Oh, My Aching Head!

Living brings headaches—and not just the metaphorical ones. Some people are blessedly free of headaches, or virtually so; many of us suffer them occasionally or periodically; for some of us they can be major disruptions in our lives.

Head pain is one of those areas where people may swear by this remedy or that, and one person’s relief may be another person’s aggravation, or simply have no effect. Headaches are often mysterious, and often traceable to specific behaviors or habits. Let’s look at some of the type of headaches that exist, and address some of the behaviors that can relieve, prevent, or unwittingly foster them.

Tension headaches are the most common type. Pain is often moderate—it may be diffuse across the head, or present itself in the classic “tight hatband” pattern.  More localized and often more intense headaches, including ones that occur suddenly during sex, may be traceable to specific muscle groups.

Tension headaches may simply resolve in a half hour or so, or can last much longer. In addition to (or instead of) over-the-counter pain relievers, a combination of distraction and mild stimulation may help: hot or cold packs, a shower, rest, relaxation, or moderate exercise. Rubbing peppermint oil on the affected area may offer some relief. Any massaging action may help break up the underlying tension, as will a break from whatever concentrated activity may have brought the headache on.

Posture seems to contribute to tension headaches. We’ve probably all heard, maybe even uttered, the admonition to “throw your shoulders back!” Try this instead—no throwing of body parts involved!

• Start by standing in your normal “relaxed” posture.
• Lift your shoulders gently toward your ears, no more than an inch or so.
• Now move your shoulders back, keeping them at the same height, and again, no more than an inch or so.
• Gently let your shoulders drop until they come to rest. You will probably feel your shoulder blades sliding into their natural relaxed position, nested against the rib cage. You may also feel your head rise to balance properly on top of your spine, and your pelvis move forward as you align the curve of your spine with your center of gravity. You are now in a healthy, relaxed posture.

You can do a miniature version of this while sitting, but especially if you are working at a desk or table, why not take a moment to stand for a break and get the full benefit?

Another way to get at positioning your shoulders—this one can also be done lying down—is to:

• breathe as much air out of your lungs as you comfortably can
• take an unforced, deep breath, starting by directing air down into the belly
• fill the lungs upward from the belly until they feel full
• continue inhaling!

The all-too-often unused tops of your lungs will expand, and naturally push the collarbone back and down, and the shoulder blades into their lowered and restful position against the rib cage.

Migraines are notoriously intractable, and one hesitates to offer advice, knowing that even more than for headaches in general, the few things reported to be effective work for some and not others, and even work on some occasions and not others—and knowing that the migraine sufferer has probably heard and tried them all. Most helpful is learning to recognize migraines as they come on—or in some cases announce themselves through their flashing, blinding, or tingling “auras”—and developing the reflex of immediate action, which can vary from sleeping or lying down in a darkened room to taking an herbal remedy or an over-the-counter pain reliever to taking caffeine.

Progressive muscle relaxation can be helpful for some at onset. A course of biofeedback can train one to recognize which techniques are most helpful. Relaxation, with or without movement, seems to help with prevention. The kind of activity—exercises, yoga, or meditation, or generally relaxing and pleasurable activities such as gardening, reading, listening to music or dancing (no headbanging!)—seem to matter less than reserving a half hour or so a day for taking that kind of care of yourself.

Migraine sufferers need to make sure family members or others in the household understand how debilitating migraines can be, that whether the pain is severe or relatively mild, it is throbbing, intrusive, and may be accompanied by nausea and extreme sensitivity to light, sound or odor. You may have to work with your household on a way to shield you from disturbances while you pull yourself back together.

Cluster headaches may also be debilitating, simply because of the typically sudden and excruciating pain, not to mention its usual location in or around the eye. The “cluster” refers to temporal proximity—a series that can last from weeks to months, with happily longer periods of remission. These types of headaches may be brought on by a variety of “triggers”; whether the triggers can be generally avoided or not, they should certainly be avoided during a cluster period or “bout”:

• drinking alcohol
• exposure to other volatile hydrocarbons, such as gasoline, solvents, oil-based paints
• reduced oxygen from high altitude, overexertion, or their combination
• tobacco
• smoked and processed meats and some medicines that contain nitrates

It may be worth mentioning that certain root, cruciferous, and green leafy vegetables contain significant amounts of nitrates. These are typically found at levels that are considered not only non-toxic, but (arguably) supportive of good health. Since we don’t understand the relationship between nitrate exposure and cluster headaches, and appropriate levels of nitrate intake are scientifically controversial, diet may be worth looking at during a bout. (Proven excess levels of nitrates, including potentially fatal effects on infants, much more commonly stems from groundwater than from vegetables. Agricultural runoff is the typical culprit for excess nitrites and nitrates in drinking water, including well water.)

A regular sleep pattern may be protective and prolong the periods of remission, and conversely disruptions in the pattern may trigger a new cluster.

Herbs and supplements

Studies on the following herbs and supplements tend to confirm their usefulness, particularly for migraine sufferers:

• The best-attested herbal remedies and preventatives are feverfew and butterbur—often packaged together, although each seems to work separately. Migraine sufferers take these at the first sign of onset, take them regularly as a preventive step, or both. (As with many herbs and other medications, these are not advised for pregnant women.)
• Riboflavin, or vitamin B2 (sometimes called vitamin G), may help prevent migraines when taken in high doses, although it offers no immediate relief upon onset. Some have reported reduction in cluster headache frequency and severity.
• Magnesium supplements may help, particularly in the case of deficiency that can be associated with migraines. A variety of foods help support healthy levels of magnesium.
• Coenzyme Q10 may reduce frequency of migraines, along with a host of other potential benefits.

General Preventive Steps

We have mentioned a few risk or triggering factors for specific headache types. The following may be more general triggers. If you suffer from frequent headaches, try avoiding each of the following to see if it makes a difference. You may notice that this list is a mixed bag.

General Risks to Health and Well-Being:

• smoking
• fatigue, stress, anxiety or depression
• inadequate sleep, or changing sleep patterns
• skipping meals or irregular meals
• MSG or nitrites in preserved meats, Chinese food, and some commercial seasoning blends
• eyestrain or poor posture
• polluted outside air or inadequate ventilation inside
• excess noise

Generally Considered Healthy, But May Trigger Headaches for Some:

• even moderate alcohol, particularly red wine
• bananas, citrus, dried fruit
• chocolate, nuts, peanut butter

Things Usually Considered Neutral, or with a Separate Risk-Benefit Tradeoff:

• changing weather, time zone, or altitude
• food that is marinated, pickled, fermented or aged
• oral contraceptives or hormone replacement
• bright or flickering lights
• strong odors, including some flowers as well as perfumes and sulfur

Caffeine is something of a wild card:

• For some, it can forestall or relieve migraines when taken at onset.
• It can bring on headaches from withdrawal when your usage patterns change.
• If aspirin-like drugs don’t work for you, sometimes they work better in a caffeine combination like Excedrin.
• Taking any non-steroidal anti-inflammatory drug more than a few times a week may result in “rebound” headaches from developed dependency. Caffeine-NSAID combinations can increase this possibility.