The most common types of repeating headaches are migraine, tension and cluster headaches. These are not serious or life threatening but they can and do cause severe pain.

Your doctor needs to know everything about your headaches to make a correct diagnosis. The treatment of each type is different. Before talking to your doctor, take a few minutes to think about the following questions:

When did your headaches start?
Did they begin following a physical injury or emotional upset?
How often do you have headaches?
How long do they last?
Where is the pain located?
Does the pain throb or is it steady?
Do you have other symptoms along with headaches?
Are headaches related to your menstrual cycle?
Is your headache brought on by certain foods or weather changes?
How do you deal with your headaches?
What medications have you tried?
Does anyone else in your family suffer from recurring severe headaches?

Keep a diary of your headaches and how you treat them. Note the time and date, how your headache begins and its severity. List any triggers you notice, the intensity of the headache, other problems like nausea or light sensitivity and how long symptoms last. Women should record where they are in their menstrual cycle at the time the headache starts. When you make your appointment, tell the receptionist or nurse why so enough time is allowed for a full discussion.
In 1988, the International Headache Society created a classification system for head pain. Your doctor uses it to decide on treatment. Cluster, tension and migraine headaches are illustrated at right. By looking at these symptoms, you may be able to identify your headache type.

Medication Induced Headache (MIH)

This type of headache is all too common. With MIH, medication has been used to cope with daily or almost daily headaches. Treatment does not get rid of headaches, but actually causes them. Pain can be mild to severe. You may wake up in the morning with a headache. Sleeping poorly, nausea, memory problems, difficulty concentrating, restlessness and irritability may all play roles.

Are you using headache medication more than three days a week, and taking more without much relief? Doctors recommend against medication for mild headaches. Try comfort measures instead. Use medication only if you must for moderate or severe headaches. Your headache diary can help you and your doctor decide if MIH is a problem for you.

Migraine headache

This type of headache is very complex. It involves many brain chemicals, inflammation and irritation of blood vessels in the covering of the brain, and the brain itself. About 18 per cent of women and six per cent of men are affected by migraine headaches. A family history is very common. The first two illustrations on page 11 illustrate the kind of symptoms migraine sufferers can experience.

Headaches that indicate a serious problem

See your doctor if you have:

a new severe headache which
appears suddenly
headaches that are steadily
getting worse
headache that begin after exertion, coughing, straining or sexual activity
headache along with drowsiness,
confusion, memory loss, fever,
visual or speech disturbances,
weakness, clumsiness or loss of balance
a first severe headache
after age 50.

Many triggers can bring on migraine headaches. Some people are more likely to experience them at work. Migraines may cost corporate Canada more than $500 million each year, thanks to shared drug costs, lost productivity and missed days. Take time to identify possible headache triggers in your office, such as bright lights, computer screens, or glare from venetian blinds. Even chairs that do not promote good posture may be a trigger.

In Calgary, research has shown that pre-chinook day weather conditions or Chinook winds increase migraines for some people.

Headaches in children

When children complain of headaches, parents worry that it may signal something serious. Between five and 10 per cent of children get migraine headaches. In fact, 10 per cent of all migraine sufferers are children under age 15. The highest incidence of migraine in males is between age 10 and 14. For females, it is age 20 to 24 years. Diet seems to be an important trigger in children.

The tendency for headaches can be inherited. Children are more likely to suffer from migraine if one or both parents do. To treat migraine headaches in children:

make sure your child gets regular and adequate sleep
try the prevention and comfort techniques listed below
and, if necessary, offer mild medication.

Treating headaches

Once you know the type of headaches that bother you, consider the following approaches.

Prevention techniques

Avoiding common triggers may stop your headaches from starting.

Get enough sleep every night.
Exercise and eat regularly.
Stay up to date on the latest news about headache causes and treatment.
Keep a supply of medications you require with you at all times.
Eliminate triggers you can control:
Use sunglasses whenever you are in bright light.
Take breaks outside – fresh air helps in poorly ventilated buildings.
Avoid sports requiring head-down positions.
Watch for and avoid possible food triggers, especially red wine and chocolate.
Keep a regular sleep schedule. Oversleeping or sleeping in can trigger headaches in some people.

Comfort Measures

These strategies relieve many types of headaches.

Change into loose clothing.
Try ear plugs or cotton balls in your ears to dull outside noises.
Elevate your head when lying down, using a foam pillow wedge. This can slow the throbbing.
Lie down in a quiet, dark place.
Practice relaxation exercises or visualization techniques.
Learn how to massage your temples to ease the pain.
Some find a cold compress on the forehead gives relief – others prefer heat.

Medications

Two useful Internet resources are:

Migraine Association of Canada www.migraine.ca

World Headache Alliance
www.w-h-a.org

Two basic types of medications are available. Some prevent headaches, others treat them. If you already have a headache, painkillers and muscle relaxants may work. A number of treatment medications have been specially designed for migraine headache. Talk to your doctor or pharmacist about which might be most appropriate for you.

Medication that prevents headaches, particularly migraines, is taken daily whether you have a headache or not. Again, your family doctor or pharmacist can provide guidance.

Resources

More resources are in place for headache sufferers than you may realize. Your family doctor is a good starting point. You may be referred to a neurologist specializing in the diagnosis and treatment of headaches. A number of support groups exist as well. The Migraine Foundation is a very useful source of educational information for migraine sufferers. Your family doctor may be able to direct you to support groups in your community.

Heading Off Headaches Their causes and how to control them

Types of headaches