Causes and Treatments of Headaches and Migraines
June is migraine and headache awareness month. Migraine affects more than 38 million Americans and is the third most common condition worldwide. Despite such a vast number of sufferers, however, significant development of migraine treatment options continue to lag.
According to Regina Krel, M.D., a neurologist in the Headache Center at the Neuroscience Institute at Hackensack Meridian Health Hackensack University Medical Center, migraine is a very multifaceted and multifactorial neurological condition. The underlying cause of migraine is genetic, however, there are many factors that can influence the course migraines will take.
“Patients with anxiety or depression, sleep disorders and medication overuse are likely to have more frequent headaches that are more difficult to treat,” explains Dr. Krel. “Even with the introduction of new medications, patients may not be ‘cured’ of their migraines, but rather their pain may be better controlled.”
Dr. Krel, who is fellowship trained and board-certified in Headache Medicine, offers this Top 10 list of Headache/Migraine causes and remedies:
(in no particular order)
1. Genetics- Migraine headache disorders account for the second most common headache subtype and tend to be genetic. Although there is no method to changing your genetic makeup, getting a proper diagnosis early will yield better treatment results.
2. Poor sleep- Inconsistent sleep, both too much and too little, can contribute to developing headaches. Sleep hygiene revolves around consistent sleep. Pick a set bedtime and a wakeup time and attempt to not deviate from them significantly. Avoid caffeine intake in the second half of the day since it can make falling asleep difficult. In the age of technology our brains are constantly stimulated and winding down becomes challenging. It is best to avoid electronic devices prior to bedtime. To prevent middle of the night bathroom breaks, it is best to avoid drinking just before bed, including alcohol which can also make for a poor night’s rest. Lastly, relaxation techniques, meditating, drinking calming tea (such as chamomile), warm bath/shower can relax you before bed and make falling asleep easier. In addition, patients who complain of snoring, daytime sleepiness or fatigue, and those who wake up several times per night may have sleep apnea. If undiagnosed and untreated individuals are at an increased risk for not only developing headaches, but also memory loss, weight gain, depression, heart attacks, and stroke.
3. Dehydration- Not drinking enough water can certainly trigger a headache. It is important to remember that drinking beverages with high sugar content will add to dehydration. This is especially common in children. In fact, some headaches can be alleviated by just drinking water.
4. Excessive caffeine- Although caffeine can be used to manage an acute headache when one comes on, consuming too much caffeine can lead to increased frequency and severity of headaches. Patients are often advised to limit their caffeine intake to about two regular cups of coffee per day or take a “caffeine holiday” two days a week and avoid all caffeine.
5. Skipping meals- Not having a balanced diet and skipping meals greatly contributes to triggering headaches, especially in children. In addition, high intake of processed foods, food that contains MSG or high levels of nitrates can also bring on headaches. Other common food triggers include aged cheeses, chocolate, and alcohol (in particular, red wine). Keep something healthy in your bag/car that you can quickly snack on when you’re on the go.
6. Stress/Mood disorders- It is no secret that being stressed can trigger headaches. Several studies have delineated a bidirectional relationship between mood disorders, such as anxiety and depression, and headache. Relaxation training techniques, meditation, yoga, cognitive behavioral therapy and biofeedback can all be helpful in managing stress, anxiety and even depression.
7. Poor Posture- Frequent slouching and hunching over can put a lot of strain on your neck, back, and shoulders. This can lead to muscle strain and spasm and can subsequently lead to triggering a headache to come on. It is always important to work on maintaining good posture.
8. Pain Medications- Interestingly enough, taking too much pain medication, even if it is for a headache, can lead to more headaches which are more severe. Medication overuse, headache or rebound headaches are a known risk factor to developing chronic headache disorders. It is best to limit the use of these medications to 2-3 times per week at most or 9-15 days per month, depending on the medication. It is also important to note that if you require so much pain medication for headaches, it might be time to see a headache specialist!
9. Changes in weather and altitude- Traveling to areas where there is an abrupt climate change or change in altitude and air pressure can bring on a headache. To remedy these headaches, it is best to discuss with your doctor and prepare a game plan so you are well prepared should one of these headaches occur.
10. Hormones- Abrupt changes in hormones such as a drop in estrogen that occurs just before the onset of your period can be a key factor in triggering migraine headache attacks to occur. If headaches consistently occur around your menstrual cycle it is important to tell your doctor since there are management strategies that can be implemented. For example, sometimes short-term prophylaxis with naproxen (which is a non-steroidal anti-inflammatory [NSAID]) can be used for a few days prior to the onset of your period in an attempt to prevent some headaches from coming on.