The Real Reason Behind Your Headaches
New treatments mean you do not have to suffer in silence any more
It’s been a busy day. You have juggled a million things and now your head is throbbing with pain. But you probably pop a painkiller and carry on, because you have too many things to do. Headaches are one of the most common neurological diseases. Most of us get at least one headache a year, for a variety of reasons. And mostly, we just try to deal with them ourselves.
Research in Singapore finds that even when it comes to super-painful types of heachaches like migraines, most sufferers just try to tough it out. Studies at Duke NUS Medical School found that migraine affects up to 10 percent of the population in Singapore (that’s around 330,000 people), with about 100 new patients added every month at the Headache Services referral clinic at the National University Hospital (NUH).
Some of these migraine patients felt such bad pain they had to take days off work - yet one in four of them did not seek any medical treatment for their headaches. Dr Jonathan Jia Yuan Ong is President of the Headache Society of Singapore and Consultant, Division of Neurology, National University Hospital explains. He explains, ‘They often suffer in silence. For those who do try to manage the condition, they typically resorted to acute medications which may not be the most effective strategy in the long term, adding to their overall healthcare costs”
Headaches remain one of the most under-reported and unrecognised disorders. ‘When it comes to pain, many women feel that they just have toi put up with it. Women often do not realise that things can be better’ says Professor Lauren Sanders, a neurologist and Co-Secretary of the Australian and New Zealand Headache Society.
Professor Sanders notes that it is common for women to call their headaches, ‘normal’ – but this can backfire and make the underlying condition worse.
She says, ‘Headaches may just be the result of a stressful day at work. But they indicate your body is out of balance and needs attention. And for people with a primary headache disorder such as migraines, physiological, mental or emotional stress will all increase the chances of your body responding with a headache.’
When it comes to preventing headaches, it is rare that the solution is medication alone. Lifestyle also plays a part. Here are three non-medical things to look at:
Are you drinking enough water? When you are dehydrated the blood vessels in your head and neck are reduced, and this can cause headaches.
Are you getting enough quality sleep? Because our bodies are not designed to be ‘on’ 24 hours and seven days a week.
Are you managing your stress well?
If you get a lot of headaches, you should see your doctor. They can do tests to check if there are any problems - for example with your blood pressure. Depending on the kind of headaches you get, they can also do tests to determine if you need further tests - for example brain imaging tests. But they are often not needed.
“Many people do not know that there are new headache treatments available now. So you should see a doctor if you are suffering, “ says Prof Sanders.
For example, treatments at NUH Headache Services referral clinic include treatments for primary and secondary headache disorders, including, migraine with or without aura, tension-type headaches, medication overuse headaches and many other headache disorders
Most of the treatments are performed at the outpatient clinic, so there is no need to be warded. The treatments can include OnabotulinumtoxinA (or Botox) injections for the treatment of tension headaches and chronic migraine, and Occipital Nerve Blocks.
There’s growing evidence that some headaches can be a symptom of food allergies. This is because the body can confuse food as a danger and release antibodies into the blood. These can cause changes in the behaviour of the blood vessels and cause headaches.
If you regularly suffer headaches, try keeping a food and headache diary then keeping a food diary. DO not change your diet, but take note of each meal, what you ate and the time any headache starts. This can help you identify any patterns in what you eat and your headaches.
More research needs to be done, but there’s some evidence that processed foods high in refined sugar, salt and preservatives can cause headache reactions. Typically, if a headache is food related it occurs between 20 minutes and two hours after eating. If you eliminate certain foods that you think may be causing the headaches - and you still get the headaches, you know it was not that ingredient.
Also look at the amount of food you are eating. Are you eating too much food at one time – or too little food? And remember that dehydration and not drinking enough water is a common cause of headaches.
Tension headaches and cervicogenic headaches are common. Tension in the upper body and neck can cause headaches because it tightens the muscles and joints and reduces blood flow.
Cerviogenic headaches are caused by problems in your back and neck. Nerves in the upper neck and back connect to the head.
‘Our modern lifestyle causes these problems. We put strain on our shoulders and neck by doing common things like carrying children on one hip, or carrying shopping bags in one hand, “ says physiotherapist Helen Fleming.
Sitting for hours at a computer and looking at your phone or tablet for hours can also cause headaches - especially if you work at home sitting on the sofa. Says Helen Fleming, ”Physiotherapy treatments include manual therapy to improve your muscles and joints and exercise to improve posture, muscle strength and flexibility.” Helan also recommends taking frequent short breaks from your computer and desk and regularly changing your posture.
”For every 30 minutes of sitting, spend five to ten minutes away from your workstation, so you can ease your neck and spine strain. Remember to gently stretch out your neck and shoulders” says Helen Fleming. “ When you are doing regular activities like carrying the shopping, try to distribute the weight of the bags evenly between both your arms and shoulders.”
When we feel under threat our body releases hormones that cause our muscles to tense - a side effect of this tension can be headaches.
‘Relaxation therapies can help you deal with anxiety and stress headaches’ says Dr Jodie Lowinger, a physiotherapist and author. ‘Calm breathing can help to bring your stress levels down. When it comes to preventing headaches, it is important to practice self-care.”
She suggests getting outside every day to connect with nature and make sure you get enough sleep. She says ‘Instead of just worrying about everything, focus on the things you can control. This stops your stress from spiralling out of control.
‘Many women develop a headache just before their period, or when the period begins,’ says Dr Peter England, an obstetrician and gynaecologist.’These headaches are caused by a drop in hormone levels and is known as a premenstrual migraine.’
Symptoms can include nausea and visual disturbances – for example it might hurt to look at bright lights.
Headaches are also common during pregnancy – and again it is due to your hormone levels. ‘Women may get headaches in early pregnancy due to the changes in hormone levels, but these tend to get better by 20 weeks into the pregnancy. Other headache triggers include dehydration due to morning sickness and high blood pressure, ‘ says Dr England.
Lifestyle management can help. Drink plenty of water during pregnancy and in the last phase of the menstrual cycle can help reduce headaches. Also ensure you get enough rest and sleep. Your doctor can also prescribe suitable pain relief medication.
Text: Bauer Syndication/ARE Media