment for it can help you manage your headaches.

You may be able to reduce headache symptoms with stress management and nonmedication therapy alone, although you may need drugs if the symptoms get worse. Stress management and nonmedication therapies to help prevent and reduce the severity of headaches include:

* Biofeedback, a relaxation method to help you learn to control a body function that is not normally under conscious control, such as muscle tension.
* A relaxation exercise during which you focus on relaxing each muscle group. Relaxation exercises can help with tension headaches. When relaxation exercises and antidepressants are used together as treatment, the results are even better.
* Acupuncture, which involves putting very thin needles into the skin at certain points on the body to produce energy flow along the body’s meridians. Evidence specifically for tension headaches shows that acupuncture is no better than sham acupuncture (when needles are put into the skin, but not at the right points).
* Transcutaneous electrical nerve stimulation (TENS), which may help reduce pain.
* Cognitive-behavioral therapy or problem-solving therapy during counseling sessions. Cognitive-behavioral therapy and problem-solving therapy can help with tension headaches. When cognitive-behavioral therapy or problem-solving therapy and antidepressants are used together as treatment, the results are even better.
* Yoga.
* Meditation.

Professional counseling can also help reduce stress, anxiety, and symptoms of depression.

Why should you quickly manage your headache?

Early treatment is important because it may prevent headache symptoms from getting worse and help you feel better sooner. You will miss less work or school, and improve the quality of your life.

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Taking good care of yourself can help prevent most types of headaches.

* Avoid headache triggers. If you’re not sure what triggers your headaches, keep a headache diary. Include details about every headache. When did it start? What were you doing at the time? What did you eat that day? How did you sleep the night before? What’s your stress level? How long did it last? What, if anything, provided relief? Eventually, you may begin to see a pattern — and take steps to prevent future headaches.
* Get enough sleep. Go to bed and wake up at the same time every day — even on weekends. If you’re not tired at bedtime, don’t fight it. Read or watch television until you become drowsy and fall asleep naturally.
* Don’t skip meals. Start your day with a healthy breakfast. Eat lunch and dinner at about the same time every day.
* Exercise regularly. Physical activity causes your body to release chemicals that block pain signals to your brain. With your doctor’s OK, choose activities you enjoy — such as walking, swimming or cycling. To avoid injury, start slowly.
* Reduce stress. Get organized. Simplify your schedule. Plan ahead. When the going gets tough, stay positive.
* Relax. Try yoga, meditation or relaxation exercises. Set aside time to slow down. Listen to music, read a book or take a hot bath.
* Quit smoking. If you smoke, talk to your doctor about quitting. Smoking can trigger headaches or make them worse.

Complementary and alternative medicine

For many people, complementary or alternative therapies offer welcome relief from headache pain. It’s important to be cautious, however. Not all complementary or alternative therapies have been studied as headache treatments, and others need further research.

* Acupuncture. This ancient technique uses hair-thin needles to promote the release of natural painkillers and other chemicals in the central nervous system. There is some evidence that it can help control headaches and other conditions that cause chronic pain.
* Hypnosis. During a hypnosis session, a trained hypnotist might suggest ways to decrease your perception of pain and increase your ability to cope with it — such as visualizing a calm, safe place when a headache strikes.
* Meditation. During meditation, you focus on a simple activity, such as breathing or repeating a single word or phrase. The practice creates a deeply restful state in which your breathing slows and your muscles relax — which can help you manage pain and reduce the stress that can trigger or worsen a headache.
* Massage. Massage can reduce stress, relieve tension and promote relaxation. Although its value as a headache treatment hasn’t been fully determined, massage may be particularly helpful if you have tight, tender muscles in the back of your head, neck and shoulders.
* Herbs, vitamins and minerals. Some dietary supplements — including magnesium, feverfew and butterbur — seem to help prevent or treat some types of headaches, but there’s little scientific support for these claims. And ongoing challenges in regards to quality of supplements in the United States makes decisions about using herbs even more complicated. If you’re considering using supplements to treat headaches, check with your doctor. Some supplements may interfere with the effectiveness of prescription or over-the-counter drugs or have other harmful effects.
* Chiropractic care. Spinal manipulation can effectively treat some types of pain, but studies don’t support claims that chiropractic care relieves headaches. Chiropractic manipulation of the neck has been associated with injury to the blood vessels supplying the brain. Rarely, this may cause a stroke.

If you’d like to try a complementary or alternative therapy, discuss the risks and benefits with your doctor.

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Chronic daily headaches can interfere with your job, your relationships and your quality of life. But you can cope with the challenges.

