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Headaches: Triggers and treatments

Headaches affect millions of Americans each year and it is easy to pop nonprescription pain relievers to get rid of them. However, according to Krishna Goli, M.D., a neurologist at Piedmont, this might not be a wise move every time.

Tension headaches

Dr. Goli says a majority of the patients she sees who complain about chronic headaches actually have tension headaches caused by stress. Tension headaches usually consist of forehead, neck and shoulder pain. There is no light sensitivity or nausea with tension headaches. Tension headaches can range in severity, from annoying discomfort to pounding pain.

“It is safe to treat tension headaches with over-the-counter pain relievers, but if you suffer from these headaches on a regular basis, it is important to address the root of the problem,” Dr. Goli says. “Stress can wreak havoc on your health, so popping pills is not the answer.”

Sinus headaches

When the weather changes, people who suffer from sinus problems are usually hit with more headaches. A sinus headache is often accompanied by common cold symptoms like stuffiness, cough and sore throat. A sinus headache will cause pain and pressure around the sinuses and can worsen with movement like bending or lying down.

For a sinus headache, it is important to treat the underlying cause. This often means taking a decongestant that has a pain reliever or an antihistamine allergy medicine if it is linked to allergies. Other at-home remedies include flushing out the sinuses with salt water and using a humidifier to keep the air moist.

Migraine headaches

Migraine headaches can be extremely debilitating. Dr. Goli says in order to treat them properly, you have to understand what triggers them. She points out that there can be many different causes, including:

  • Sleep disturbances

  • Hormone imbalance

  • Diet triggers - too much caffeine

  • Stress

  • Dehydration

  • Environmental chemicals

“These triggers create a chemical imbalance that causes a chain reaction, ultimately causing your blood vessels to dilate. This stimulates all your nerves which in turn creates the painful side effects of a migraine headache,” Dr. Goli says. “But once again, reaching for pain medication is not the answer. This will ultimately send false messages to your brain, which can cause rebound headaches.”

The overuse of over-the-counter pain medication interferes with the brain sensors that regulate the cascade of pain messages from the brain to the nerves. Taking more medication will prompt withdrawal symptoms, which in turn leads to another headache. By the time Dr. Goli sees migraine patients, she says they are usually in the rebound phase, which is more difficult to treat.   

When to seek medical advice

If you experience more than two headaches per week for four to six weeks, Dr. Goli recommends seeing your doctor for an evaluation. Identifying your headache triggers is an important first step in treatment. This can be done by keeping a diary of what you eat, sleep habits, exercise, exposure to chemicals and stress levels for each day. By finding and avoiding your triggers, you can limit the severity and frequency of your headaches.

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