Smart Ways to Stop A Headache

Tension & Migraines

About 45 million people suffer from headaches every year. And women are twice as likely to get them as men. While all headaches are painful, migraines are especially so. "That no one dies of migraine seems to someone deep into an attack an ambiguous blessing," mused the writer Joan Didion. Here we give you the typical symptoms of many types of headaches, including migraines, so you can figure out what makes your head pound. You'll also find out the right remedies, so you'll be pain free in no time. However, anyone who has recurring headaches should see a doctor.

Tension

Who gets it: Almost everyone. This most common type of headache has been experienced by up to 90 percent of adults, according to the American Council for Headache Education.

What it feels like: A dull, nonthrobbing ache or a gripping, viselike sensation on both sides of the head. This type of headache is not associated with nausea or vomiting and is usually not disabling.

What it's caused by: For a long time it had been thought that tension headaches were caused by muscle tension. Experts now believe this is not the case. Although they are not sure what causes them, these headaches can be triggered or made worse by stress, anxiety or fatigue.

What it's treated with: OTC analgesics, such as aspirin, ibuprofen or acetaminophen. But be careful: Taking these drugs more than twice a week can cause rebound headaches (which are brought on by overuse of pain medication).

Migraine

Who gets it: Nearly 28 million Americans (70 percent of whom are women) routinely suffer from this brutal pain.

What it feels like: Stabbing pain, typically on one side of the head (but can also occur on both sides), sometimes accompanied by nausea, vomiting, sensitivity to light and sound, a runny or stuffy nose and watery eyes. It can last up to 72 hours. About 15 percent of migraine sufferers get an early warning before the headache (called an aura) with visual disturbances like flashing lights or zigzag lines.

Migraines can be extremely debilitating. The National Headache Foundation reports that 53 percent of sufferers go to bed until they're over.

What it's caused by: The latest thinking is that the tendency to get migraines might be inherited. If both your parents had migraines, there's a 75 percent chance that you will as well. Even if a distant relative of yours has migraines, there is a 20 percent chance that you'll get them too. Researchers also believe that migraines might be a brain disorder, similar to epilepsy. Hypersensitive nerves in the brain stem fire inappropriately in response to internal or external stimuli. This prompts a cascade of neurochemicals, including serotonin, that cause inflammation and blood vessel dilation in the brain's covering (called the meninges). Pain messages are sent back to the brain stem (precipitating nausea), then to the cortex (causing light and sound sensitivity).

Practically anything can induce a migraine. While stress is the most common trigger, others include weather changes, perfumes, pollutants, lack of sleep, skipping meals, and even certain foods, like red wine, aged cheese or cured meats. Research suggests that migraines that occur around your period are triggered by estrogen levels dropping at the beginning of menstruation.

Migraines often coexist with depression and anxiety. Generally one condition does not cause the other. Rather, there appears to be an underlying brain condition common to all three, possibly involving changes in the levels of the brain chemical serotonin, according to Stewart J. Tepper, M.D., assistant clinical professor of neurology at Yale University School of Medicine.

What it's treated with: The best treatment is prevention, which is possible if you can sleuth out your migraine trigger and then avoid it. Keep a headache diary, noting the circumstances surrounding each headache to see if a pattern emerges. For instance, note if a migraine strikes every time you drink a glass of red wine.

Lying in a dark room with ice on your head may reduce the pain. Mild migraines often respond to OTC migraine formulations such as Excedrin Migraine. This medication contains aspirin, acetaminophen and caffeine, which constrict blood vessels and reduce pain and inflammation.

For moderate to severe migraines, "triptans are usually the first line of treatment," says Christine Lay, M.D., director of the Women's Comprehensive Headache Center at St. Luke's Roosevelt Hospital Center in New York City. Triptans are prescription medications that reduce inflammatory chemicals in the brain, bringing blood vessels back to normal size, thus alleviating the migraine. Triptans work best at the first sign of pain.

For migraines that don't respond to triptans, preventive medications, taken daily, may help. These include antidepressants (such as Elavil, Celexa, Desyrel), which regulate serotonin levels; beta blockers (such as Inderal) or calcium channel blockers (such as Verapamil), which stabilize blood vessels, making them less apt to dilate; and anticonvulsants (such as Depakote and Topamax), which regulate the activity of the central nervous system.