Six tricks to heal a headache

The surprising triggers behind the pain

Dehydration, tension and hormone fluctuations around menstruation and menopause are all a well-known headache and migraine triggers, but many myths pervade. Poor eyesight is often incriminated, but rarely causes a problem and there’s no good scientific evidence to prove chocolate is a cause, though it frequently gets blamed. What we do know is that many people with migraines get symptoms before a headache starts – things such as excessive tiredness, the munchies and a desire for sugar – which indicate that things have started shifting in the brain. But if you grab some chocolate to satisfy your craving, develop a headache and assume chocolate is the culprit, you can miss what’s really responsible. If you get recurring headaches, keep a diary for three months to document what’s happening around the time it starts, to help nail down potential triggers. Here are some causes you may not have considered.

LOW BLOOD SUGAR

This is a potential headache trigger, so don’t be tempted to skip breakfast and start your day with nothing in the tank. Paradoxically, if you fill up on sugary foods or refined carbohydrates, you push your blood sugar levels up very quickly and then it crashes, which leaves you sensitive to headaches again. A balanced diet full of whole grains, beans, and whole fruit is very good for preventing headache and migraine as you’re getting carbs in a form that’s slowly released into your system. Aim for regular meals and healthy snacks between meals to keep blood sugar steady

IRREGULAR SLEEP HABITS

We know that too much sleep and too little sleep both act as triggers, and those with erratic sleep patterns, like shift workers, suffer worse migraines, but we still don't understand how this happens. Regular sleep appears to be key: I’ve had patients who have kept headache diaries and pinpointed a migraine every weekend when they’ve enjoyed a lie-in. If you’re vulnerable, the only answer is to set your alarm for the same time every morning. And improve your sleep hygiene: avoid caffeine, alcohol or screens before bed, and ensure your bedroom is quiet and dark.

PAINKILLER OVERUSE

Around 25 percent of the new patients I see suffer from medication-overuse headaches. If you’re in the habit of popping painkillers, when painkiller levels drop, your brain interprets it as pain. Codeine drugs are the worst culprits and if you’re taking them for more than 10 days each month for more than four months, you’ll get into a medication-overuse pattern. For ibuprofen and paracetamol, it’s 15 days a month. You have to grit your teeth and give your body a break for two to three months to get the offending painkiller out of your system and reboot your brain. A headache specialist can provide treatments to help you through the withdrawal, and you can use those painkillers again, but not at the same level as before.

CAFFEINE

Many people consume more caffeine in a day than they realize – as well as tea and coffee, caffeine is an ingredient in some fizzy and energy drinks, plus it’s in chocolate and some over-the-counter medications. So there can be a lot of dripping into your system. Caffeine is a good painkiller in its own right so you can get headaches from overuse in the same way you might from painkillers. The withdrawal is similar, too – headaches get worse for a while, but if you stick with it, things will improve. Minimize risk by switching to decaf or herbal and fruit drinks.

DIET

Some people are sensitive to food triggers. Smelly cheeses contain tyramine, which can be a trigger and citrus fruits cause migraines in some people, but there aren’t enough studies on diet to know what can or can’t cause a migraine in every case. This is true of dairy, though research shows it can affect children. If you think that something you’re eating is making headaches more likely, cut it from your diet for one to three months and keep a diary to see what effect it’s having on you, although nothing is likely to switch off your migraine completely.

COMBINING TRIGGERS

Be aware of the ‘threshold theory of triggers’: when you’re layering one trigger on top of the other. So you might be going through a period of stress at work, putting in long hours, skipping meals, having late nights and drinking more than usual, and the result is headaches. One of those triggers might not be enough in itself to cause a headache, but the combination will. There are things you can’t do anything about, like your workload, but you can do other things to limit your risk: for example, going to bed on time, having healthy meals and staying hydrated. These basic acts of self-care can help keep you below the threshold.