HEADACHES AND MIGRAINES

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TALK WITH YOUR DOCTOR Table of Contents Whether this is your first visit or a follow-up, answer these questions for your doctor: TYPES OF HEADACHES 4 MIGRAINE RELIEF 9 MIGRAINE TRIGGERS 10 REBOUND

2 TALK WITH YOUR DOCTOR Table of Contents Whether this is your first visit or a follow-up, answer these questions for your doctor: TYPES OF HEADACHES 4 MIGRAINE RELIEF 9 MIGRAINE TRIGGERS 10 REBOUND HEADACHES 12 KEEP A HEADACHE DIARY 14 How often do you get headaches? Do headaches run in your family? When did they start? Most people get mild headaches from time to time. But an unfortunate few get severe headaches on a regular basis. Headaches shouldn t ruin your life. Your doctor can help you find ways to relieve headache pain and help keep headaches from happening in the first place. Has the pain changed? How long do they last? Do they interfere with your work and family? Have you noticed any triggers? What stops your headache pain? How often do you take medications? What is the pain like? Tell your doctor about any side effects from your medications. 2 headaches and migraines headaches and migraines 3

TYPES OF HEADACHES Most headache sufferers have what doctors call primary headaches. That means the pain is just a headache, and not a sign of a more serious problem.

your body, confusion, double vision, or a stiff neck You have the worst headache of your life You get a severe headache when you rarely, or never, get headaches A headache starts after a head injury

3 TYPES OF HEADACHES Most headache sufferers have what doctors call primary headaches. That means the pain is just a headache, and not a sign of a more serious problem. WHEN TO CALL YOUR DOCTOR You get a sudden, severe headache that feels like a blow to the head You have a severe headache along with fever, nausea, vomiting, shortness of breath, weakness anywhere in your body, confusion, double vision, or a stiff neck You have the worst headache of your life You get a severe headache when you rarely, or never, get headaches A headache starts after a head injury The most common primary headaches are tension headaches and migraines. Most headaches are caused by stress, fatigue, hunger, hormonal changes, weather changes, or caffeine withdrawal. Always take children who have frequent headaches to the doctor, especially when the pain occurs at night or is present when the child wakes in the morning. Testing Brain scans, such as CT scans, MRIs, and brain wave tests, usually aren t needed for people whose symptoms strongly suggest a tension, migraine, or cluster headache. 4 headaches and migraines headaches and migraines 5

They are usually caused by: muscle tightness in the scalp or neck eyestrain poor posture Over-the-counter pain relievers can ease the pain.

4 CLUSTER HEADACHES A less common kind of primary headache is a cluster headache. Cluster headaches cause intense, sharp, penetrating pain. TENSION HEADACHES Tension headaches cause dull squeezing pain on both sides of the head. They are usually caused by: muscle tightness in the scalp or neck eyestrain poor posture Over-the-counter pain relievers can ease the pain. To prevent tension headaches, try not to skip meals, make sure you get enough sleep, and pace yourself to avoid fatigue. Massage, relaxation techniques, biofeedback, and other ways to reduce stress can also help relieve tension headaches and sometimes prevent them. Cluster headaches come in several attacks a day, for a week or longer. Headache-free periods occur between attacks. Successful treatment of cluster headaches can take trial and error before finding the most effective plan. Medications and avoiding triggers things that start these headaches are usually part of treatment. 6 headaches and migraines headaches and migraines 7

MIGRAINE HEADACHES MIGRAINE RELIEF Migraine headaches can completely disrupt a person s day. The word migraine comes from a Greek term meaning half a head.

5 MIGRAINE HEADACHES MIGRAINE RELIEF Migraine headaches can completely disrupt a person s day. The word migraine comes from a Greek term meaning half a head. That describes what many people feel: throbbing or pulsating pain on one side of the head. The pain is often felt around the temple. Many people with migraines feel nauseous or vomit. Bright lights and loud noises can worsen the pain. The average migraine lasts four to twelve hours, though they can be shorter or longer. Common migraine symptoms include: Throbbing pain Visual blank spots Sparkling or flashing lights Light sensitivity Increased pain in response to noise For some people, over-the-counter pain relievers knock out migraine pain. Some of these products are specifically made to treat migraines. Some simple steps to ease migraine pain include: applying heat or cold to your head, neck, or face drinking coffee or other caffeinated beverages resting in a quiet, dark room massaging the scalp, or other body areas Many migraine sufferers need prescription medications to relieve pain, nausea, and vomiting. These work best if taken at the first sign of an attack. Some prescription medications, if taken every day, can help prevent migraines from starting. Some people feel completely wiped out for a day or two after an attack. Fatigue Nausea Nervousness or anxiety Migraines seem to run in families. They may be caused by overactivity in certain brain cells. 8 headaches and migraines headaches and migraines 9

