Ask The Experts

Q. What causes headaches?

A. Got a headache? Between the current financial crisis, the onset of flu season and the hectic pace of modern life, it’s no wonder.

Headaches afflict almost everyone at some time or another. They may occur when you’re sick, when you’re stressed about an exam or meeting, when you’re taking medication, or for a variety of other reasons.

Fortunately for most people, headaches are more of a nuisance than a real problem. For some sufferers, though, headaches become more frequent, more severe and more troublesome.

Migraines cause pain, nausea and sensitivity to light and sound. Activity makes them even worse. Cluster headaches cause excruciating pain, red watering eyes, and disruptions in sleep. Even garden-variety tension-type headaches can become problematic when they occur frequently.

But many sufferers can find relief through lifestyle changes and might be able to avoid taking significant amounts of medication to stop the pain.

Ingredients in your food can get your head pounding, including caffeine, monosodium glutamate (MSG), nitrates and alcohol. If you suffer from frequent headaches, you should reduce caffeine, which can be a pain trigger or cause withdrawal headaches. Caffeine also disrupts sleep, which can make your headaches worse. Even though many over-the-counter headache medicines contain caffeine, these are only useful for people with infrequent headaches. Otherwise, these medications only add to the problem.

MSG is a flavor enhancer added to many processed foods and snacks, such as potato chips. MSG can activate pain centers in the brain and trigger headaches.

Nitrates are added to processed meats as a preservative, but they also act to dilate blood vessels, which can trigger headaches in people who are susceptible. Even various alcoholic beverages are known to cause headaches. If you drink red wine for the health benefits but find that your head hurts after a glass, try grape juice instead.

Poor sleep can cause increased headaches or make you more sensitive to other triggers. Doctors often recommend that headache sufferers:

  • Set regular wake-up and bed times.
  • Avoid caffeine in the afternoon and evening.
  • Don’t watch television or do work in bed.
  • Stay away from the computer or television if you wake during the night.
  • Get regular cardiovascular exercise, but not within two hours of going to bed.

If stress and anxiety are a cause of sleep difficulty, you can try relaxation techniques such as breathing exercises, meditation or biofeedback.

One of the most common causes of increasing headaches is actually taking too much medication for headaches. Various over-the-counter pain relievers such as acetaminophen (Tylenol®), ibuprofen (Advil/Motrin®), and caffeine-containing medications (Excedrin®) are some to watch out for. Consult with your doctor before you stop taking any medicine.

Prescription medications can also cause increasing headaches when used frequently, such as opiate/narcotic pain relievers, butalbital, and even triptans. The general rule is that medications for headaches should not be used more than 2 days per week on average.

If you find that you need pain relievers more often than this, you may have developed medication overuse headaches, also known as Rebound Headaches. These often improve over time by simply stopping or reducing the frequency of treatment.

Even if you require medicine to manage your headaches, living a healthy “headache lifestyle” is very important and can help make the medications more effective.

Be aware that new headaches, increasing headache frequency or changing patterns of headaches can be a cause for concern, so you should consult a primary care provider or a neurologist even if you are trying to avoid prescription medications.