* Take control. Commit yourself to living a full, satisfying life. Work with your doctor to develop a treatment plan that works for you. Take good care of yourself. Do things that lift your spirits. Set aside time for your loved ones — and yourself — every day.
* Seek understanding. Don’t expect friends and loved ones to instinctively know what’s best for you. Ask for what you need, whether it’s time alone or less attention focused on your headaches.
* Check out support groups. When your head is throbbing, companionship may be the last thing on your mind — but perhaps it’s just what you need. A support group can put you face to face with people who share your physical symptoms and emotional responses. You may learn useful coping strategies — or help others by sharing some of your own.
* Consider counseling. A counselor or therapist can help you manage stress and maintain your emotional balance. Through therapy, you can learn to change behavior that’s not good for you and reinforce behavior that’s helping you manage your headaches.

Complementary and alternative therapies

For many people, complementary or alternative therapies offer welcome relief from headache pain. It’s important to be cautious, however. Not all complementary or alternative therapies have been studied as headache treatments, and others need further research.

* Acupuncture. This ancient technique uses hair-thin needles to promote the release of natural painkillers and other chemicals in the central nervous system. There is some evidence that it can help control headaches and other conditions that cause chronic pain.
* Biofeedback. With this relaxation technique, you can learn to control headaches by producing changes in bodily responses such as muscle tension, heart rate and skin temperature.
* Meditation. During meditation, you focus on a simple activity, such as breathing or repeating a single word or phrase. The practice creates a deeply restful state in which your breathing slows and your muscles relax — which can help you manage pain and reduce the stress that can trigger or worsen a headache.
* Massage. Massage can reduce stress, relieve tension and promote relaxation. Although its value as a headache treatment hasn’t been determined, massage may be particularly helpful if you have tight, tender muscles in the back of your head, neck and shoulders.
* Herbs, vitamins and minerals. Some dietary supplements — including magnesium, feverfew and butterbur — seem to help prevent or relieve some types of headaches, but there’s only modest scientific support for these claims. If you’re considering using supplements to treat headaches, check with your doctor. Some supplements may interfere with the effectiveness of prescription or over-the-counter drugs or have other harmful effects.
* Chiropractic care. Spinal manipulation can effectively treat some types of pain, but studies don’t support claims that chiropractic care relieves headaches. Chiropractic manipulation of the neck has been associated with injury to the blood vessels supplying the brain. Rarely, this may cause a stroke.

If you’d like to try a complementary or alternative therapy, discuss the risks and benefits with your doctor.

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In most cases headache pain, even severe headache pain, isn’t the result of an underlying disease. In fact, the vast majority of headaches are primary headaches — headaches not caused by a specific medical condition. These include migraines, tension headaches and cluster headaches.

Based on the length of the cluster periods and the remission periods, the International Headache Society has classified cluster headache into two types:

* Episodic. In this form, cluster headache occurs at least daily for one week to one year, followed by a pain-free remission period lasting at least one month before another cluster period develops.
* Chronic. In this form, cluster headache occurs daily for more than a year with no remission or with pain-free periods lasting less than one month.

About 10 percent to 15 percent of people with cluster headache have chronic symptoms with no periods of remission. Chronic cluster headache may develop after a period of episodic attacks, or it may develop spontaneously, without a prior history of headaches. Some people experience alternating episodic and chronic phases.

Researchers point to different mechanisms to explain the major characteristics of cluster headache. There may be a family history of cluster headache in some people with this condition, meaning a possible genetic component. Several factors may work together to produce cluster headache.

Cluster headache triggers

Unlike migraine and tension headache, cluster headache generally isn’t associated with triggers such as foods, hormonal changes or stress. But some people with cluster headache are heavy drinkers and cigarette smokers. Once a cluster period begins, consumption of alcohol can trigger a splitting headache within minutes. All it takes is one drink. For this reason, many people with cluster headache stay completely away from alcohol for the duration of a cluster period. Other possible triggers include the use of medications such as nitroglycerin, a drug used to treat heart disease.

The beginning of a cluster period often follows occasions when normal sleep patterns are disrupted, such as during a vacation or when starting a new job or work shift. Some people with cluster headache also have sleep apnea, a condition in which the walls of a person’s throat collapse momentarily, obstructing the sleeper’s breathing repeatedly during the night.

Increased sensitivity of nerve pathways

The intense pain of a cluster headache is centered behind or around your eye, an area that’s served by the trigeminal nerve, a major pathway for pain. Stimulation of this nerve results in abnormal reactions of the arteries that supply blood to your head. These blood vessels enlarge (dilate) and become painful.