6 PREVENTING MIGRAINES In many people with migraines, headaches are set off by triggers. Some common triggers include: FATIGUE TRAVEL ALCOHOL WEATHER CAFFEINE FOOD To identify your headache triggers, try to answer these questions: What were you doing when the migraine started? Was the migraine mild, moderate, or severe, and how long did it last? If you re a woman, at what part of your menstrual cycle did it occur? Were you stressed that day? Were you physically active when it began? When did you last eat? Identify and avoid your triggers, get enough sleep, eat well, exercise regularly, and manage stress to reduce migraines. avocados bananas beans cheeses, aged and unpasteurized foods chicken livers chocolate citrus fruits fermented, pickled, or marinated foods herring FREQUENT MIGRAINE TRIGGERS Some people get migraines after eating certain foods or food additives. The list below includes frequent migraine triggers: monosodium glutamate (MSG) nitrates (in cured meats) nuts and peanut butter onions peas pork red wine sour cream vinegar yogurt 10 headaches and migraines headaches and migraines 11

REBOUND HEADACHES TREATING REBOUND HEADACHES Prescription and over-the-counter pain relievers sometimes can set off a cycle of headache pain. No one knows exactly what causes rebound headaches.

Getting rid of rebound headaches isn t easy. It usually means that you have to go off all headache medicines, which of course leads to pain.

7 REBOUND HEADACHES TREATING REBOUND HEADACHES Prescription and over-the-counter pain relievers sometimes can set off a cycle of headache pain. No one knows exactly what causes rebound headaches. One possibility is that taking pain relievers often makes the nervous system more sensitive to pain. When the pain medicine wears off, the slightest thing can set off a new headache. Getting rid of rebound headaches isn t easy. It usually means that you have to go off all headache medicines, which of course leads to pain. Your doctor can tell you how to taper the drugs causing the problem. She or he may also be able to suggest other medication you can take for a short time during the withdrawal period. Most rebound headaches improve once the medication is stopped. If you suffer from headaches and find that you re getting them more and more often, you may be dealing with something called medication overuse headaches, also known as rebound headaches. The same prescription and over-the-counter medications that you take to make headache pain go away may actually be triggering headaches. 12 headaches and migraines headaches and migraines 13

8 KEEP A HEADACHE DIARY Keeping a headache diary (when they happen and possible triggers) helps you and your doctor understand and treat headaches. ABOUT YOUR HEADACHE FIRST EPISODE SECOND EPISODE THIRD EPISODE Date/Day of the week Time of onset Time of resolution Warning signs Location(s) of the pain Type of pain Intensity of pain (scale 1-10) Additional symptoms Activities at time of onset Time of last prior meal at onset Most recent food/drink at onset Medication(s) taken for headache Response to medications Other actions taken for relief Response to other actions Last menstrual period (start/end) Medications for other conditions 14 headaches and migraines headaches and migraines 15

CONTENT CREATED BY Harvard Health Publications and Harvard Medical School content should not be used for diagnosis or treatment, or as a substitute for visits to your medical provider.

9 CONTENT CREATED BY Harvard Health Publications and Harvard Medical School content should not be used for diagnosis or treatment, or as a substitute for visits to your medical provider. Always seek the advice of your health care provider if you have questions regarding your health or any medical condition Harvard University. All Rights Reserved. Harvard Health Publications and Harvard Medical School do not endorse drug products. MIG-H0416 headaches and migraines

HEADACHES: MIGRAINE SYMPTOMS OF MIGRAINE HEADACHES PREVENTION

HEADACHES: MIGRAINE SYMPTOMS OF MIGRAINE HEADACHES PREVENTION HEADACHES: MIGRAINE Migraine headaches occur when there are changes in some of the nerves and blood vessels. Migraines are common in children. Often there is a history of headaches in the family. Your