It’s been a busy day, and your head is hurting. But you cannot stop now – you have work to do, kids to entertain and teach, plus responsibilities on everything from your family’s health to travel planning. So what to do? You probably pop a painkiller tablet and carry on.
Headaches are one of the most common neurological problems, with an estimated 80 percent of adults suffering at least one headache in the past year. No-one’s quite sure how many people in Singapore suffer from migraine headaches, but a study by Duke-NUS Medical School into local sufferers found it damaged their quality of life. Respondents missed 9.8 work days a year, on average, due to migraine – and many of them forced themselves to go to work even though their head was splitting. Yet headaches remain one of the most unrecognised and unreported disorders.
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Why do we put up with this suffering? “When it comes to pain, many women think they have to ‘just deal with it’ and carry on,” says Associate Professor Lauren Sanders, a neurologist and co-secretary of the Australian and New Zealand Headache Society. “It’s common for women who have bad headaches to also have menstrual problems. But many women do not even think that their health could be better.”
Professor Sanders notes that it is common for women to describe their headaches as “normal”, but trying to tahan or endure a bad headache can make it worse. “Headaches show your body is out of balance and needs attention.” For example, psychological and emotional stress can increase migraine headaches. Says Prof Sanders, “The three non medical things you can do to reduce headaches are; Get enough hydration. Drink enough water. Get enough quality sleep and manage stress.”
So let’s look at what may be really causing your headache — and what you can do about them:
Tension headaches
These are the most common headaches. They’re cause by poor posture, stress, muscle pain and stiffness. Symptoms include mild to moderate pain, a feeling of pressure or tightness around the head and tenderness in the scalp, neck and shoulders. Dehydration – or not drinking enough water – can also be a cause of tension headaches.
Cluster headaches
The least common headaches. Cluster headaches typically occur over a certain period, lasting from 15 minutes to several hours. Symptoms include intense pain in one eye and on one side of the head, with a blocked sinus. The eye may also swell, water, and go red.
Migraine headaches
The most severe form of headache. It can last from a few hours to a few days. Symptoms include strong pain that affects one side of the head, visual disturbances, sensitivity to light and noise, nausea and vomiting.
Here’s good news. Prof Sanders says many headaches are not sue to some terrible medical problem. They happen because we’ve lost the ability to listen to what our body wants. We try to push on when we are thirsty or tired or stressed – and it causes a headache.
But if you get frequent headaches, your doctor or polyclinic can help you understand them – and manage them better. They can check your blood pressure and do blood tests to rule out medical causes. If you often have very bad headaches, they may also suggest brain imaging tests – but these are not usually needed.
You may think pain pills like paracetamol are the only treatment available for headaches. But that is not true. “There are a number of new headache treatments available now, ” explains Prof Sanders.
There’s growing evidence that some headaches can be caused by food allergies or sensitivities. Such sensitivities can make your body release hormones that affect the blood vessels, and cause headaches. “If you regularly suffer headaches, try keeping a headache and food diary, so you can work out which ingredients might be triggering your headaches. Note down what you ate, what time you ate, the ingredients and the time the headache starts,” says Kate Save, an accredited dietician. “If a headache is food related, it will typically occur about 20 minutes to two hours after you eat that ingredient.”
Also look at how much you are eating, and how much water you are drinking. If you are eating too much food – or too little food – this can cause headaches. And dehydration is one of the most common causes of headaches.
There’s some evidence that processed food, refined sugar, chocolate and salt may also cause headaches – but more research needs to be done into this. Says Kate, “My best advice is to eat lots of colourful vegetables, fruits, whole grains, legumes and healthy fats. Avoid very processed foods.”
Tension headaches and cervicogenic headaches are common. Tension in the upper body can cause headaches by increasing stiffness in the muscles and joints. Cervicogenic headaches are caused by problems in the neck and back. These cause headaches because important nerves go up your back and neck to your head. Physiotherapist Helen Fielding explains that the life of a busy working mother can make these problems more common. “You might be carrying shopping in one hand, and carrying your children at the same time. This can put strain on the neck and shoulder.”
Sitting for a long time or looking down at your smartphone or keyboard can also put a strain on your neck. Physiotherapy treatments may include manual therapy (like massage) to help tight muscles. You may also be given exercises or moves to improve your muscle strength, posture and flexibility.
And if your headaches are caused by poor posture, it’s also good to take regular breaks from your desk. Says Helen, “After you have been sitting down for 30 minutes, take five or 10 minutes away from your workstation. Walk around and ease your neck and spine. Reduce tension when you sit by gently stretching your neck, back and arms.
“When it comes to everyday activities like carrying shopping, or carrying a load of washing, try to carry the weight equally between both your arms. And if you are carrying your baby or toddler on your hip, swap sides frequently to avoid strain on one side of your body,” says Helen.
When we feel in danger, our bodies release hormones to get us ready to run away or fight. These hormones cause your muscles to tense up. And the side effect can be headaches. “Relaxation strategies help reduce anxiety and stress hormones. Calm breathing techniques can reduce your stress levels. It’s important to also practice daily self care,” says psychologist and self-help author Dr Jodie Lowinger.
She says it helps to get outside and walk or exercise in nature, connect with your community, get enough sleep and be kind to yourself. With so much news about recession and climate change in the news, it is easy to be worried. “Try moving away from worry into problem solving. Think about one thing you can do to improve things, so you can step out of just feeling worried.
“And try to focus on the present. Distract your attention away from endless anxious thoughts about what could go wrong in the future.”
Many women develop a headache just before their menses. Others get a headache when their menses begin. Dr Peter England, obstetrician and gynaecologist explains why. “It’s caused by a dip in hormones and is known as premenstrual migraine.” Symptoms can include nausea, visual disturbances and discomfort with noise and bright lights.
Headaches related to hormones are also common in pregnant women. “Women generally get headaches in early pregnancy, and they often settle down by 20 weeks,” says Dr England.
Dehydration caused by vomiting and morning sickness can also cause headaches. But so can high blood pressure or pre-eclampsia. So if you are pregnant and experiencing headaches, do let your doctor know so they can work out what is behind it.
Text: Jo Hartley for Bauer Syndication /ARE Media