Some symptoms of cluster headache, such as teary eye, stuffy or runny nose and droopy eyelid, involve your autonomic nervous system. The nerves that are part of this system form a pathway at the base of your brain. When the trigeminal nerve is activated, causing eye pain, autonomic nerves also are activated in what is called the trigeminal-autonomic reflex. Researchers believe that a still-unidentified process involving inflammation or abnormal blood vessel activity in this region also may be involved in the headache.

Abnormal function of the hypothalamus

Cluster attacks typically occur with clock-like regularity during a 24-hour day. The cycle of cluster periods often follows the seasons of the year. These patterns suggest that the body’s biological clock is involved. In humans, the biological clock is located in the hypothalamus, which lies deep in the center of your brain. Among the many functions of the hypothalamus is control of the sleep-wake cycle and other internal rhythms.

Abnormalities of the hypothalamus may explain the timing and cyclical nature of cluster headache. Studies have detected increased activity in the hypothalamus during the course of a cluster headache. This activity isn’t seen in people with other headaches such as migraine.

Studies also indicate that people have abnormal levels of certain hormones, including melatonin and testosterone, during cluster periods. These hormonal changes are believed to be due to a problem with the hypothalamus. Other studies show activity in the hypothalamus during cluster attacks. But it remains unknown what causes these abnormalities in the first place.

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There is no cure for migraines but there are many ways in which the condition can be managed and treated and these include identifying one or more of the triggers which may be responsible for your condition. In addition, medical studies have shown that there may well be a migraine personality where a migraine sufferer could have one or more of these characteristics: perfectionist; highly strung; conscientious; orderly; analytical; critical.

Such characteristics may in turn help the sufferer to understand why a particular trigger causes the onset of a migraine headache. A significant change in a sufferer’s life style is probably necessary. The following changes could make all the difference:

- Identify the triggers for your migraines and avoid these.
- Establish regular sleeping hours even when on holiday or over weekends.
- Try to sleep in a quiet and dark room.
- Take regular exercise and if necessary, exercise under the supervision of a trainer.
- Learn and follow stress management techniques.
- Learn and follow a relaxation routine.
- Try to avoid taking tea, coffee, cola drinks or heavy meals before going to sleep.
- If you are a diabetic, in addition to being a migraine sufferer, then eat small amounts of food frequently.

If you are diagnosed with migraine, your doctor will inform you of the different medications which can be prescribed together with any possible side effects. He will monitor symptoms like nausea and vomiting. There are two types of medicine used for treating migraines - namely prophylactic medication (taken every day to reduce the severity and frequency) while the other is abortive medication (only taken if a migraine begins).

Some complementary treatments for migraines include:

- Botox which has been used with success in some sufferers for reducing the frequency and intensity of migraine attacks.
- Acupuncture which has offered some sufferers relieve and a better quality of life.
- Chiropractic (a method employing a holistic approach to pain relief through massage, spinal manipulation and periodic adjustment of joints and soft tissue) which has had some positive results with migraine sufferers.
- Natural healing products (produced from essential oils and applied to the forehead, neck and temples as well as the soles of the feet) are becoming popular for treating migraine headaches.

It is important to treat a migraine as soon as it starts and, while the treatment is doing its work, to drink plenty of water and to rest quietly in a darkened room.

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Headaches Caused by Muscle Contraction (Tension Headaches)

This type of headache begins in the back of the NECK or head and develops into what is usually described as a non-throbbing, tight, cranial band that puts pressure on the head. Health professionals agree that these headaches are the result of excessive tone or contraction of the muscles in the face, head and NECK areas. They are by far the most common type of headache and Esgic Plus is often prescribed. This condition varies from mild severe discomfort in pain levels and afflicts men and women equally.

There are a number of underlying causes of the muscle contraction and tension that lead to these headaches. They can be related to spinal misalignment that often starts with poor posture that comes from sitting in uncomfortable positions for long periods. Other causes include fatigue or stress that causes contraction or excess tone in various muscle groups. Pelvic irritation, poor dental health, misaligned mastication or anything else that results in stress in the muscles of the face, skull, shoulders and upper back can all lead to chronic tension headaches. Any of these things can lead to muscles that are constantly contracted and suffering from a reduced oxygen supply. Muscles with low oxygen levels become fatigued, which leads to a buildup of histamines and other chemicals, which accumulate and trigger neurons, creating pain.

Smoking, irregular sleep patterns, bitterness, grief, anger, depression, fear and heightened levels of anxiety can all trigger tension headaches. Poor diets, high caffeine intakes, strong light, or illness can also play a role and sufferers know that once tension headaches start, Esgic Plus or other therapies are often needed to stop the cycle.

That’s because at the first sign of a tension headache, patients develop heightened levels of fear, producing muscle tension that creates anxiety and so on. That’s why it is important to take Esgic Plus at the first sign of a headache.

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